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Found 7 results
  1. Content Article
    Fitness to Practise is the process by which the Nursing and Midwifery Council (NMC) investigate concerns about the professionals on their Register and take action if it is required to protect the public. Fitness to Practise affects relatively few of our professionals but it can have significant consequences and is therefore subject to particular scrutiny. This publication provides new insights about: Why some cases about similar concerns receive more serious sanctions than others. What types of behaviours constitute dishonesty. Why some concerns raised by employers concluded at the initial stages, indicating that some concerns can be safely and fairly resolved locally. What was found Continuing rise in new concerns NMC have seen a 13% increase in the new concerns they received in the last year. The number of professionals on their Register increased by 3%. Members of the public continue to be the biggest source of concerns, but referrals from employers are increasing and returning to pre-pandemic levels. The number of Fitness to Practise concerns received each year involves less than 1% of the professionals on their Register. Concerns raised by employers Between 01 April 2024 and 31 March 2025, 15% of concerns which were closed after an initial assessment and did not progress beyond screening for regulatory investigation were raised by employers. The NMC want to work more closely with employers to support the right decisions about the concerns they can manage locally, and when a fair and appropriate referral is required. Making unnecessary Fitness to Practise referrals causes additional stress and worry for those involved. It also causes delays in the progression of other Fitness to Practise cases. The analysis of a sample of employers’ concerns found that just over half of employers in the sample had not used the employer advice line before making the referral, and that employers had been unable to complete local investigations for a quarter of the concerns because professionals had not engaged with the process. Outcomes at hearing stage Factors which result in the most serious sanctions include conduct which puts people risk of harm, a lack of insight into failings, a pattern of misconduct over time, and abuse of a position of trust. Dishonesty is one of the concerns most likely to result in a more serious sanction. The analysis reveals the types of behaviours that constitute dishonesty and some of the reasons expressed by professionals for this behaviour. A culture of learning It is important that professionals experience working environments and workplace cultures that enable them to speak up and report mistakes so that learning can be shared. This also prevents repetition of that mistake and enables the nurse, midwife or nursing associate to rectify errors immediately without fear of blame, bullying or harassment.
  2. Content Article
    The Professional Standards Authority for Health and Social Care (PSA) twice-yearly bulletin provides a valuable overview of the volume of learning points the PSA send and the themes identified. The PSA checks all final fitness practise decisions across the 10 health and social care regulators they oversee. This means they can highlight issues and identify themes. PSA regularly provide these to the regulators by way of learning points.  This can assist regulators in improving their decision-making processes. The learning points PSA identify will also be considered by their performance review team and explored in more detail as part of PSA's annual reviews on how the regulators are meeting their Standards of Good Regulation. PSA Learning Points Bulletin Issue 4 (March 2026) PSA Learning Points Bulletin Issue 3 (September 2025) PSA Learning Points Bulletin Issue 2 (February 2025) PSA Learning Points Bulletin Issue 1 (July 2024)
  3. Content Article
    The General Medical Council (GMC) may decide to investigate a concern about a doctor, physician associate (PA) or anaesthesia associate (AA) registered with them. Their website contains information about the support available as we know this can be a difficult and stressful time. It also explains their investigation processes and the actions they may take. Fitness to practise explained How we investigate concerns about doctors Doctors under investigation - Find out what support is available for doctors. And find out how the GMC investigation process works. Physician associates or anaesthesia associates under investigation - Find out what support is available for PAs or AAs. And find out how the GMC investigation process works. Hearings and decisions - Find the latest results of hearings and decisions by GMC and the Investigation Committee. Help for witnesses - Guide for witnesses helping the GMC with an investigation. It sets out how you can help, what to expect and the support available.
