Student Fitness To Practise

1. Student Fitness To Practise Ruth H Chadwick RHC

2. The White Paper

3. Why do we need FTP? “We need a system that understands the pressures and strains under which all professionals operate and shows understanding, compassion and support where these are appropriate. It also means a system that is better able to identify people early on who are struggling – perhaps with personal problems of mental health or addiction – supporting them, showing the same care to them that they have shown to their patients…” page 2; section 4 Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century. February 2007. Cm 7013. The Stationery Office, London.

4. The Code The Code

5. Alignment • Professionalism and regulation should run as a developing strand of the curriculum throughout the course of study. Measures should be put in place between the Regulatory Body and Higher Education Institution for the student to develop a thorough understanding of professionalism and the purpose of regulation … CHRE 2008

6. Student Guidance

7. Student Guidance • Aggressive, violent or threatening behaviour • Cheating or plagiarising • Criminal conviction or caution • Dishonesty • Drug or alcohol misuse • Health concerns • Persistent inappropriate attitude or behaviour • Unprofessional behaviour

8. Impact of student behaviour and conduct • 24 / 7 professional and personal life • Student fitness to practise • Student’s ability to complete the programme • The willingness of the university to sign the declaration of good health and good character for the student to become a registered nurse.

9. NMC Good Health and Good Character • HEI’s tasked with ensuring Fitness for Practice, during and up to the point of registration • Good Health • Good Character

10. Good character • NMC state “A persons character must be sufficiently good for them to be capable of safe and effective practice without supervision” NMC guidance CHRE approach

11. University policy • Fitness for Professional Practice Procedure • Fitness to Study • Procedure for Dealing with Academic Misconduct • Academic Appeals Procedure • Student Disciplinary Procedure • Student Complaints Procedure

12. Challenges facing the implementation of Fitness for Practice Procedures • Identifying Fitness for Practise (FFP) cases • Investigating FFP cases • Consistency of approach

13. Identifying Fitness for Practise (FFP) cases • Who identifies issues of concern? • What kind of concerns are raised? • What should happen when concerns are raised? • When will the identified matter be investigated?

14. Investigation • Follow FFP policy • Remember these are allegations not proven fact • Why might the identified matter affect FFP? • What is the evidence to support the allegation?

15. Consistency of approach • Application of the policy to all allegations raised against students • Proportionality and risk • Equity and fairness • Advice to students

16. Cases • An investigation that did not result in a Fitness For Practise (FFP) panel • An investigation was referred to a FFP panel • An investigation was referred to a FFP panel and subsequently to a FFP Appeal Panel

17. Things to consider • Are the allegations clear? • Can you relate them to The Code? • Is there evidence to substantiate the allegation? • Have reasons for decisions been given? Standard of Proof

18. Student context • Student maturity • Ethnic and cultural factors • Educational background • Personal problems student experiencing at the time

19. Justice and fairness • Found unfit for practice by FFP, but academically sound • NMC state that student may be granted academic award BUT this must not in any way infer that the student is a qualified nurse or midwife.

20. Sign off for registration • If not content; for conduct or health reasons, to sign the student’s supporting declaration or the student has charges pending • The supporting declaration of good health and character should be returned to the NMC UNSIGNED and clearly marked that the nursing programme leader or midwife for education is unable to sign it NMC H &C

21. Should regulators receive every outcome? CHRE SFTP

22. References • CHRE 2008 Advice on the civil standard of proof London CHRE • CHRE 2008 Advice on student registration London CHRE • CHRE 2008 A common approach to good character across the health professions regulators London CHRE • CHRE 2010 Fitness to practise audit report Audit of health professional regulatory bodies’ initial decisions London CHRE • CHRE 2010 Student Fitness to Practise Should the regulators receive every outcome? London CHRE • DoH 2007 Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century London The Stationery Office • NMC 2008 The Code Standards of conduct, performance and ethics for nurses and midwives London NMC • NMC 2008 Good Health and Good Character: guidance for educational institutions London NMC • NMC 2009 Guidance on professional conduct for nursing and midwifery students London NMC • School of Nursing & Midwifery 2010 The Nursing and Midwifery Workbook Salford School of Nursing and Midwifery • University of Salford 2010 Fitness for Professional Practice Procedure Salford University of Salford

23. Raising and escalating concerns:Guidance for nurses and midwives • The new guidance will remind nurses and midwives of their obligations – The code: Standards of conduct, performance and ethics for nurses and midwives stipulates: • Acting without delay if you suspect a colleague or anyone else may be putting someone at risk • Informing someone in authority if you experience problems that prevent you working within the code • Reporting any concerns in writing if problems in the environment of care are putting people at risk