The management of poor performance in nursing and midwifery: a case for concern.

Aim(s) - To examine the evidence of how poorly performing nurses and midwives are managed in the UK NHS Background – There is little evidence about poor performance and its management in nursing and midwifery literature. Method(s) – The scoping study comprised a literature search, analysis of recent Nursing and Midwifery Council data and a day’s observation at NMC fitness to practice hearings. Results – Nurses and midwives are the clinical groups most likely to be suspended from work in the NHS; NHS Trusts do not report data on suspensions therefore no statistics exist on numbers, reasons for suspensions, managerial processes, gender, area of work, or ethnicity of those suspended; the few major research projects identify variable management practices regarding poor performance, the significant financial cost to the NHS and the personal cost to those suspended; there is some evidence that inexperienced, poorly trained, or poorly supported managers use suspension inappropriately. Our day of observation supported this.
Conclusion(s) – There is a need for more robust data gathering and research in the field of NHS managerial practice.
Implications for Nursing Management – Managers should refrain from adopting punitive forms of performance management. Both frontline staff and management need better training and support for dealing with poor performance.

Pre refereed version as permitted by publisher.