We are grateful to the Nursing Standard for again raising issues in regards to FtP process – please read the article below or click to read on Nursing Standard (subscription required).
- Online hearings for fitness to practise cases were introduced as a COVID-19 pandemic measure, but the NMC has now adopted them as a long-term approach
- Read about the benefits and drawbacks of participating in proceedings from your own home rather than in an NMC office building
- Find out the steps you can take to ensure you are fully prepared to participate in a remote FtP panel hearing
Remote fitness to practise (FtP) hearings were introduced to limit the need for people to gather in one place, as part of emergency measures introduced by the Nursing and Midwifery Council during the pandemic.
But as restrictions start to be relaxed across society, the nursing regulator has had to consider whether this approach should be continued for FtP.
Here, we look at how FtP proceedings will run in the future, and how these changes may affect you as a registrant or witness.
Are all FtP hearings moving back to being held face-to-face?
No. The NMC has announced it will continue to use virtual FtP hearings beyond the end of the COVID-19 pandemic.
Video and audio hearings were introduced as one of a raft of emergency measures during the first wave. Initially, the change applied to cases where there could be an immediate risk to the public, such as interim orders and substantive order reviews.
From September 2020, all types of hearings were able to be held virtually, and the ongoing use of this method was approved at an NMC council meeting in March 2021.
Why has the NMC decided to continue with virtual hearings?
All types of FtP hearings were all able to be heard virtually
The provision of virtual hearings was supported by 70% (112) of 160 respondents to a public consultation run by the NMC.
The regulator said it wanted to continue to hold meetings virtually unless there is a good reason not to, and where it is fair and practical for everyone involved.
What are the benefits of virtual hearings?
Respondents, including nursing unions, told the consultation that those involved can feel more empowered when engaging from their own home, that there are considerable savings in time and costs, improved accessibility for those unable to travel for physical, financial or care responsibility reasons, and increased engagement from registrants.
‘Virtual is less stressful for the registrant and gives a potential for a more open exchange and engagement from them, as they aren’t so anxious being in a hearing centre’
Cathryn Watters, founder of NMC Watch
For anyone shielding, or who feels uncomfortable travelling on public transport due to the pandemic, virtual hearings can be valuable.
Unions say it has been easier to get people to engage with the process, particularly when it comes to witnesses.
RCN legal officer Georgia Chapple says: ‘Defence witness are so important to our cases, particularly when it comes to whether a nurse’s practice is impaired. But people often have difficulty finding the time to travel down to London and arrange childcare, to give evidence in person. We have found virtual hearings very useful for this.’
Cathryn Watters, founder of NMCWatch, which supports registrants through FtP proceedings, feels the move will help make the process more accessible. ‘Virtual is less stressful for the registrant and gives a potential for a more open exchange and engagement from them, as they aren’t so anxious being in a hearing centre,’ she says.
‘It reduces costs for the registrants, as they can have witnesses attend without having to reimburse them for travel and risk them taking time away from home, only for the hearing to be adjourned. It also means they don’t have to pay travel expenses and accommodation for their legal representative if they are not in a union, which is good.’
Will cases be judged fairly if people are on the phone or a computer?
Differences in how people might come across and be assessed if the panel can only hear their voice or see them on a screen was initially a concern.
But in reality, it has worked out well, especially as everyone has got so much more used to using virtual communication methods since the pandemic, Ms Chapple says. ‘We have found the panels have been very fair since the move to virtual hearings.’
Is this method used for every hearing?
The NMC decides on a case-by-case basis, and in consultation with those involved, on the best approach for a particular hearing.
Hearings may be held virtually, physically or in some cases a mixture of both.
Factors that are considered include the views of hearing participants, whether everyone can take part virtually, the complexity of the hearing, including factors such as duration and the number of registrants, witnesses and charges involved, and whether a particular format might prevent the hearing from running fairly and smoothly.
The RCN says this has worked well so far, and the NMC has been open to discussing the best approach for all involved.
‘We’ve found that the NMC has been helpful and flexible when it comes to discussing the best way forward for each case, and are taking a hybrid approach,’ Ms Chapple says. ‘Sometimes someone may appear in person on one day of their case, perhaps if they are giving evidence, and then do the rest remotely.’
What are the drawbacks of virtual hearings?
NMC council agreed that virtual FtP hearings could continue past the end of the pandemic
Potential issues raised included difficulties assessing evidence, communication problems and hearings feeling impersonal. Some respondents told the NMC’s consultation of their concerns about data protection and prolonged screen use.
NMC interim executive director of professional regulation Tom Scott says the main challenges experienced so far are to do with connectivity and communication via camera with multiple people.
‘Sometimes people speak over one another due to connectivity issues, meaning they have to start speaking again, or an attendee should have re-joined the hearing but they are away from their device,’ he says.
