Delay in nurse misconduct cases

By Branwen Jeffreys
Health correspondent, BBC News

Richard Grun had to wait two years to be cleared

The safety of NHS patients is at risk because of long delays in hearing complaints against nurses.

Some cases are already taking more than a year to be heard.

Documents obtained by the BBC under the Freedom of Information Act suggest the delay could rise to more than three years by March 2007.

The documents show the Nursing and Midwifery Council (NMC) has been warned that undue delays put patient safety at risk.

They could also lead to legal action from nurses under human rights legislation.

The NMC said that if there was a real risk, the nurse involved would be taken off the register and be unable to work.

Complaints against nurses are heard by the NMC, which can suspend them or permanently remove their right to work as a nurse.

Right now there are people out there who should have been seen and dealt with, who should have been struck off but who are working Gary Fitzgerald Action on Elder Abuse 'My mother was assaulted'

One relative said he complained to the NMC after his elderly mother - named only as Mrs A - was subjected to a serious sexual assault in hospital weeks before her death.

In July 2006 Albert Rampaul was struck off the nursing register for the assault. It had taken two years for the NMC to agree the complaint should be heard, and another year to schedule a hearing.

Mrs A's son showed the BBC the letter from the NMC explaining that financial pressures had led to a backlog and delays.

"I can't believe they could put budget constraints ahead of patient safety.

"My mother was assaulted by a nurse on her deathbed. She spent the last few weeks of her life deeply traumatised by what had happened."

'Edge of a cliff'

Internal documents show this financial year the situation is expected to get worse. One memo warns: "If these rates continue, the last case added to the backlog in March 2007 would wait three years and eight months to be heard".

Gary Fitzgerald from the charity Action on Elder Abuse says the delays are inexcusable. Nurses facing the most serious allegations can be suspended until full hearings, but he does not believe that offers enough protection.

Two years is too long, and I was found not guilty. What if someone has to wait longer to be found not guilty?

Richard Grun

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"Right now there are people out there who should have been seen and dealt with, who should have been struck off but who are working."

Nurses are also complaining about the long wait for allegations to be heard.

Richard Grun was exonerated two years after an allegation that he roughly handled an elderly resident in a care home.

During those two years he suffered stress, anxiety and a total loss of self-confidence as the final hearing was repeatedly delayed.

"It was like being taken to the edge of a cliff, told you're going to be thrown over and pulled back at the last moment.

"I just felt grubby, belittled. My self-esteem and confidence were totally shot."

Tackling the backlog

When the Nursing and Midwifery Council was set up a few years ago it inherited a £1.7m deficit.

If there is a situation where we have decided there is a real risk to public protection, those nurses are suspended and taken off the register so they can't work Sara Thewlis, Nursing and Midwifery Council

At the same time a change in the law has led to more cases being referred to its fitness-to-practise procedures.

Between 2004 and 2005, the number of cases going to a full hearing increased by 203%, according to NMC documents.

The council is now proposing to increase the annual fee to nurses from £43 to £80 from August 2007.

Fitness-to-practise proceedings use up almost half of the money raised from registration fees because the cost of hearing a case is about £6,000 a day.

NMC chief executive Sara Thewlis refused to comment on its own predictions of escalating delays in an interview with the BBC. She would only confirm that currently 345 cases are waiting to be heard.

The NMC has put an additional £1.2m into the fitness-to-practise hearings this year. Ms Thewlis said it had to balance various financial priorities, but insisted patient safety was not being compromised.

"If there is a situation where the NMC has decided there is a real risk to public protection, those nurses are suspended and taken off the register so they can't work."

After years of spiralling delays, the real test for the NMC will be to show that this year it is managing to reduce the backlog of cases to a level that reassures campaigners and patients.