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Opinion
What to do when under scrutiny The recent investigation at Brithdir Care Home provides lessons for other organisations being monitored for care quality, says Lucy Williams IN AUGUST, the Nursing and Midwifery Council (NMC) concluded an 81-day hearing into care failings at Brithdir Care Home in Caerphilly, Wales. The hearing ended the UK’s biggest inquiry into allegations of neglect to date. It led to three nurses being struck off, a fourth being suspended for one year and a fifth being given a caution order. The three nurses who were struck off displayed limited insight and did not attend the hearings or engage with proceedings. The panel chair commented that one nurse had ‘attempted to deflect her personal responsibility by blaming others’, another was accused of ‘a lack of respect for human dignity’ while the third showed ‘little if any insight into her failings’. In contrast, the panel was satisfied that the one nurse who attended the hearings and provided substantial mitigation had faced up to her failings. She received a caution order, so can continue to work as a nurse. Thus, the different sanctions show how ‘insight’ and engagement with the regulator can significantly alter the outcome of fitness-to-practise investigations. Fair process The prospect of investigation by, and proceedings before, a regulatory body can be terrifying, but the NMC operates a fair process designed to consider evidence and representations from all parties. As a regulatory lawyer specialising in health care, I advise clients of the importance of engaging with but challenging NURSING OLDER PEOPLE
allegations that they contest, and to show remorse about allegations that they do admit to. The Brithdir case demonstrates that this is a sound policy. A list of dos and don’ts when responding to allegations of poor care is set out in the panel below. Of course, the regulator needed to send a message to the public and to other professionals that grave betrayals
of trust will be dealt with robustly. However, the lesson for nurses is that demonstrating to an NMC committee that they recognise where and why they went wrong in the past, and how they would act differently in the future, can go a long way to mitigating penalties. Lucy Williams is a regulatory lawyer specialising in health care, Kingsley Napley, London
How to respond to allegations of poor care What you should do: ■ Get advice early Taking advice about how to approach complaints from the start could alter the inquiry outcome in your favour, and even save your career ■ Gather evidence Go back to the relevant patient files and read the notes you made, look at dates of appointments and keep a copy of all this material. It could be invaluable later ■ Think about who you need to inform For example, insurers and supervisors ■ Speak to witnesses Ask them if they can write down what they saw and heard for you
■ Prepare your account Write down your best recollection of events, putting it in chronological order with as much detail as possible ■ Engage with the regulator It is rarely in your interests to put your head in the sand. Have the courage to attend any hearings to present mitigating factors, demonstrate insight and remorse, and explain the steps you have taken to improve. A written statement is much less convincing than a heartfelt explanation delivered in person
What you should not do: ■ Respond immediately Take time to provide a considered response within the deadline set by the NMC. If you cannot meet this deadline, ask for more time ■ Speak to complainants This is unlikely to be in your best interests ■ Ignore complaints Regulators can decide what to do about complaints without your involvement but if they have only the complainant’s account, they are less likely to reach a fair decision ■ Panic Panicking will stop you from being rational and making sensible decisions
December 2015 | Volume 27 | Number 10 11
Downloaded from RCNi.com by ${individualUser.displayName} on Dec 18, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
Opinion
What to do when under scrutiny The recent investigation at Brithdir Care Home provides lessons for other organisations being monitored for care quality, says Lucy Williams IN AUGUST, the Nursing and Midwifery Council (NMC) concluded an 81-day hearing into care failings at Brithdir Care Home in Caerphilly, Wales. The hearing ended the UK’s biggest inquiry into allegations of neglect to date. It led to three nurses being struck off, a fourth being suspended for one year and a fifth being given a caution order. The three nurses who were struck off displayed limited insight and did not attend the hearings or engage with proceedings. The panel chair commented that one nurse had ‘attempted to deflect her personal responsibility by blaming others’, another was accused of ‘a lack of respect for human dignity’ while the third showed ‘little if any insight into her failings’. In contrast, the panel was satisfied that the one nurse who attended the hearings and provided substantial mitigation had faced up to her failings. She received a caution order, so can continue to work as a nurse. Thus, the different sanctions show how ‘insight’ and engagement with the regulator can significantly alter the outcome of fitness-to-practise investigations. Fair process The prospect of investigation by, and proceedings before, a regulatory body can be terrifying, but the NMC operates a fair process designed to consider evidence and representations from all parties. As a regulatory lawyer specialising in health care, I advise clients of the importance of engaging with but challenging NURSING OLDER PEOPLE
allegations that they contest, and to show remorse about allegations that they do admit to. The Brithdir case demonstrates that this is a sound policy. A list of dos and don’ts when responding to allegations of poor care is set out in the panel below. Of course, the regulator needed to send a message to the public and to other professionals that grave betrayals
of trust will be dealt with robustly. However, the lesson for nurses is that demonstrating to an NMC committee that they recognise where and why they went wrong in the past, and how they would act differently in the future, can go a long way to mitigating penalties. Lucy Williams is a regulatory lawyer specialising in health care, Kingsley Napley, London
How to respond to allegations of poor care What you should do: ■ Get advice early Taking advice about how to approach complaints from the start could alter the inquiry outcome in your favour, and even save your career ■ Gather evidence Go back to the relevant patient files and read the notes you made, look at dates of appointments and keep a copy of all this material. It could be invaluable later ■ Think about who you need to inform For example, insurers and supervisors ■ Speak to witnesses Ask them if they can write down what they saw and heard for you
■ Prepare your account Write down your best recollection of events, putting it in chronological order with as much detail as possible ■ Engage with the regulator It is rarely in your interests to put your head in the sand. Have the courage to attend any hearings to present mitigating factors, demonstrate insight and remorse, and explain the steps you have taken to improve. A written statement is much less convincing than a heartfelt explanation delivered in person
What you should not do: ■ Respond immediately Take time to provide a considered response within the deadline set by the NMC. If you cannot meet this deadline, ask for more time ■ Speak to complainants This is unlikely to be in your best interests ■ Ignore complaints Regulators can decide what to do about complaints without your involvement but if they have only the complainant’s account, they are less likely to reach a fair decision ■ Panic Panicking will stop you from being rational and making sensible decisions
December 2015 | Volume 27 | Number 10 11
Downloaded from RCNi.com by ${individualUser.displayName} on Dec 18, 2016. For personal use only. No other uses without permission. Copyright © 2016 RCNi Ltd. All rights reserved.