Late submission of paperwork, sometimes on the day of the hearing, can also cause delays. ‘At physical hearings, we can photocopy documents and hand them to attendees relatively quickly, whereas at virtual hearings, we have to collate documents saved on different software and combine them into one single electronic document that can then be securely emailed to everyone.’
How to ensure a virtual FtP hearing runs smoothly
The NMC recommends registrants:
- Check the date and start time
- Check they have access to the hearing documents and any additional documents needed
- Have a pen and paper to make notes
- Use two devices, if possible – one for joining the virtual event and one for accessing hearings documents
- Ensure devices are connected to the internet or mobile phone network and are fully charged or connected to a power outlet
- If possible, have access to a headset with a microphone. This can make the audio clearer. Many smartphones come with earphones that have a built-in microphone that can be plugged into your computer or tablet
- Choose a location that is comfortable, private and free from interruptions
- Put microphones or telephones on mute when they do not need to speak
- Raise their hand if they need to speak during the hearing or speak to their representative
- Let the chair or panel secretary know if they need a break – sitting at a computer or being on the phone for long periods can be tiring
(Adapted from NMC virtual fitness to practise guidance)
How will a nurse find out about a virtual hearing?
As with a physical hearing, nurses involved will be sent a notice of hearing. This is a letter that explains about the virtual event, why it is being held and information about the registrant’s right to attend and be represented. This will most often be sent by email. The NMC recommends those involved check the email address that is held by the regulator, and its junk file, regularly.
How does a nurse prepare for a virtual hearing?
Usually, on the day before a hearing, a member of NMC staff will hold a test call with those involved so that they are familiar with the technology.
Shortly before the hearing, the NMC will send the meeting link to participants. The panel secretary will contact the registrant, usually by email or telephone, to check they can access the event.
‘Our panel and the other parties attending will be flexible and patient so that you can participate effectively,’ the NMC states.
As with other hearings, virtual hearings may need to examine confidential or sensitive issues, for example, where matters relate to an individual’s health. When this happens, it is common for the panel hearing the case to agree that such private matters should be heard in private, rather than in public session. This applies whether a hearing is virtual or physical.
of people who responded to an NMC public consultation backed continued use of virtual FtP hearings
What about the necessary paperwork?
This should be made available before the hearing. It will be accessible by a data security system called egress, which the NMC uses to securely share documents and emails, or people can request a paper version of the bundles be sent to them.
The NMC urges registrants involved to ensure they have submitted any paperwork they want the panel to see in good time before the hearing, so that it can be shared.
What if the internet connection is lost during the hearing?
If the screen freezes or suddenly goes dark during in a hearing, ‘please do not worry or panic’, Ms Chapple says. ‘We are all working in a new way and anyone involved in virtual hearings will know technology is not always reliable.’
Before the beginning of a hearing, she recommends nurses involved provide a phone number to either a legal representative or someone in the hearing, so that they can be informed by someone if the internet connection is lost. ‘You can then call them, or they can contact you, to see if there is anything that can be done, such as taking a short adjournment to allow you time to reconnect to the hearing,’ she says.
The NMC’s Mr Scott says: ‘Technical problems can be frustrating but our panel secretaries are able to pause hearings where these happen. We encourage participants to notify them if they experience any problems.’
Is a remote FtP hearing more informal?
While a virtual hearing can potentially have the benefit of being less stressful for a nurse who is in their own home, it should still be treated as the same important, formal event as a face-to-face hearing.
The RCN encourages those involved to dress smartly, in interview-style clothes. Have a glass of water to hand, but don’t eat, or move around the house carrying the phone or screen that connects to the hearing. Limit distractions and background noise as much as possible.
‘Behave as you would if you were in the hearing room itself,’ Ms Chapple says.
Is it possible to observe a hearing?
Attendance at many of the virtual hearings is open to members of the public, including the media, family members or other registrants.
‘We just ask that people wishing to attend take the time to complete a form up to two working days before the start of the hearing, confirming they agree to the protocol for observing an NMC hearing,’ says Mr Scott.
Are there any security concerns?
Suggestions that people could film proceedings and then share online have been raised.
The NMC says attendees are not allowed to record hearings, as this could breach other people’s rights and jeopardise confidentiality.
‘Before a hearing takes place, attendees must register with us and to sign up to our protocol, confirming they will respect the process and not record any of the proceedings,’ Mr Scott says. ‘We know some information needs to be kept private so participants should let the panel know in advance – this will help them to decide if the panel should go into a private session.’
- Virtual fitness to practise hearings to continue beyond pandemic
- FtP process: what every nurse and manager needs to know
- Remote nursing consultations: how to get them right