Mental Health Nursing: Attending an NMC Fitness to Practise Hearing

A few weeks ago we had a session on ethics in mental health and our tutor mentioned that attending a FTP hearing is a really good learning experience. So today I went to see one with a few of my uni friends. The committee that we observed was conduct and competence.?I didn't know much about how hearings worked so the panel secretary explained it to us before it began. There are four stages to the hearing:

1. establishing whether the facts had been proven
2. establishing whether the registrant's fitness to practise is impaired
3. receiving information from the registrant
4. deciding upon a sanction if necessary

The panel was made up of a registrant member (a registered nurse), a legal assessor, lay chairwoman, lay panel member, typist, and case presenter. As no witnesses turned up the case presenter had to read their statements whilst he was giving the panel information about the case. In this instance "lay" means the panel member was not a registered nurse. The secretary explained to us that this is because the hearing is supposed to represent members of the general public. The hearing is open to members of the public because of the accountability that registered nurses have.

The hearing started off with the case presenter giving information about the case, he was reading from a booklet that was 100+ pages long (this was the case?- to summarise, there were two instances of section 17 leave being used wrongly because the registrant had not read the care plan, then changed documentation when they realised the error without reporting it). This included reading all the witness statements. The registrant admitted all the charges and then there was a 20 minute break for the panel to read through the pages and pages before them. After the break, the panel questioned the registrant about the case. They allowed them to take an oath as a witness so that they could ask them more specific questions. This is where I began to feel a bit uncomfortable because I felt like they did not really understand the questions put before them. Several of the witness statements said that the registrant did not appear to understand the gravity and seriousness of the case. The registrant was asked to give details to their personal circumstances around the case. This is when the legal assessor and the case presenter intervened, saying that when giving personal details the hearing can go in to private session. This is because anything said in the hearing is in the public domain (because of aforementioned accountability) and the registrant probably wouldn't want their personal information to be known. The chairwoman did not seem happy about this but the legal assessor insisted so again we were sent outside whilst the panel discussed this.

When we came back in the registrant was asked about how much clinical supervision they received, what practice on the ward was usually like, and how their practice had changed since. Again, it didn't seem like they understood the question and when we were talking after my friends agreed. The panel said they would adjudicate and come back with sanctions (if any) a few hours later. I didn't realise how long hearings could take so unfortunately I missed the last part.

Attending this FTP hearing raised several points for me.

1. As mental health nurses, communication is our ultimate tool. If you are not proficient enough in English, how effective can your communication be? If the registrant couldn't understand questions put before them then I'm not sure how they would be able to communicate with patients in crisis on an acute ward.?
2. I already knew how important accountability was but this really drummed it in. Having people come in to watch your hearing must be a horrible feeling but it's a reminder of a nurse's duty to the general public. However there was only one registered nurse on the panel who was an RGN and I wondered if having an RMN's opinion would make any difference.
3. Mistakes happen but if something happens you can't cover it up, honesty is the best policy.
4. The registrant admitted to all of the charges and had done so during her disciplinary with her employer. I understand that to consider a sanction a hearing is needed, but is it really necessary to spend a whole day going over it? Especially when the NMC are saying their impending fee rise is all down to holding FTP hearings.
5. The registrant had been dismissed and unable to work as a nurse. However she had been able to get a job as a domiciliary care worker, where they said their main tasks were care planning and risk assessment. This played a huge part in why they were in front of an FTP panel anyway. I've always thought that support workers/healthcare assistants/etc should be regulated, but even more so now. I will blog about this in future.

Attending a hearing is really easy, you just need to complete a form online. It's definitely a good learning experience and I would imagine it would be useful for qualified as well as student nurses.
(One thing I do have to point out: the NMC headquarters are in a very spacious, modern looking office in the centre of London. Air conditioning on full blast too. Fees well spent?)

Source: http://nataliemhn.blogspot.com/2013/01/attending-nmc-fitness-to-practise.html

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