  4. Content Article
    The National Institute for Health Research (NIHR) awarded researchers from The Open University (OU), Manchester Metropolitan University, the Universities of Oxford, Glasgow and Edinburgh more than £141,000 to expand their world-first study of witnesses’ experience of giving evidence during health and social care workers’ professional conduct hearings. The project, Witness to harm, holding to account: Improving patient, family and colleague witnesses’ experiences of Fitness to Practise proceedings, mainly focuses on cases where there are allegations of harm. This focus should help regulators and employers identify potential improvements to support witnesses whose role in giving evidence is crucial to a fair hearing. Since September 2021, the project has explored the experiences of witnesses involved in Fitness to Practise (FtP) proceedings with UK health and social care regulators. It aims to determine what support witnesses expect, what they receive and what they need. The researchers are exploring current best practice and potential improvements to how the public engages with FtP processes to develop workable recommendations, videos and other support resources for the public and professional bodies. Annie Sorbie, Lecturer in Law (Medical Law and Ethics) at Edinburgh Law School and a co-investigator on the project said: “The provision of written and oral evidence by witnesses is a crucial part of the fitness to practise process. This helps to ensure that when regulators make decisions about whether health and care professionals are fit to practise, these are fair, timely and protect the public. Our study will provide novel insights into the experiences of witnesses and use these findings to create resources and guidance that enable people to be better supported when they provide evidence. I will be producing a report comparing the systems of regulation of the devolved Scottish government and the public’s involvement in professional regulation. I am delighted to work on this NIHR-funded project with colleagues across the UK and from a range of disciplinary backgrounds.” For more information or to get involved with the Witness to harm, holding to account project, please email Louise Wallace ([email protected]) or Amy Clow ([email protected]).
  5. Content Article
    In December 2022, the All Party Parliamentary (APPG) for Whistleblowing heard evidence on the state of the NHS following the recent report on the avoidable deaths and life changing injuries caused to mothers and babies at the East Kent Trust. The culture at this hospital was described as one where “everyone knew the problems” and where whistleblowers were “thrown to the lions”. A culture attributed to 45 of the 65 baby deaths reviewed.  This blog first appeared on the Whistleblowers UK website in December 2022. In 2015 the Government introduced a Freedom to Speak Up Guardian and a system of Local Speak Up Guardians in response to the recommendations made by Sir Robert Frances following the scandal at Mid Staffordshire. From the outset, this system has attracted significant criticism and the APPG has heard from whistleblowers who have been failed by local guardians sharing their experiences that included the disclosure of their identity to hospital management and boards – resulting in retaliation. The APPG has also heard from Local Guardians who were not supported and themselves the target of retaliation after supporting whistleblowers. Local Guardians in East Kent were described as, “dishonest” and that the Guardian system had failed in every case that had been investigated throughout the UK. Further evidence was provided of a tick box approach to the Duty of Candour introduced by the former Secretary of State for Health. The APPG was told that both the Guardian and Duty of Candour systems are beyond resurrection and that across the NHS there is no ownership of problems. All attempts to encourage speaking up have been hindered by a failure to introduce an effective and safe whistleblowing regime across the NHS, resulting in the NHS being unsafe for whistleblowers, making it unsafe for patients. The APPG were told that, in over 50 years of investigation experience, little has changed, and that “these issues are not new, nor are they confined to a small number of rogue hospitals”. That league table results are inaccurate because of a flawed regulatory system with no ownership of the problems and where the regulators are “caught up in the fraud”. The APPG was provided with a series of examples of what were described as “deep seated problems” relating to teamwork and culture, which resulted in the failure to join up clinical and ethical responsibilities. These responsibilities were described as being on separate tracks and a failure by the regulatory regime to identify or report on the impact of this has significant consequences for patients, whistleblowers and the future