A review from the Professional Standards Authority (PSA) found that the Nursing and Midwifery Council (NMC) took too long to act on public concerns about midwives.
Between 2004 and 2013, 11 babies and 1 mother died at Furness General Hospital, Barrow, Cumbria, which launched an investigation into fitness-to-practise concerns.
‘The NMC’s approach to the Morecambe Bay cases – in particular the way we communicated with the families – was unacceptable and I am truly sorry for this,’ said Jackie Smith, chief executive of the NMC.
‘We take the findings of this review extremely seriously and we’re committed to improving the way we communicate with families, witnesses and all those involved in the fitness to practise process.’
The PSA identified several occasions where the NMC didn’t act or keep sufficient records and raised the following concerns:
- A lack of clinical knowledge in both its Fitness to Practise teams and its external lawyers
- Over-reliance on local investigatory reports
- Failing to engage with the points raised by the families
- Failing to engage with the information provided by Cumbria Police.
There was also evidence that warnings from the police were unheeded for nearly 2 years as well as ‘cultural failings’ where the family’s safety was disregarded and they were not told the truth about mistakes that were made.
Ms Smith, who will now be stepping down from her position, went on to say that that NMC has made significant changes, claiming that the organisation is ‘very different’ and they are now putting vulnerable witnesses ‘at the heart’ of their work.
The PSA report criticised the NMC for taking 8 years to conclude fitness-to-practise hearings, meaning that midwives who were later struck off the register continued to work during this time.
Philip Graf, chair of the NMC, has said they will act on the ‘lessons learned’ and work closely with the PSA and other regulators to put into action the report’s recommendations.
‘We were particularly horrified that even when Cumbria Police directly raised significant issues, the NMC effectively ignored the information for almost two years,’ said three families who lost loved ones at Furness General Hospital in a joint statement.
‘Whilst this was going on, serious incidents involving registrants under investigation continued, meaning lives were undoubtedly put at risk.’
‘Avoidable tragedies continued to happen that could well have been prevented.’