Witness information Investigations
We are the nursing and midwifery regulator for England, Wales, Scotland, Northern Ireland and the Islands. We exist to safeguard the health and wellbeing of the public. We set the standards of education, training and conduct that nurses and midwives need to deliver high quality healthcare consistently throughout their careers. We ensure that nurses and midwives keep their skills and knowledge up to date and uphold the standards of their professional code. We ensure that midwives are safe to practise by setting rules for their practice and supervision. We have fair processes to investigate allegations made against nurses and midwives who may not have followed the code. 2 Witness information Investigations
Contents Introduction 2 Frequently asked questions 3 Glossary 16 Forms 18 Witness expenses claim form 19 Change of address form for witnesses 21 1 Witness information Investigations
Introduction When we receive an allegation about a nurse or a midwife the Screening team assesses any allegation before deciding whether to refer it to the Investigating Committee for a decision. In carrying out its assessment the Screening team decides if there is an allegation of impaired fitness to practise at all and if so, if it is in the form required by our legislation and the Council. If we decide to proceed with the matter we will carry out a full investigation into the allegation so that the Investigating Committee can make an informed decision as to whether or not there is a case to answer and where necessary, the Conduct and Competence Committee or Health Committee can make a final decision on what to do. This leaflet has been produced to answer any questions you might have about investigations and acting as a witness. We hope that you find it useful. 2 Witness information Investigations
Frequently asked questions How does the NMC know if there is a problem? We rely on employers, colleagues, patients and members of the public to let us know if they have any reason to be concerned about a nurse or midwife s fitness to practise. If someone wishes to refer an incident to us they must do so in writing. They must also give their consent for us to show this to the nurse or midwife in question. In some circumstances where the NMC does not receive an allegation, but where it appears that there should be an investigation into the fitness to practise of a nurse or midwife or into their entry in the register, it may refer the matter to the appropriate person or committee. When this happens the NMC Registrar is the referrer. All of the information we receive or obtain will be sent to the nurse or midwife so they have an opportunity to comment. We will then commence our investigation. What does an investigation involve? If you have reported the incident to us, or if your name has been given as a possible witness, an NMC case investigation officer, or a legal firm acting on our behalf, will speak with you to discuss what you saw and to build up a clear picture of what took place. You will be given a six digit case reference number which you should quote in all correspondence and telephone calls with the NMC. The person investigating the case will interview witnesses, gather evidence, and draft witness statements and reports. The results of their investigation will then be given to a panel of the Investigating Committee, so that the panel can decide how to deal with the case. 3 Witness information Investigations
Who is a witness? Usually, we will want to talk to the people who actually saw the reported incident, or some part of it. Incidents usually occur in the workplace, such as a hospital or a nursing home, so witnesses are often colleagues, including fellow nurses, midwives or care assistants. Sometimes, a patient or member of the public will be the witness. Even if you did not see the incident, we may still need you to give us background information or documents relating to the case. Why does the NMC want to speak to me and not others involved in the incident? The person investigating the case will have studied all the documents that were forwarded to us, usually by the relevant employer. If we have asked to speak with you it is because, at this stage, we think it will help if you tell us what you saw or did in relation to the event. We may also want you to give us any relevant documents you might have. Even though you may not think that you saw anything important, you might still be able to help with the investigation, so a conversation with you will help ensure that our investigation is thorough and fair. 4 Witness information Investigations
Will the NMC speak to patients? We may speak to patients if it helps our investigation. We always try to give them a chance to talk to us if they want to. We will not speak to patients if doing so could harm their health or wellbeing in any way. Generally, we will consult the professionals involved in their care before deciding whether or not to make contact with a patient. What if I don t want to act as a witness? The NMC has a duty to safeguard the health and wellbeing of anyone who comes into contact with a nurse or a midwife. Because of the nature of the work, this will often involve regular and unsupervised contact with very vulnerable people such as children, the elderly, adults with learning disabilities, and people whose ill health has made them vulnerable. We need your help to make sure that all nurses and midwives are competent and safe to carry out their professional duties. Support for NMC investigations is vital to our success in safeguarding the health and wellbeing of the public so much so that it is written in The code: Standards of conduct, performance and ethics for nurses and midwives (The code) which all nurses and midwives must adhere to. Published in April 2008, the code can be downloaded from our website www.nmc.org.uk. 5 Witness information Investigations
