Working without professional registration

Renewing registration with your professional healthcare regulator is no trivial matter – without it you may be unable legally to do your job.

MDDUS has noted a recent increase in reports of practice nurses continuing to work after inadvertent lapses in their Nursing and Midwifery Council (NMC) registration. An individual in such circumstances may turn up for work one morning and be unable to perform many or indeed any of the tasks or duties for which they are employed. This can impact not just the individual but an entire clinical team.

UK professional regulators remind all registrants that they have a personal responsibility to ensure that their registration status is current. Renewal notices are typically sent by text, email and/or post.

Lost in the post

Common circumstances in which someone may overlook renewing their registration include moving house and forgetting to update personal information, or changing email address – with reminders then being sent to the wrong place. Other factors can include personal or family illness and bereavement – and of course the pandemic has necessitated many clinicians working in unusual situations. Employers should therefore remain vigilant at times of personal distress or upheaval for whatever reason, and have a process in place to routinely check on the registration status of staff.

Lengthy readmission process

The NMC operates a policy where lapsed annual registrations automatically result in removal from the professional register. A nurse must then go through a process of readmission, which can take up to six weeks. The disruption this can cause speaks for itself.

Doctors overlooking their annual renewal must also go through an administrative process to re-register. The General Medical Council (GMC) may decide to call a doctor to a hearing if the lapse has been long or inadequately explained.

The General Dental Council (GDC) requires the completion of a form to enable registration to be restored. This asks if you have been working as a dentist in the UK during the time you were not registered. If the answer is "yes", you are advised by the GDC to contact your solicitor or defence organisation before submitting the form.

In any of the above circumstances MDDUS can offer guidance to members and primary care employers on how to best mange the situation.

Monitoring registration

Employers in primary care and organisations where multi-disciplinary teams increasingly operate are advised to have a formal process in place to monitor and ensure that individual professional registrations are up-to-date. This should also include checking membership with a relevant defence organisation, such as MDDUS, to ensure that professional indemnity is in place.

Primary care employers using locums and temporary clinicians should undertake appropriate registration checks before allowing individuals to commence clinical duties. Doing so will help prevent unnecessary lapses in registration and the troublesome staffing issues that result from clinicians being unable to work until the matter is resolved. It is important to note all patients who have been provided care and treatment by an unregistered clinician must be notified this has occurred, and a risk assessment and review undertaken by the practice to ensure that individual patient care has not been compromised.

Employment issues

Staff found to have lapsed professional registration must be redeployed to non-clinical work if available and paid at the relevant grade or pay scale applicable until such time as their registration is renewed.

Should appropriate non-clinical work not be available the individual could be suspended and unpaid for the relevant period. Lapsed registration can lead to internal disciplinary proceedings or to an employee’s contract being terminated due to statutory illegality.

This can be a complex area to manage fairly and MDDUS employment law advisers are available to provide specific advice to members who employ staff.

Action points

  • Check your current registration status and, if an employer, those of any employees and contracted clinicians.
  • Update your regulator with any change of address, contact or banking details without delay
  • Employers should have a robust system in place for keeping track of the registration status of all professional employees.
  • Do not rely on guarantees from temporary employment agencies: carry out your own checks.

Alan Frame is a risk adviser at MDDUS

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