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

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

Sorry is the Easiest Word to Say

On 26^th January, Jeremy Hunt apologised in Parliament, over the death of a one year old boy from septicaemia. Hunt said: “Whilst any health system will inevitably suffer some tragedies, the issues in this case have significant implications for the rest of the NHS that I'm determined we should learn from." (1)

But how can he say he is “determined” to learn from it when the changes brought in his government party lead to this boy’s death.

William Mead (The one year old boy) died on 14^th December 2014 from septicaemia, secondary to pneumonia. The boy’s parents had repeatedly taken him to his GP and repeatedly called to NHS 111 about William’s deteriorating health. The official NHS England report (Only published in January 2016) stated that if the Call Handler (Non-clinically trained staff who answer NHS 111 calls), who spoke to William’s parents the last time they called, had recognised how seriously ill the child was, William’s death may have been prevented (1). This is very demanding.

NHS 111 has been plagued with problems; poor staff training (3) using untrained temporary staff and poor supervision of staff (3), claims of being “dangerously understaffed” (4) and an uncomfortable lack of clinical staff (5). In January this year; Integrated Care 24, which handles NHS 111 and out-of-hours GP calls in Norfolk and Wisbech, was criticised for not publishing a damning, leaked report into their performance. The report stated that people had to wait 12 hours for a call-back, which caused significant patient safety issues, a lack of GPs employed there and the poor level of staff recruitment (2). This was over a year after William’s death.

To be cynical it always looked like NHS 111 was brought in as a cheap replacement to its predecessor, NHS Direct, but what other conclusion can be drawn. NHS Direct employed experienced nurses to triage all symptomatic callers (Any call about a person with medical symptoms) and gave them appropriate advice, these nurses were employed on the equivalent of Band 6 and above. With NHS 111 all calls are triaged by non clinical call handlers, using computer algorithms (a computerised assessment system), which seems to be a tick-box assessment. These call handlers only have six weeks training (6). They do not have the clinical experience to recognise when something is wrong, when symptoms do not sound “right”, when there are complications that increase the severity of a person’s symptoms. There are nurses available in the call centres but they don’t triage calls, they are there to advice the call handlers. There have also been whistleblower claims that NHS 111 is short of these nurses (5).

I used to work for NHS Direct (Back at the beginning of the millennium) as a Nurse Advisor. Telephone Triage (Assessing patients over the telephone) is a difficult and complicated skill, because you cannot physically examine the person so you have to carefully talk to them to get a “picture” of their symptoms. I couldn’t have safely done that without the years of nursing experience I had built up before starting that job to call on. Many of the people I spoke to had a poor basic knowledge of their bodies, what is normal and what are symptoms of illness. I do not know how we can expect non-clinical call handlers to do this complicated assessment, it is more than just reading questions off a screen.

I have repeatedly turned down offers of jobs at NHS 111 in the last four years and always for the same reason, I do not feel it is clinically safe and I don’t want to work for a clinically unsafe organisation. It may sound selfish, but I want to keep my registration as a nurse.

Unfortunately I do not see NHS 111 improving any time too soon. Jeremy Hunt has proved very deaf to the concerns of healthcare professionals and this Government has reduced their spending on the NHS (7). Are they willing to spend the money it will take to make NHS 111 a safe service?

Drew Payne