1. Fitness to Practise
Alison McLachlan
Christine James
School of Health,
Nursing &
Midwifery

2. 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)

3. N
Dumfries Campus
Ayr Campus
Hamilton Campus
Paisley Campus
Campus Locations

4. N
NHS Dumfries & Galloway
NHS Ayrshire & Arran
NHS Lanarkshire
NHS Greater
Glasgow & Clyde
(Clyde Division)
NHS Highland
(Argyll & Bute)
The State Hospital
NHS Scotland
NHS Board Partners

5. Overview
• Legal Perspective
• Professional Position
• Employability

6. 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

7. 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

8. 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 grounds
2. 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

9. 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

10. Fitness to Practise (FtP) in Context
• FtP as component of learning Curve.
• Engagement
• Professionalism in both professional and
personal context
• Process and Cases

11. 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

12. 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