NMC Guidelines
NMC Guidelines
NMC Guidelines
concerns
Guidance for nurses
and midwives
We are the nursing and midwifery regulator for England, Wales,
Scotland and Northern Ireland.
• W
e set the standards of education, training and conduct and
performance so that nurses and midwives can deliver high
quality healthcare consistently throughout their careers.
• W
e make sure that nurses and midwives keep their skills and
knowledge up to date and uphold our professional standards.
• W
e have clear and transparent processes to investigate
nurses and midwives who fall short of our standards.
* Taken from Chapter 14, Care and Support Statutory Guidance (2014) issued
by the Department of Health under the Care Act 2014 - https://www.gov.uk/
government/uploads/system/uploads/attachment_data/file/315993/Care-
Act-Guidance.pdf
2 Raising concerns: Guidance for nurses and midwives
also be particularly difficult for those of you who work and
live in remote and small communities. However, the health and
wellbeing of the people in your care must always be your main
concern. Raising your concern early can prevent minor issues
becoming serious ones, and so protect the public from harm and
improve standards of care.
If you are not sure how this guidance applies to your situation,
or if you want some confidential advice before you raise your
concern, or at any stage during the process, we recommend
that you get advice from your professional body, trade union or
the independent whistleblowing charity Public Concern at Work
(PCaW). PCaW provides confidential advice to employees who
witness wrongdoing or malpractice in the workplace and who
are not sure whether or how to raise their concern.
Professional bodies and trade unions can play a vital role in
offering local support and guidance to staff who have concerns
about any part of their work, including fears about patient
or client care. They can also raise matters formally with your
organisation on your behalf and can access other forums within
your organisation. Raising a concern can often seem isolating
and intimidating - having this support can help you to meet your
professional standards with more confidence.
You can find further information on where you can get advice
from page 21 onwards.
4 F
ailure to report concerns may bring your fitness to
practise into question and put your registration at risk. If
you experience any negative reactions within your workplace
after raising a concern appropriately, you should contact
your professional body or trade union for support and advice.
5 In line with the Code, we expect nurses and midwives to work
with others to protect the health and wellbeing of those
in their care. As a result, this guidance applies to a wide
range of situations, not just where a concern relates to the
practice of individual nurses and midwives. Examples may
include the following.
5.1 Danger or risk to health and safety, such as where health
and safety rules or guidelines have been broken.
5.2 Issues to do with staff conduct, such as unprofessional
attitudes or behaviour, including concerns related to
equality and diversity.
5.3 Issues to do with delivering care involving nurses,
midwives or other staff members.
5.4 Issues to do with care in general, such as concerns over
resources, products, people, staffing or the organisation
as a whole.
5.5 Issues to do with the health of a colleague, which may
affect their ability to practise safely.
Nursing and Midwifery Council 5
5.6 M
isuse or unavailability of clinical equipment, including
lack of adequate training.
5.7 Financial malpractice, including criminal acts and fraud.
6 Y
ou do not need to have all the facts to prove your concern
but you must have a reasonable belief that wrongdoing is
either happening now, took place in the past, or is likely to
happen in the future.
22 Immediate concerns
If you witness or suspect that there is a risk of immediate
harm to a person in your care, you should report your
concerns to the appropriate person or authority
immediately. You must act straightaway to protect their
safety.
25 W
hile you should also keep a record of any written or verbal
communication that you send or receive from your employer,
be aware of the need to protect confidentiality. For example,
if you need to refer to an incident with a particular patient
or client, record details of the event and take appropriate
steps to maintain confidentiality.
Concern Stage 4:
Stage 3: You Take your concern
Take your not dealt should get
with advice further to a
concern further properly, or healthcare
to a higher level immediate (see below) regulatory
risk to organisation
others
(or both)
Getting advice
If you are not sure about whether or how to raise a concern
at any stage, you should get advice.
You can get independent, confidential advice from your
professional body, trade union or PCaW. Students can also
speak to their university tutor or mentor.
36.5 K
eep the employee who raised the concern up to date
with what’s happening. This will give them and others
confidence in the system.
36.6 T
ake action to deal with the concern and, record and
monitor this action.
36.7 M
ake sure staff who raise concerns are protected
from unjustified criticism or actions.
43 E
mployers can also refer to our publication Advice and
Information for employers of nurses and midwives (NMC,
2012). www.nmc-uk.org/Publications/Information-for-
employers/
Independent organisations
Public Concern at Work (PCaW)
020 7404 6609
www.pcaw.co.uk
Whistleblowing Helpline (England only)
08000 724 725
www.wbhelpline.org.uk
Medical Defence Union
0800 716 646
www.the-mdu.com
Medical and Dental Defence Union of Scotland
0845 270 2034
www.mddus.com
England
Care Quality Commission
03000 616 161
www.cqc.org.uk
Ofsted
Regulator of education, early years and children’s social care
0300 123 1231
www.ofsted.gov.uk
Wales
Care and Social Services Inspectorate Wales
Responsible for social services and care homes.
www.cssiw.org.uk
Health Inspectorate Wales
Responsible for all NHS-funded care (including independent
hospitals).
0300 062 8163
www.hiw.org.uk
Department for Health and Social Services (Wales)
English 0845 010 3300
Welsh 0845 010 4400
www.wales.gov.uk
Scotland
Care Inspectorate
0845 600 9527
www.careinspectorate.com
Healthcare Improvement Scotland
Edinburgh 0131 623 4300
Glasgow 0141 225 6999
www.healthcareimprovementscotland.org
Northern Ireland
Regulation and Quality Improvement Authority Northern Ireland
028 9051 7500
www.rqia.org.uk
Department of Health, Social Services and Public Safety (Northern
Ireland)
028 9052 0500
www.dhsspsni.gov.uk
Crown dependencies
Jersey
States of Jersey, Health and Social Services Department
01534 442 000
www.gov. je
Guernsey
States of Guernsey, Health and Social Services Department
01481 725 241
www.gov.gg
Isle of Man
Isle of Man Government, Department of Health
01624 642 608
www.gov.im
NMC publications
• he Code: Professional standards of practice and behaviour
T
for nurses and midwives (2015).
• A dvice and information for employers of nurses and midwives
(2014).
External publications
• B
eing open: communicating patient safety incidents with
patients, their families and carers (2009) National Patient
Safety Organisation.
• C
onfidentiality: NHS Code of Practice (2003) and
supplementary code of practice on public interest disclosures
(2010) Department of Health.
• N
HS Constitution (2009) Department of Health.
• C
are and Support Statutory Guidance (2014) issued by the
Department of Health under the Care Act 2014.
• S
afeguarding adults: A national framework of standards for
good practice and outcomes in adult protection work (2005)
Association of Directors of Social Services (Northern Ireland,
Wales and England).
• S
peak up for a healthy NHS (2010) Department of Health, the
Social Partnership Forum and Public Concern at Work.
• B
ridging the Gap Summary Report (2013) Whistleblowing
Helpline.