We asked each organisation for the total number of nurses and midwives they referred between 2019 and 2023.

Some trusts have readily provided this information. Some have struggled but thanked us for highlighting that they need to start collating this data, and have then worked hard to provide the data. Some have ignored the requests completely or used excuses to avoid them – but thanks to the Information Commissioners Office they have latterly complied.

For those trusts we are struggling to gain the information from we have approached the NMC to see if they can assist. We have been using the online service WhatDoTheyKnow – a great tool that tracks compliance and keeps FOI requests in the public domain.

Up until this month we were gradually gaining missing information via the NMC – however we have now reached a stumbling block – Section 12 of the Freedom of Information Act.

Organisations need to have limits when dealing with FOIs so as not to get overwhelmed and to be fair to everyone placing requests.

We are concerned about why the NMC is not compiling the information we are requesting already.

NMC FtP report published

The recent NMC report gives a first review of the issues around Fitness to Practice referrals to the NMC. We hear that strike-off orders are at their highest rate and that there are a record number of referrals from members of the public. We also hear of particular groups of nurses and midwives being at higher risk of referral – such as male mental health nurses.

Finally, the NMC acknowledge that a relatively low number of registrants are represented at hearing which may account for the high level of sanctions.

“Professionals who have representation, actively engage in reflection, and take steps to strengthen their practice, are less likely to receive FtP outcomes that restrict their practice.” NMC

We hear from many nurses and midwives undergoing FtP – they have no union support and the following reasons are given:

“I was not in a union at the time of the incident” – and if you joined since, but were not a member for at least 3 months prior to the incident, your union won’t cover you.

“I could not attend the hearing” – unions will not represent if the registrant does not attend. Many can not take time away from work or are too unwell to do so, but do not realise this means they lose their representation.

“My union said they could not represent me because of my mental health” – a worrying element. We are at our most vulnerable when referred to the NMC and this is when we need our union most.

“My union do a triage assessment to see if I fulfil the criteria to be represented” – this can be very confusing as most registrants do not realise this when they join a union.

Having representation is the difference between remaining on the register and not – are our unions doing enough to explain this?

Registrants can be tricky to support at times, we as a profession are not used to showing our vulnerabilities and accepting that we may have got it wrong and that there may have been a better way of doing things. But it is ingrained into our Code to do so – so why is there such a void?

The FOI work we are doing gives vital insight into patterns of referrals by employers. The NMC should be examining the results carefully to detect where the referral process is going wrong and why. A high number of referrals from one organisation or one CEO, for example, should immediately sound alarm bells but currently,  the NMC does not have the infrastructure to collate such data and so can use Section 12 as a means to not explore the issues further.