Concern over nurse complaint process

Serious concerns about the way complaints against nurses are investigated have been expressed in a report commissioned by the Nursing and Midwifery Board of Ireland (NMBI).

In some cases, the interests of the nurse facing an allegation have been put before that of the patient making the complaint, according to the report from the UK- based Professional Standards Authority.

It is strongly critical of a three-year delay in hearing many cases, as well as the failure of some members of the nurse-dominated fitness-to -practise committee to stay for the entirety of a meeting.

The report expresses concern that the composition of the committee appears to have affected the quality of decision-making because of its focus on the registrant (the nurse facing a complaint) rather than the patient/public interest.

Nurses’ fitness-to-practise inquiries currently take place behind closed doors. The present report was commissioned in preparation for a move to public hearings akin to those held for doctors, in accordance with the Nurses and Midwives Act 2011.

Majority

Under the current system, the committee is dominated by nurses but this will change to a lay majority under the new system. The first public hearings are expected to start shortly.

Delays of up to three years in the hearing of complaints are common, the report shows. For example, in 2012, there were 42 inquiries pending, eight of which dated back to 2009 and 16 to 2010.

There was no valid reason for a three-year delay in the investigation of one "relatively straightforward" claim. The cases examined are indicative of the failure of An Bord Altranais (the body that preceded the NMBI) to deal with cases efficiently, it states.

The NMBI should take steps to address the “significant delays” which have been part of the fitness-to-practise process for several years. The report says the board should review the tone of its correspondence, which is currently “very formal and legalistic”.

It expresses “overriding concerns” at a failure by the committee to make express reference to patients, patient safety or action in the public interest in its deliberations, and says it did not always give sufficient weight to the concerns raised.