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NMC Investigating How Best To Tackle Cases Of Suspected Systematic Failure, UK

Following our recent report on failings at Basildon and Thurrock University Hospitals NHS Foundation Trust, we have begun exploring when and how we will intervene to protect the public in future cases of suspected systematic failure.

We have appointed Dame Elizabeth Fradd to assist us in identifying how the NMC should address similar failures in healthcare settings when nurses or midwives are involved.

List of triggers

The project will aim to create a list of triggers that might lead to a healthcare setting coming under scrutiny by the NMC, a set of criteria against which that healthcare setting would be evaluated and details of how such interventions will be carried out.

Proactively working

Director of standards and registrations Roger Thompson said:

“The Nursing and Midwifery Council exists to safeguard the health and wellbeing of the public and this includes protecting them when systemic failures prevent nurses and midwives from providing adequate care.

“Over the coming months we will be looking into how and when the NMC should go about proactively working to ensure that neither care of the public nor education of student nurses and midwives is compromised by systemic failings.

“We are looking forward to putting in place a robust system for effectively tackling these cases in the future.”


Independent health service adviser Dame Elizabeth Fradd said:

“I am delighted to be involved in such an important piece of work which I hope will ensure the future safety of patient care and nursing and midwifery practice. It is a measure of the determination of the NMC to prevent either individual or systemic failings undermining the level of care the public receive from nurses and midwives.”

Working with other organizations

The project, which will be completed this autumn, will also explore ways the NMC can work more productively with other organizations, such as the Care Quality Commission, to improve patient safety and care in healthcare settings where systems appear inadequate.

This is in keeping with the Council for Healthcare Regulatory Excellence’s ‘Performance review of health professional regulatory bodies 2008/09’, which recommends that “regulators give consideration to how they can co-operate more effectively to ensure that any relevant intelligence on individuals or organizations is shared and that cross regulatory learning is encouraged.”


The review into Basildon and Thurrock University Hospitals NHS Foundation Trust was carried out in response to concerns raised in a report in November 2009 by the CQC and Monitor who are the regulators of NHS systems and clinical standards. The extraordinary review looked specifically at the education environment of pre-registration students to make sure it was suitable and safe, whether women in the maternity unit were receiving safe care from midwives and whether the supervision of midwives was meeting the required NMC standards within the trust.

Dame Elizabeth Fradd DBE

Dame Elizabeth Fradd DBE is an independent health service adviser whose work focuses on the continuous improvement of healthcare. She was until April 2004 the Nurse Director and lead Director for the Review and Inspection program in the Commission for Health Improvement (CHI). Prior to this appointment she was Assistant Chief Nurse in the Department of Health. Her current portfolio of work includes commissioned independent inquiries / investigations, the delivery of innovative professional development programs and the mentoring of senior personnel.

Nursing & Midwifery Council

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