Past and present versions of the code require nurses and midwives to cooperate fully with internal and external investigations, and make it clear that failure to do so may result in their registration being called into question. If you are not a nurse or a midwife, you are not bound by this code. However, if you are a healthcare or medical professional, your own professional code of conduct may carry a similar requirement. Whilst members of the public are not bound by a code of conduct we would hope that, like us, they would want to play their part in safeguarding the health and wellbeing of the wider public and would want to engage in our investigation. In exceptional circumstances, a witness can be served with a formal summons but this is something that we would only consider if all other avenues have been exhausted. The summons is a legal requirement for a witness to appear at a hearing, and, if a summons is ignored, legal action can be initiated for contempt. 6 Witness information Investigations
What about the nurse or midwife? The person who has been referred to us will be told that an investigation is being carried out into their practice and conduct. They will also have a case officer managing their case who they can contact at any time. The case officer will keep them up to date and answer any questions they might have about the process. Some witnesses feel guilty about providing evidence about a friend or a colleague. However, nurses and midwives must act in accordance with the code and recognise their role and the NMC s duty to make sure that everyone on the register is fit to practise. How is the investigation carried out? In most cases we will liaise directly with the organisation or individual who reported the case. The person investigating the case will arrange a time either to meet with each witness or interview them over the phone. Most interviews are conducted over the telephone and arrangements will be made so that the interview takes place at a time convenient to you when you will be able to discuss the matter in private without being disturbed. Meetings may take place at the hospital or care home where the alleged incident took place. Usually, we ask one of the people working there to make arrangements for the interviews. In certain circumstances, if the witness feels uncomfortable about meeting the investigator at work, we will try to find an alternative location. If the complaint is from a member of the public, we try to organise a convenient and neutral place to meet. Where necessary, we will accommodate any special needs and make sure that the location has wheelchair access. We will also reimburse all reasonable travel expenses. 7 Witness information Investigations
Can someone sit in with me during the meeting? Yes, we would be happy for you to have a friend or colleague sitting in with you during the meeting if it makes you feel more comfortable. However, this should not be another witness in the case. The person who comes with you will not be allowed to have any input into the conversation about the events. Any information you give us must be your own and come from you. You decide whether or not you want someone to come with you. If you are uncomfortable with a colleague sitting in with you, but your employer wants this to happen, you should tell the interviewer so that they can make your feelings clear. What questions will I be asked? You will be asked about what you saw, or did, in relation to the incident. You may be asked why the incident caused you concern. You may also be asked to provide relevant documents. There is no need to worry. This does not mean that we are investigating you, your actions or those of the other witnesses. It simply means that we need to have the clearest picture possible of what took place, so that our investigation is fair. To help us achieve this aim, we will need you to tell us as much as you can about what happened. We will also need your contact details, so that we can keep in touch with you right the way through the case. You may be asked about your employment history, experience, and qualifications, but only if this is relevant to the case. You will also be asked if you have any criminal convictions or cautions. We need to have the clearest picture possible of what took place, so that our investigation is fair. 8 Witness information Investigations
Why will I be asked about convictions or cautions? The NMC is required by law to investigate cases in a fair and neutral way. This means that we have to find out about anything that might help the person being investigated, or that might undermine the NMC s case. Very occasionally, witnesses have criminal convictions or cautions that are relevant to the case. When this happens, the person under investigation has to be told about them. If the conviction or caution is not relevant to the case, we will not tell anyone about it. For instance, we do not usually tell anyone about driving offences. What if I am going to move my home or job soon? We would still like to speak to you even if you are going to be starting a new job or moving away. If this is likely, we would ask you to tell us as soon as possible, so that we can keep in contact with you during the case. You can use the change of address form at the back of this leaflet. How long will the investigation take? We aim to complete the investigations stage within twelve months of the referral, but most cases are completed in less than that. However, sometimes they may take longer than this if we have problems identifying or locating witnesses, or getting the evidence we need. We will keep you up to date with any developments in the case, but we need your help to make sure we can finish our investigation as quickly as possible. 9 Witness information Investigations
