Health Adviser Alert: Draft NMC Code of Conduct Published – Key Headlines and Impact - July 2014
Published 31 July 2014
The Nursing and Midwifery Council ('NMC') has launched the second phase of its public consultation on the new Code of Conduct for nurses and midwives which is due to come into force in December 2015 (the delayed timing to be aligned to the nurse revalidation process in 2015).
The NMC had committed to reviewing the Code in its response to the recommendations made by Robert Francis QC in the Mid-Staffs inquiry. The draft Code (found here) is approximately twice the size of the current Code and has a number of proposed additions which include:
- The implementation of a requirement to exercise a professional duty of candour and to give a constructive and honest response to anyone who complains about the care that they have received, including an apology where appropriate (paragraph 4);
- Those with management or leadership responsibilities must ensure that those they are responsible for are enabled and supported to comply with the Code at all times, have the knowledge, skills and competence for safe practice, understand how to raise any concerns linked to potential or actual breaches of the Code (paragraphs 5 – 10);
- There is an increased emphasis on compassionate care, setting out fundamental standards of care. It will become a nurse's individual professional responsibility to ensure that their patients are kept in clean and hygienic conditions, and that their basic nutrition and care needs are met (paragraphs 11 – 39);
- The introduction of a requirement to provide information to enable people to make a complaint relating to the care received, the handling of complaints, a "whistleblowing duty" and a requirement to cooperate with investigations (paragraphs 63 – 67);
- There is a new section on dealing with complaints and reflecting on feedback (paragraphs 101 – 107). This includes a requirement to act immediately to put matters right if a patient in their care has suffered harm for any reason or been the victim of a 'near miss', and explain to them what happened and the likely effects;
- A new paragraph referring to the use of social media. Nurses and midwives will no longer be permitted to refer to employers or patients (past and present) in a way that could identify them on Facebook, Twitter or other social media (paragraph 114).
The proposed changes to the Code reflect the regulator's impetus to seek to protect the public and uphold public confidence in the professions by placing the duty of candour and compassionate care at the heart of the Code. In doing so, it demonstrates the cultural shift post-Francis and the new ways in which healthcare professionals will be held accountable by their regulator. It reflects the concerns captured in the Francis report for cultural change by healthcare organisations and professionals, and for fundamental standards of care for patients to be set with healthcare professionals to be held accountable in the event that they breach these standards.
The impact of the new Code of Conduct will be felt across all healthcare organisations employing registered nurses. In conjunction with the new CQC regulations addressing fundamental standards, duty of candour and the new Fit and Proper Person Test for Directors and equivalents, the new Code represents the sector step change on care and conduct at a regulatory level.
There is a need for organisations and individuals to understand the practical and cultural changes that the new Code of Conduct will bring in relation to nursing staff. Whilst the draft Code is still under Consultation, it is clear that it seeks to mirror the wider sector changes seen in 2014.
Interestingly, the NMC decided not to implement the recommendation of the Francis report that it should proactively launch its own investigations into hospitals where nurses or midwives may be breaching the Code. However, it is likely that healthcare bodies will need to work closer with the NMC to share concerns and address investigative issues. Indeed, the NMC is considering NMC liaison officers to attach to NHS Trusts.
Healthcare organisations will need to consider how to support nurses and midwives in understanding their new professional obligations and the practical implications for the organisation. There will be a need to recognise the changes that may need to be implemented.
The Consultation is open until 11 August 2014 and can be viewed on the NMC's website. We would encourage individuals and organisations to respond to the Consultation.
How we can help
Our experience of healthcare organisations, the regulatory landscape and professional disciplinary proceedings enables us to support your organisation by:
- Working with you to consider the impact of the draft Code in all areas;
- Assisting you in completing a response to the Consultation;
- Taking part in training and staff engagement sessions to disseminate knowledge about the impact of the new Code of Conduct and to facilitate discussions about changes to policies and practices needed;
- Reviewing your policy and guidance documentation.