Fitness to PractiseAlison McLachlanChristine James

School of Health,Nursing & Midwifery

The public is adamant that they want nurses who are the complete package.

Is this a big ask? Damn right it is

(Darbyshire & McKenna 2013)

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Dumfries Campus

Ayr Campus

Hamilton Campus

Paisley Campus

Campus Locations

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NHS Dumfries & Galloway

NHS Ayrshire & Arran

NHS Lanarkshire

NHS Greater Glasgow & Clyde(Clyde Division)

NHS Highland(Argyll & Bute)

The State HospitalNHS Scotland

NHS Board Partners

Overview• Legal Perspective

• Professional Position

• Employability

PROFESSIONALISM

‘…..but by lawful judgement of his Peers…’ Magna Carta Libertatum (1215)

‘An ideal to be pursued’

PILLARS OF PROFESSIONALISM

EXPERTISE ETHICS SERVICE SELF REGULATION

The Rise and Fall of Professionalism

• Bristol• Alder Hay Reflection • Shipman• NOW Francis

• State Control• CHRE• Systems Regulation

• Deregulation of Markets

• Regulatory Tools • Service Regulation

• Decline in Trust • Increasingly informed

public• League Tables

Social & Political

Attitudes

Government Policy

Regulatory Failures

Meta Regulation

Fitness to Practise

•FtP- highest profile part of regulators work/substantial portion of regulators resources (Public Confidence) •Statutory Grounds-Misconduct, deficient performance, convictions & determinations and health –often imprecise and confusing concepts•‘Apply the law of the land and not just a formula of its own making’ Shipman Enquiry Fifth Report (2004)

•FtP Determinations-Fact finding stage, FtP findings and sanctions•Future options:1. Retain existing single framework-2 tiered approach with list of

statutory grounds2. Implement Shipman recommendations-’has in the past

acted/brought/breached and is liable to ……in the future’ –Test: What a reasonable and well informed member of the public would conclude

3. Risk to public /confidence in the professional approach –Test: Risk to health, safety or well being of public

Francis Inquiry: Recommendations

•Total Recommendations=290 •Nursing Practice =25 •Care of the Older Adult -8•Regulatory function of the Nursing & Midwifery Council (NMC) =10 •Resolution?•Simpler system of regulation-single regulator (9/10 PRB’s) •System of Revalidation-reinforce competence •Reduced complexity in standards of education/conduct/practice –overlap from multiple PRB’s/other agencies

Fitness to Practise (FtP) in Context

• FtP as component of learning Curve.

• Engagement

• Professionalism in both professional and personal context

• Process and Cases

Reason for Referral 

 

Social Network Sites 16

Inappropriate Conduct Practice 3

Good Character Issues 11

Issues related to Plagiarism 0

Inappropriate Conduct/Attendance 6

Competency Issues 5

Total 41

Outcome  

No Further Action 5

Student Withdrew 1

Referred to Disciplinary 3

Stage 1 with Monitor 19

Stage 1 Repeat Programme Component 4

Refer to Stage 2 7

Stage 2 with Monitor 4

Occupational Health Referral 4

Student Withdrawn 2

Reprimand at Stage 1 2

Reprimand at Stage 2 2

Referral to Health Board-Access 4

Suspension pending outcome 6

Cases Pending 5

Fitness to Practise Cases: 2012-13

Nursing has been overwritten and reformatted into something that makes curricular and academic sense but is unrecognisable to health services, other nurses, patients, families and communities whom we serve

(Carter 2007, Darbyshire & McKenna 2013)

• Educational preparation inclusive of Fitness to Practise must develop in students the core values, attitudes and behaviours inherent in competent, compassionate and professional care