Monday 28 November 2016

The NMC Disappoints Me Again, Why Aren’t I Surprised

I am disappointed and disillusioned by the NMC (Nursing and Midwifery Council). What can I do about it?

Last week their tribunal found Donna Wood guilty of “dishonesty” (1) and she has been suspended from practising as a nurse for two months (2). Yet this whole process has left a nasty taste in my mouth because from all the reports I have read of her tribunal I cannot see what evidence they based their decision on.

Dr Martin Dheal, a consultant psychiatrist who also volunteered to look after Ebola patients in Sierra Leone, said: "I can't help but think that part of what's happened subsequently is just scapegoating, and trying to deflect blame on to individuals" (2). I agree with him. This and the persecution of Pauline Cafferkey (3) has left me with the deep feeling that NMC is not professionally regulating nursing, but is instead bowing to pressure from NHS institutions.

Donna Wood was accused of falsifying the record of Pauline Cafferkey’s temperature on a screening form at Heathrow Airport, yet the tribunal couldn’t even determine who wrote actually the temperature on the form (1).

Pauline Cafferkey, Donna Wood and Dr Hannah Ryan (A newly qualified doctor who also volunteered to look after Ebola patients) all took each other’s temperatures at the screening centre, when they arrived back into Heathrow from Sierra Leone, because there were no Public Health England clinicians available to do so (1, 2 & 4). 

From the reports of her tribunal I have read, Donna Wood seems to have been convicted only on the evidence of Hannah Ryan; yet Hannah Ryan is also facing a GMC disciplinary panel next year for her actions at Heathrow Airport (4), she physically took Pauline Cafferkey’s temperature. Why did the tribunal place so much emphasis on her testimony? Her testimony should have been questionable at most. Hannah Ryan was testifying to the NMC tribunal, ahead of her own GMC tribunal, the tribunal should have questioned how much of her testimony was placing herself in a good light. Her evidence was that it was Donna Wood who said to record a falsely low temperature on Pauline Cafferkey. In the end it seemed to be Hannah Ryan’s word against Donna Wood’s. 

There is a lot of discussion and evidence of the unreliability of eyewitness testimony on its own (5, 6, 7 & 8). In British law we have The Turnbull Guidelines (9) whereas if a defendant has been identified solely on eyewitness testimony then a judge has to give instruction to a jury on the unreliability of eyewitness testimony. This NMC tribunal has just seemed to have accepted Hannah Ryan’s testimony without question.

Donna Wood’s treatment at the hands of the NMC has left me feeling disgusted and also very unsafe. The evidence against her was thin and she was put into a ridiculous position by Public Health England’s chaotic organisation of the screening centre at Heathrow (This blog goes into much more detail of that); yet the NMC tribunal has found her guilty. The NMC does not seem to have questioned the nature of the complaint against her (Public Heath England brought complaints against Pauline Cafferkey, Donna Wood and Hannah Ryan after Pauline Cafferkey developed Ebola, shifting the blame?) nor have they seemed to question the nature of evidence against Donna Wood.

If a patient was to make a malicious and false complaint against me, what chance would I have to clearing my name if this is how the NMC works?

Drew Payne

Wednesday 23 November 2016

Just When I Thought the NMC Had Hit Rock Bottom…

They go and prove me wrong.

I was disgusted at the NMC’s treatment of Pauline Cafferkey, and expressed it in this blog. She was the nurse who contracted Ebola, while volunteering to look after Ebola patients in Sierra Leone, but her symptoms didn’t appear until she was on her way home. The NMC (Nursing and Midwifery Council) charged her with misconduct for having a temperature and for someone else recording it wrong. She wasn’t on duty, she didn’t take her own temperature and no one caught Ebola from her. She was cleared of all charges when the NMC tribunal collapsed and very quickly (1).

With the tribunal collapsing so fast I thought that it was the end of it all, but no. Not being able to prosecute Pauline Cafferkey, they have turned their attention to the woman who wrote down Pauline Cafferkey’s temperature.

Donna Wood is now facing charges of misconduct, bought against her by the NMC, the regulator of her own profession (2). She was one of the first British nurses to volunteer to look after Ebola patients in West Africa. She was on the same flight back to the UK as Pauline Cafferkey and she walked into the same chaos at Heathrow Airport as Pauline Cafferkey.

Public Health England (3) organised the screening of passengers at risk of being infected with Ebola at Heathrow Airport. But of this screening process was shown to be chaotic and extremely poorly organised (4). Half of the people screening passengers were administration workers from the Cabinet Office, with no clinician experience. The manager of the screening centre was a former Metropolitan police officer, not a doctor or a nurse, he didn’t have the clinical experience to run a screening centre and he didn’t even have the correct telephone number for the infectious diseases consultant at Northwick Park hospital, the north-west London hospital were any suspected Ebola patients were to be taken. Pauline Cafferkey were classified as category 2, which related to journalists and others who only visited Ebola treatment centres, and not category 3, which was for healthcare workers who had been looking after Ebola patients.

Donna Wood walked into all this chaos. She was tired after nursing Ebola patients for several months, wearing full protective clothing in a hot climate, she was tired from a long flight home, she was in a noisy and chaotic environment, is it any wonder she made a mistake writing down a colleague’s temperature. But she should never have been put into this position, she should never have been asked to check a colleague’s temperature. There should have been enough experienced healthcare professionals to screen passengers, healthcare professionals who knew what to do with a person who had a temperature.