of the NHS, as demonstrated by the case of the Bristol Children’s Heart scandal brought to light by Dr Steve Bolsin 30 years ago. Dr Bolsin was shunned for exposing the failures that resulted in the death of so many babies because funding the unit was more of a priority that the lives of the babies (he has since made a successful career in Australia). In every case, a failure to listen to whistleblowers, followed by attempts to discredit the whistleblowers, and a deliberate cover up has proved in many cases fatal for patients. What has been proved time and time again is that The Public Interest Disclosure Act (PIDA) has made little or no difference to this failure to protect patients or whistleblowers or to learn and improve our NHS. Evidence provided to the APPG is of a lack of system-wide action and an absence of commitment to speaking up beyond excellent PR. It is unclear who, if anyone, is responsible for the monitoring and reporting on recommendations contained in investigation reports. In addition, there is no coherent process for triggering high-level independent reviews of major patient safety failings. This causes confusion, suffering and leads to missed opportunities. Mary Robinson MP, chair of the APPG for Whistleblowing, said: “We have a duty to support and protect whistleblowers because without them we cannot prevent more deaths like those in East Kent. My APPG is committed to making whistleblowing safe and will continue to press the Government to introduce the Whistleblowing Bill which will incentivise and normalise speaking up. I encourage everyone to write to their MPs and ask them to join the APPG and support the Whistleblowing Bill.” The Right Hon. Baroness Susan Kramer, said: “Doing nothing is not an option that we can afford. It’s time to put an end to ‘tick box culture’ and turning a blind eye to whistleblowers. Whistleblowing law must be meaningful, easily understandable and enforceable. The Whistleblowing Bill will do this and in doing so will save lives and protect our NHS.” Wendy Morden MP, member of the APPG for Whistleblowing, said: “I hear about problems when I am at the hairdresser because people are too afraid to speak up in their place of work. The Office of the Whistleblower will be the catalyst for meaningful change.” Dr Bill Kirkup, author of Reading the Signals Report, said: “I support the proposals set out in the Whistleblowing Bill because the NHS urgently needs an effective early warning system.”
  6. Content Article
    This code sets out a common overarching framework for the corporate governance of trusts, reflecting developments in UK corporate governance and the development of integrated care systems.  Key points Corporate governance is the means by which boards lead and direct their organisations so that decision-making is effective, risk is managed and the right outcomes are delivered. In the NHS this means delivering safe, effective services in a caring and compassionate environment while collaborating through system and place-based partnerships and provider collaboratives to integrate care. Best practice is detailed in the following sections: Board leadership and purpose, Division of responsibilities, Composition, succession and evaluation, Audit, risk, and internal control, and Remuneration. Action required Trusts must comply with each of the provisions of the code or, where appropriate, explain in each case why the trust has departed from the code.
  7. Content Article
    More information about "Why patient safety demands a Hillsborough Law with a legal duty of candour for all health and care professionals"
    More than three decades after the preventable death of 10-year-old Robbie Powell, the UK still does not have a legal mechanism to hold individual clinicians accountable for dishonesty. This evidence-based opinion piece from Steve Turner argues that an ethical code of conduct is not sufficient to ensure accountability and that an individual legal duty of candour is essential for patient safety. It makes the link between Hillsborough Law and Robbie's Law. No legal duty to tell the truth More than three decades after the preventable death of 10-year-old Robbie Powell and the subsequent cover-up by medical professionals, the UK still does not have a legal mechanism to hold individual clinicians accountable for dishonesty. The proposed Hillsborough Law[1]—which seeks to establish an individual legal duty of candour on public officials—must include all health and care professionals: managers, leaders and frontline clinicians alike. Anything less would be an affront to patient safety and public trust. The heart breaking story of Robbie Powell, who died in 1990 due to multiple clinical failings has long been a call to action for legal reform.[2] His case, meticulously documented and campaigned for by his family, exposed how doctors could mislead families and official inquiries without legal consequence.