Midwifery and health visiting regulator ‘has problems at every level'

The Council for Healthcare Regulatory Excellence (CHRE) was commissioned by public health minister Anne Milton to conduct a review into failings at the Nursing and Midwifery Council (NMC), particularly relating to its handling of cases about the fitness to practice of nurses and midwives.

According to the final report of the review, the council’s failures are due to confusion over its regulatory purpose, its lack of a clear strategic direction, inadequate systems, weak governance and poor financial oversight.

While the report conceded that the council is showing “encouraging signs” by recruiting a new chair and chief executive and has taken steps to improve, it states that a culture change is needed at the organisation.

Harry Cayton, chief executive of the CHRE, said: “The NMC must finally leave its troubled past behind and apply itself to protecting the public and rebuilding confidence in regulation.

“New leaders must be appointed who are competent, credible and capable of addressing the NMC's very serious organisational problems and transforming the NMC into the regulator that the public, nurses and midwives deserve.”

Unite’s lead professional officer Obi Amadi added: "The report is a searing indictment that highlights a dysfunctional organisation which appears not to be fit for purpose in regulating the nursing professions and ensuring that the public has confidence in the regulatory framework.”

The report contains 15 recommendations for change, which include encouraging a more open culture, where staff feel listened to and where management take responsibility.

It also calls for the council to develop a more constructive dialogue with the sectors it oversees and to follow best practice examples in all public consultations.

Jackie Smith, acting chief executive and registrar of the NMC, said: “We recognise the failings that CHRE have set out in their reports, and we are sorry. It is clear that the NMC has not delivered effective and efficient regulation, and we are committed to putting that right.

“In response to CHRE’s interim report in April, we established a change management programme to implement the recommendations they made at that time. The council and executive will now want to study the findings and recommendations of these reports in detail, and put in place further plans to address the weaknesses.

“The reports rightly challenge us to effectively deliver our regulatory functions, to build appropriate relationships with external stakeholders, and to implement changes in our management and culture that will address our operational weaknesses.”