Donna Wood wasn’t on duty when this occurred, she wasn’t caring for patients, she was passenger flying into Heathrow Airport. She was tired and in chaotic and unbelievably poorly managed environment. She made a momentary mistake, she misheard what another person said (She was not the person who actually took Pauline Cafferkey’s temperature) in a noisy environment. No one caught Ebola from Pauline Cafferkey, there was no cross infection, so why is Donna Wood being persecuted?

The NMC has a screening process where they check the validity of all complaints (5), they say they weed out complaints were there is no case to answer. Why weren’t Pauline Cafferkey’s and Donna Wood’s cases weeded out at this point? Both these complaints were made by Public Health England, in a blatant case of passing the blame and drawing attention away from them, yet the NMC seems to have just rolled over and done what Public Health England wanted.

Donna Wood’s tribunal has already begun (2), but I really hope it collapses the way Pauline Cafferkey’s did (1). Donna Wood does not deserve this treatment, even if she did write down the wrong temperature it was during an extremely chaotic situation. Would someone who had witnessed the horrors of Ebola first hand deliberately have covered up a potential case of it?

Public Health England has not been held responsible for the shambolic way they conducted the Ebola screening at Heathrow. They are the ones responsible for this mess and yet they are the ones still trying to pass the blame onto other people.

Public Health England and the NMC are both ultimately responsible to Jeremy Hunt, as Health Minister, and what has he said about this mess and passing of the blame? Nothing. I cannot find any statements of his about all of this, but then I am not surprised. He hasn’t proved himself a competent Minister of Health so far.

Pauline Cafferkey’s tribunal fell apart and hopefully Donna Wood’s will too. This has been a complete waste of time and money, none of this has been in the public interest and it borders on a witch hunt. Again the NMC has shown themselves as less than competent at regulating the nursing profession. How can I trust them to treat me with any fairness and honesty now?

Drew Payne

Saturday 19 November 2016

When Emails Go Wrong, And Wrong, And Wrong…

On Monday (14/11/2016) my NHS email crashed (1), leaving me very frustrated because I was waiting for an email from my manager. Nothing new there, many people may say because emails crash all the time, but my NHS Email crashed because it was full of emails.

NHS Email is the secure email system for NHS staff, it enables us to safely and securely send emails that contain patients’ details, which is vital for many of our jobs.

Monday’s crash began when one person managed to send an email, entitled “Test”, to everyone on the NHS Mail system. That was 1.2 million different people (2). Now this single email alone didn’t crash NHS Mail, what happened next did. Thousands of people, annoyed at receiving this email, replied to say to remove them from this email list, but many, many of them hit the Reply All button to do so. Their email then went out to all 1.2 million people on NHS Mail. Again and again this happened and rapidly the whole system was clogged up with emails.

The distribution list on the original email was disabled (1) but the harm had already been done. The email had gone out and thousands and thousands of people were hitting Reply All when they received it. I was still receiving those damn Reply All emails at gone 9 o’clock at night on Monday.

So an email system crashed, Google Mail has crashed more than once before now. But for many NHS staff we just can’t do our jobs without our NHS Mail. The District Nurse team I work in cannot function without NHS email. We get all our referrals via email. We communicate with GPs, other District Nurse Teams, Social Workers and other healthcare professionals via email. We get all our messages from patients via email. While out visiting patients we get messages via email, we all have work IPads. We also get our list of patients we are to visit via email. My colleague Christina said it was a “nightmare” on Monday when NHS Mail crashed.

Unfortunately hitting Reply All isn’t an uncommon problem on NHS Mail. Regularly at work, I receive emails to the whole of the District Nursing Service, usually about training or a planned meeting or such, and so many people hit Reply All instead of just replying to the sender. They share their email with the whole District Nursing Service. I get to know that she is on annual leave then and he is attending another meeting and she has child care issues, and so on. Personal conversations are blasted across the service, and they are never that interesting.

Monday highlighted another major problem though, a lack of training for NHS staff. We are not born knowing how to use email, it’s not “common sense”. For many people who use NHS Mail it is only time they use email, or if they use email at home it is not often. Many NHS staff are not highly computer literate, I know from working in the NHS for over twenty years, but today we simply expect that people know how to use IT. We don’t train people to use IT, so NHS Mail crashing is going to happen again.

The NHS is facing one of its worst funding crisis in living memory (The second half of this blog explains in detail how NHS funding is falling in real terms). When funding is short the first thing that is cut is staff training. Not just IT training but training across the board. There have been cuts to training budgets in all NHS trusts, ranging from 12% in some trusts right up to 45% in other trusts (3). Not training staff will have a detrimental effect on patient care. If staff are not trained how can they implement new treatments and new patient care strategies? Plans to improve NHS productivity, new methods and models of patient care to deal with the ever increasing demand, are being seriously undermined by these cuts to training budgets (4).

Again the NHS and patient care is being short changed by this government’s short sightedness. If we want the best quality healthcare then we need the best trained staff, and cutting training budgets will never achieve this.

And last irony from Monday’s crash, the original email that was sent out to everyone on NHS Mail was sent out by IT contractor at Croydon NHS (2).

Drew Payne.