Maintaining Standards: Promoting Equality

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Maintaining StandardsPromoting Equality

• Natalie Salmon
• Head of Equality and Diversity
• NMC

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Contents

• Disability and the NMC
• Good health standards in context
• The DRC report
• The NMCs response
• Regulators working together

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Disability and the NMC

• The Nursing and Midwifery Council was formed in
  2002
• Recognising that a lot more could be achieved in
  the equality and diversity area a project board
  was set up in 2006
• In September 2007 the Equality and Diversity unit
  was established

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Priorities for the NMC

• Encouraging existing staff to feel comfortable
  disclosing disabilities
• Attracting more disabled people to apply for jobs
  at the NMC
• Developing a more proactive customer service
  response for disabled customers
• Leading on the Good Health Standards work
• Equality Impact Assessing health related fitness
  to practise procedures including providing
  training on the DDA and Disability Equality Duty
  for staff and panelists

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Why Good Health?

• Dating from a different time, when infectious
  diseases like TB were of great concern
• Disabled people were the ones being looked after
  by nurses
• Medical techniques were also very different
• Preconceptions and stereotypes about nurses being
  the epitome of health, fitness and youth.

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Times change

• In the 1930s nurses who had illegitimate babies
  were barred from nursing. They were seen to have
  bad character
• In 1974 my married mother was forced to leave her
  RAF nursing course 4 months before her final
  exams because she was pregnant with me. (2 years
  before the sex discrimination Act 1975)

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Attitudes to disability have changed

• First half of 20th Century blind people protested
  for the right to work, be paid or receive state
  support if forced out of work
• Attitudes changed after the two world wars due to
  the numbers of disabled service men
• The social model of disability coined 1970s
• The Disability Discrimination Act 1990s

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Other tricky professions

• Police service
• Fire service
• Prison Service
• Teaching

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What is wrong with Good Health then?

• Discourages potential nurses with disabilities or
  health conditions from applying in the first
  place.
• It doesnt encourage retention of staff and
  expertise.
• It doesnt do the public protection role it is
  supposed to.
• Grounds to being admitted on to the register
  should be competency based and take into account
  reasonable adjustments and changes in nursing.

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DRC recommendations

• Remove all requirements for good health or
  physical and mental fitness that are within their
  remits.
• Review their statutory disability equality
  schemes and involvement of disabled people.
• Carry out impact assessments of
• their policies, practices and procedures
• their processes for assessing fitness to
  practice, for example fitness to practice
  hearings
• English language standards and competence
  standards in general
• their main methods of communication with actual
  and potential professionals.
• Where competence standards are found to have an
  adverse impact on disabled people, consider
  whether they are necessary and, if they are, how
  adjustments can be made to enable disabled people
  to meet the required standards.

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• Carry out or commission research on the provision
  of reasonable adjustments for students (during
  university based training and work placements)
  and pull together information about good
  practice.
• Issue guidance to help higher education
  institutions to make adjustments to enable
  disabled people to meet the competence standards.
• Review systematically existing publications and
  examine the quality of advice given verbally to
  individuals and higher education institutions.
• Review registration application processes to
  ensure that disabled people are not disadvantaged
  and ensure that there are adequate feedback and
  complaints procedures.
• Where appropriate, continue to make enquiries in
  relation to prospective registrants about
  conditions which are not covered by the DDA, such
  as alcohol and drug dependence, paedophilia and
  kleptomania.
• Not use a failure to disclose a disability or
  long-term health condition as evidence of bad
  character or as something that should lead to
  disciplinary action.

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The NMCs response

• Held the first joint regulator equality and
  diversity forum. DRC findings on the first
  agenda.
• Publicly said that we agreed with the sentiment
  and recommendations of the report but the NMC
  could not take forward all of the recommendations
  alone
• Contact the DfH to find out what they propose to
  do and offer our willingness to help and be
  involved
• Set up an expert panel of disabled people
  including registrant representatives to advise.
• Consult more widely
• Hold a seminar in March 2009 which will report
  back solid actions.

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Future work for all regulators and employers

• Regulators need to work together on this
• We will all need to work with the Department for
  Health
• We will need to work with disabled people, nurses
  and midwives and respective stakeholders
• Good practice around reasonable adjustments needs
  to be shared with employers and education
  establishments.