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Professional Regulation

NMC has no plans to reinstate the nurse struck off in Bawa-Garba case

Ms. Amaro admitted that a sanction should be imposed but implored the panel not to remove her from the register. 



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David R Gee / Alamy

The Nursing and Midwifery Council has revealed it has no plans to review the fitness to practice case of Isabel Amaro.

Ms. Amaro was working as an agency staff nurse within the Children’s Assessment Unit at the Leicester Royal Infirmary at the time of the tragic death of six-year-old Jack Adcock.

Amaro was accused of contributing to the death of the six-year-old by failing to complete basic physiological observations and not recording his fluid balance. But, Amaro claimed her concerns about the child went unheard simply because she was an ‘agency nurse’ after a senior nurse on the unit said she should not escalate any concerns beyond her.


Nurse Isabel Amaro and Dr Bawa-Garba were both convicted of manslaughter by gross negligence in 2015 and handed two-year suspended prison sentences.

Others made more serious errors.

During the Fitness to Practise (FtP) hearing in August 2016, Ms. Amaro admitted making mistakes but claimed others had made more serious errors. Ms. Amaro told investigators that she felt the trust was using her as a scapegoat over the death and felt there were systematic failings within the Children’s Assessment Unit at the Leicester Royal Infirmary.

At the time, Ms. Amaro admitted that a sanction should be imposed but implored the panel not to remove her from the register after proving the regulator with references which attested to Amaro’s ‘high standards of practice’.

The NMC made the decision to remove Ms. Amaro from the register in July 2016.

Earlier this week, following a high court appeal, Lord Chief Justice Lord Burnett, the Master of the Rolls Sir Terence Etherton and Lady Justice Rafferty unanimously reversed the General Medical Council’s ruling to remove Dr. Bawa-Garba from the medical register.

A Nursing and Midwifery Council spokesperson told the NursingStandard that Ms Amaro’s case would not be reopened; “An independent panel took the decision to strike Ms Amaro from our register after hearing all of the evidence in the case and taking her conviction and suspended custodial sentence into account.”

We need the adequate number of staff with the right skills.

The Royal College of Nursing has said that healthcare needs to be viewed as a safety critical industry and we need to focus on preventing future mistakes rather than assigning blame.

Donna Kinnair, Director of Nursing, Policy and Practice at the Royal College of Nursing, said;  “Health care should be viewed as a safety critical industry, with a focus on learning and preventing future mistakes. Continuing down the path we have witnessed in the Bawa-Garba case risks creating an environment in which individuals feel afraid to come forward, or even to work in pressurised, understaffed environments for fear of blame.

“Safe and effective care can only be achieved with an adequate number of staff with the right skills, in the right place at the right time. We urgently need a workforce plan for England that responds to patient need, and prioritises recruitment and retention.”

Professional Regulation

NMC apologises after misleading Morecambe Bay investigators

Up to 19 babies and mothers died between 2004 and 2012 as a result of mistakes by staff.



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The regulator has apologised over how it handled a Fitness to Practice investigation.

The Nursing and Midwifery Council (NMC) has apologised over how it handled a Fitness to Practice (FtP) investigation following the tragic death of newborn Joshua Titcombe at Morecambe Bay.

The independent review by Verita was commissioned by the NMC after the Professional Standards Authority (PSA) raised concerns over how the regulator handled the fitness to practice investigation.


The report was initially commissioned by Jeremy Hunt, the then Secretary of State for Health and Social Care, after up to 19 babies and mothers died at the hospital between 2004 and 2012 as a result of mistakes by the staff of its maternity unit.

Jackie Smith, the former Chief Executive and Registrar of the NMC, resigned on the eve of the PSA report.

‘Incorrect and misleading statements’.

Investigators highlighted concerns over a chronology that was submitted as evidence by Joshua’s parents. They commented that they regulator failed to include the chronology in the evidence gathering process and also failed to “consider and understand the significance of this evidence and its relevance to a central issue in the case.”

The NMC then went on to make “incorrect and misleading statements” to Joshua’s parents, the PSA and the Secretary of State for Health about how it handled and reviewed the chronology.

Verita also commented that the regulator failed to treated witnesses “with the respect and sensitivity they deserved”.

Investigator on to recommend that the “NMC should make it a priority to ensure that it treats families and patients with respect and is honest and open with them” and “ensure that Panel Chairs are fully briefed about the importance of showing respect to bereaved relatives, perhaps by using this example as a case study.”

The total cost of Verita’s report was £151,742.22.

‘I am very sorry’.

Andrea Sutcliffe CBE, the current NMC Chief Executive and Registrar, said: “Throughout these fitness to practise cases the way we treated Mr Titcombe and his family was unacceptable. Our actions made an awful situation much worse and I am very sorry for that. I am also very sorry that our communications with Mr Titcombe, the PSA and the Secretary of State for Health and Social Care contained incorrect and misleading information about our handling of this evidence.”

“This investigation highlights a number of failings at the NMC at that time. We did not properly understand the significance of this important piece of evidence, in particular to Mr Titcombe and his family, and we did not put it before the panel when we should have done. This reflected a culture at the NMC at that time that prioritised process over people.”

“Since the events at Morecambe Bay we have made significant changes, including much improved record keeping, the introduction of a new public support service, and additional training for panel members to help them better understand the needs of witnesses.

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Professional Regulation

NMC launches an emotional support helpline for staff involved in fitness to practise cases

The helpline is part of the NMC’s bid to become a “person-centred” regulator.



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The helpline will provide emotional and practical support for staff involved in the fitness to practise processes.

Nurses, midwives and nursing associates involved in fitness to practise can now benefit from a new, free and confidential support service.

The NMC’s Careline, operated by an independent provider, will provide emotional and practical support is also available 24 hours a day, 365 days a year for nurses and midwives across the UK, and nursing associates in England, who are involved in the fitness to practise processes.


Staff can contact the service via phone, live chat or email, to discuss concerns with specially trained counsellors who are experienced in handling sensitive topics.

Launching less than a year since the NMC set up its support service for members of the public who raise concerns when things go wrong with their nursing or midwifery care, the 12-month CareLine pilot launched on World Mental Health day.

Becoming a ‘person-centred’ regulator.

Andrea Sutcliffe CBE, Chief Executive and Registrar at the NMC, said: “Following the launch last year of our Public Support Service for people affected by poor nursing or midwifery care, I’m really pleased we’re now able to offer this new pilot resource for professionals.

“The Careline marks another important step forward in truly humanising how we operate and becoming the person-centred professional regulator that the NMC is determined to be with everyone we interact with.

“Less than one per cent of around 700,000 professionals on our register are engaged in our fitness to practise procedures, but we know that it can have a profound effect on those that are. The impact on someone’s physical and mental wellbeing as a result of being under such scrutiny mustn’t go unrecognised.

“I hope the Careline, and our forthcoming remediation guidance, further encourages support and learning when things do go wrong in nursing and midwifery care. Together, let’s help ensure that all those involved in our processes are treated with kindness and respect.”

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