The events took place a long time ago. How am I supposed to remember what happened? The investigator will know what they want to ask you about, and they will have copies of documents which may help you remember what took place. These will be documents that you saw at the time of the incident. It might be the statement you wrote for your employer, the incident report form that you filled in, a completed medication administration record or the patient s care plan. If you are a member of the public or not part of an organisation, you will be shown a copy of your original letter of complaint to help you remember. The investigator will not expect you to remember every detail of what took place. They will understand that time has passed and that you may need to refresh your memory. What will happen during the interview? During the meeting the investigator will ask you questions about what you saw or did. They will take notes of what you say and then type these up on your behalf into a document called a witness statement. Any documents that are mentioned in your witness statement may be attached to it. These will then be known as exhibits. Exhibits help tell the story of what happened and contain useful information that can be read alongside your witness statement. 10 Witness information Investigations
When will I receive my witness statement? We will send you your NMC witness statement as soon as possible after the interview. We will ask you to read it carefully to make sure that it accurately reflects what you saw, or did. If you would like to change it, or add to it, you can do this. As soon as you are satisfied that it is correct, we will ask you to sign, date and return it to the NMC investigator. You must do this as quickly as possible, so that the investigation is not delayed without good reason. What will happen to my witness statement? A copy of your witness statement, all of the other witness statements in the case and an accompanying report from the investigator will be sent to the Investigating Committee. A copy will also be sent to the nurse or midwife under investigation. Why does the person under investigation have to see a copy of my witness statement? It is very important that the nurse or midwife who is being investigated knows what information we have about them, and how we are going to use it in a case against them. This gives them a fair chance to answer the case and give their own explanation of events. 11 Witness information Investigations
What happens after the investigation? A panel of the Investigating Committee meets to decide if there is a case to answer on the basis of the evidence gathered during the investigation. The Investigating Committee is made up of nurses and midwives, and people outside the profession. A panel will read the evidence and decide what action to take. Their four main choices are to: close the case and keep a record for three years carry out further investigations refer the case to the panel of the Conduct and Competence Committee refer the case to a panel of the Health Committee in some circumstances. We will write to let you know the panel s decision. What happens if the case is referred to a panel of the Conduct and Competence Committee? The Conduct and Competence Committee has the power to order a meeting or hearing and to make the final decision about the case. A meeting takes place in private and the outcome of the case is decided using only the case documents, including your witness statement. Usually, a meeting is used for simple cases where the nurse or midwife admits their actions fully. As meetings are held in private witnesses may not attend. We will write to let you know if a meeting is ordered. A hearing takes place in public and the panel will hear evidence from the witnesses in person. You are likely to be asked to attend the hearing to give the evidence contained in your witness statement. 12 Witness information Investigations
As with the Investigating Committee, the Conduct and Competence Committee is made up of nurses and midwives, and people outside the profession. Where will the hearing take place? Hearings usually take place in Belfast, Cardiff, Edinburgh or London depending on where the person under investigation lives. As a witness, we will pay your travel and other reasonable expenses if you have to attend a hearing. Where can I obtain further information about attending a hearing as a witness? If the case you have provided a witness statement for is referred to a hearing, you should refer to our leaflet Witness information: Hearings, also available on our website at www.nmc.org.uk/ concerns-nurses-midwives/information-for-witnesses Do all cases result in a final meeting or hearing? Nurses and midwives who admit all the charges against them may be able to provisionally agree a sanction with the NMC before the final meeting or hearing is held. The provisional agreement will then be put before a Conduct and Competence or Health Committee panel, which will have the final decision on whether to accept or reject it. If a consensual panel determination is reached this reduces the likelihood that witnesses will need to be called. Cases where the panel reject the proposed sanction will be considered in full by a fresh panel, and you will continue to be required as a witness. A nurse or midwife who admits that their fitness to practise is impaired and who does not intend to continue practising, can, in limited circumstances, apply to be permanently removed from the register. The application for voluntary removal will not be 13 Witness information Investigations
considered until a full investigation into the allegations has been completed. If the application is approved, there will be no public hearing and witnesses will not be called upon further. We will let you know if the nurse or midwife s case is resolved by a consensual panel determination or if they are granted voluntary removal. Who should I contact if I want to discuss the case? If you would like to discuss the evidence contained in your witness statement or check on the progress of the case, you should contact the investigator who interviewed you. You will have been given their contact details and the NMC six digit case reference number which you will need to quote. If the investigation has been completed and referred to the Conduct and Competence Committee by the Investigating Committee panel, the case will be passed to our Case Preparation Team and assigned to a new case officer. A hearings coordinator from our Scheduling team will contact you to make arrangements for your attendance at the final hearing, if required. 14 Witness information Investigations