[3] The European Court of Human Rights ruling on Robbie’s case made it chillingly clear: there is no individual legal duty of candour on doctors.[4] The media aptly dubbed it “a doctor’s right to lie".[5] This remains true today. A conspiracy of silence? The Robbie Powell case predates Hillsborough. It is the landmark case on duty of candour and yet it receives little attention in the press and media. It was referred to by Sir Robert Francis in the report on the failings at Mid Staffordshire,[6] and the significance of the Robbie Powell case was a factor in the collapse of the 2021 trials of former police officers and a solicitor involved in the Hillsborough disaster.[7] After Hillsborough, the Robbie Powell case, through its influence on the concept of 'duty of candour', played a role in the broader discussions around transparency and accountability in public life. Because there was (and still is) no individual statutory duty of candour on police officers or public officials, the legal framework makes it easier to defend against allegations of dishonesty or misconduct, even when unethical behaviour was clear. That such a crucial legal precedent draws so little public attention is telling. It highlights how deeply entrenched the culture of denial and protection is, not only in policing but across public institutions—including the NHS and the whole of health and social care. The argument against legally enforced accountability Some clinicians argue that a statutory duty is unnecessary. In fact, in 1998 a BMA spokesperson publicly defended this view, claiming that "the ethics of this are rather more important than the law" and a strict legal framework would be "unhelpful".[8] Sadly, history proves otherwise. In a parallel situation on public accountability, the Post Office scandal,[9], where countless subpostmasters were failed by Post Office leaders and managers who stayed silent, showed the cost of misplaced institutional loyalty. Healthcare has its own shameful examples, including the Infected Blood Scandal[10], the widespread mistreatment of people with autism and learning disabilities, and shocking failures highlighted in multiple reports and other systemic scandals examined in the Thirwall[11] and Lampard[12] inquiries. Again and again, professionals have failed to speak out—and when they do, they are often ignored and even blacklisted.[13] This is not a question of bad apples; it is a systemic failure of accountability. Without a legal duty of candour that applies to individuals, there is no deterrent to dishonesty and no justice for those harmed by it. Regulatory bodies have repeatedly proven they are not enough. Time to act: Hillsborough Law incorporating Robbie’s Law now A Hillsborough Law that excludes clinicians from individual accountability would betray the very purpose of the legislation. It would ignore the hard lessons from decades of cover-ups, including the tireless efforts of Robbie Powell’s family to expose the truth. We cannot afford to continue a system where telling the truth is optional, and silence carries no consequence. Patient safety depends on truthfulness. And truthfulness must be enforceable—not merely expected. References UK Parliament. Public Authority (Accountability) Bill ‘Hillsborough Law’, 2017 (accessed 28.07.2025). Robbie's Law – Telling the truth in healthcare. The campaign for an individual legal duty of candour, 2025 (accessed 28.07.2025). Hartles S. ‘Robbie Powell: Time for Truth, Justice and Accountability’. The Open University, Harm & Evidence research collaborative., 2025 (accessed 28.07.2025). European Court of Human Rights (45305/99) (4th May 2000) – (Third Section) – Decision – POWELL v. THE UNITED KINGDOM (accessed 28.07.2025). Hammond P. Robbie’s Law – Telling the truth about medical harm. Private Eye: Medicine Balls 1332, 2013. (accessed 28.07.2025). UK Government. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationary Office, 2013 (accessed 28.07.2025). Conn D. Hillsborough families attack ‘ludicrous’ acquittals of police. The Guardian, 26 May 2021 (accessed 28.07.2025). Powell W. Duty of Candour [Robbie's Law]. Relevant section at 9.09. Channel 4 News, 24th April 1998 (accessed 28.07.2025). Post Office Horizon IT Inquiry, 2025 (accessed 28.07.2025). Infected Blood Inquiry, 2025 (accessed 28.07.2025). Thirwall Inquiry (accessed 28.07.2025). The Lampard Inquiry is an independent statutory inquiry investigating the deaths of mental health inpatients in Essex between 2000 and 2023 (accessed 28.07.2025). Turner S. The systemic silent killer – ending the stigma around whistleblowing in healthcare. 2023 (accessed 28.07.2025). This article was first posted on LinkedIn and has been edited for the hub: https://www.linkedin.com/pulse/why-patient-safety-demands-hillsborough-law-legal-duty-steve-turner-0jgue/?trackingId=cK7GxZXtgvMnt%2FcnwYYCyw%3D%3D

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