Struck off - keeping the public safe from harm

The BBC have reported on the case of a nurse that has been 'struck off' the nursing register for misconduct. What does being struck off mean and how does this protect the public from harm?

The Nursing and Midwifery Council (NMC) are the statutory regulator of nursing and midwifery in the UK. This means that they regulate and oversee the following:

• Training and qualifications required to qualify and practice as a nurse, nursing associate or midwife
• Conditions of good character required to qualify and continue to practice as a nurse, nursing associate or midwife
• Number of hours of practice required to remain competent as a nurse, nursing associate or midwife
• Continuing Professional Development (CPD) requirements for nurses, nursing associates and midwives

Nurses, nursing associates and midwives that meet these requirements are entered onto the professional register and every 3 years nurses, nursing associates and midwives must revalidate (by proving they continue to meet the requirements) to remain on the register. Employers and the public can search the register, to ensure that any nurse, nursing associate or midwife is entitled to practice in the UK. This ensures that the public are kept safe, as only those sufficiently trained, with up to date knowledge and practice, and of good character, may provide nursing and midwifery care.

The NMC may also receive complaints about any nurse, nursing associate or midwife on the register and have a duty to investigate the complaint. The investigation culminates in a 'fitness to practice panel', which decides whether the nurse, nursing associate or midwife is still considered fit to practice. The NMC can take any of the following legally enforceable actions:

• No further action
• A caution order of one to five years: this is the least restrictive sanction and is like receiving a written warning. It does not restrict practice.
• A conditions of practice order for up to three years: this might require the professional to undertake further training or to work under the supervision of a senior colleague.
• A suspension order of up to 12 months: during the suspension the professional may not practice nursing or midwifery. This might be used when the professional has a personal issue that affects practice but they are not fundamentally unsafe.
• A striking off order: this permanently removes a nurse/nursing associate/midwife from the register and prevents them from re-joining it at any point in the future.

Sanctions enable the NMC to restrict or remove from practice, any nurse, nursing associate or midwife that has been to have caused harm or a risk of harm to the public.

This BBC report - Somerset nurse struck off for failing to dispense morphine - discusses the case of a nurse that failed to administer morphine (a pain relieving medication) to a patient prior to them undergoing a painful procedure. The nurse falsified the patient record (created a false entry), to show that the medication was given. The nurse was found to have been deliberately dishonest and to have caused harm to a patient. As a result the nurse received a striking off order and will no longer be permitted to practice as a nurse in the UK.