Thank you Without the evidence provided by witnesses we would not be able to safeguard the health and wellbeing of the public, so we would like to thank you for agreeing to act as a witness. We recognise the valuable contribution you have made to this investigation, and understand that some witnesses may find the process difficult and intimidating. Your help is greatly appreciated. 15 Witness information Investigations
Glossary Case officer responsible for the administration and management of the case. Case investigation officer responsible for the administration and management of the case and carrying out the NMC legal investigation; conducts interviews with witnesses, drafts witness statements and reports. Conduct and Competence Committee made up of nurses and/or midwives and lay people (people who have had no nursing or midwifery training), the committee has the power to order a meeting or hearing and to make the final decision about the case. Fit to practise that a nurse or midwife is able to remain on the register without any restrictions. Investigating Committee made up of nurses and/or midwives and lay people (people who have had no nursing or midwifery training), the committee has the power to order investigation and decide if there is a case to answer. 16 Witness information Investigations
Paralegal conducts interviews with witnesses, drafts witness statements and reports. Register the NMC register that contains the names of all of the men and women who have qualified and are able to work as a nurse or midwife in the UK. Registrant nurse or midwife on the NMC register. Statutory body the NMC is a statutory body, which means that it is an organisation which was created through laws passed by the government in order to fulfil a particular role. The NMC is not part of the government. Statutory duty a duty that a statutory body is required to fulfil by law. 17 Witness information Investigations
Forms 1. Witness feedback form The NMC aims to provide the best standard of witness care possible. In order to assess our level of service, and to help us improve our service in the future, we would be grateful if you could spare a moment to complete the online version of this form at: www.nmc.org.uk/concerns-nurses-midwives/ customer-service. Alternatively you can request a printed version from us. 2. Witness expenses claim form Use this form to claim back any expenses incurred while you were acting as a witness at a hearing of the Conduct and Competence Committee. Please write clearly and answer all questions so that we can deal with your claim quickly. You must send proof of all expenses by providing purchase receipts (not just credit or debit card receipts) or we may not be able to refund your costs. To reduce costs, we ask you not to travel by car or taxi unless in exceptional circumstances. If you do travel by car, you will need to tell us the size of the engine so that we can reimburse you at our current rates. If you travel by taxi, please give the name of anyone who shared the taxi with you. 3. Change of address form for witnesses 18 Witness information Investigations
Witness expenses claim form Use this form to claim back any expenses incurred while acting as a witness. Please write clearly and answer all questions. Car travel From Mileage to Engine cc Train/Tube fare(s) (please state whether single or return) Bus fare Taxi fare Names of people who shared the taxi with you (if any) Reason for travelling by taxi Meals and snacks Please give details (breakfast, lunch, dinner) Loss of earnings You must send us a letter from your employer which must include the number of hours lost, hourly rate of pay, and confirmation that you did incur loss of earnings for the days claimed. If you are self-employed, you must confirm the number of hours lost, and send us a letter from your accountant confirming your hourly rate of pay. 19 Witness information Investigations
Other expenses (please give details) Total amount Full name Address Total amount claimed Name of the case in which you were a witness Case reference number Date(s) of hearing Signed Date Please return this form, together with proof of all expenses by providing purchase receipts (not just credit or debit card receipts), to: Business Support Nursing and Midwifery Council, 1 Kemble Street, London, WC2B 4AN FOR OFFICIAL USE ONLY 20 Witness information Investigations
Change of address form for witnesses Your name Name of the case in which you are a witness Case reference number Name of case officer as shown on the letters and documents we sent you Have you already been asked to tell us some dates when you would be available to attend the hearing? Have you already had a letter telling you the date of the hearing at which you will be giving evidence? yes/no yes/no I am changing my home address Old home address New home address New home phone number (if changed) New home email (if changed) Date of moving to new home address 21 Witness information Investigations
I am changing my work address Old work address New work address New work phone number (if changed) New work email (if changed) Date of moving to new work address Signed Date Please return your completed form to: Service Quality Manager Nursing and Midwifery Council, 1 Kemble Street, London WC2B 4AN FOR OFFICIAL USE ONLY 22 Witness information Investigations
Useful contacts If you have any questions about the case you are a witness in, please contact your Case Investigation Officer or Hearing Coordinator. If you would like to observe a hearing, call the NMC offices on 020 7681 5502 or email fitness.to.practise@nmc-uk.org. 23 Witness information Investigations
Contact us Nursing and Midwifery Council 1 Kemble Street London WC2B 4AN 020 7333 9333 fitness.to.practise@nmc-uk.org www.nmc.org.uk This edition of Witness information: Investigations was published in April 2013. 24 Witness information Investigations