title: The management of poor performance in nursing and midwifery: a case for concern.
abstract: OBJECTIVE
  To examine the evidence of how poorly performing nurses and midwives are managed in the UK National Health Service (NHS).
  
  
  BACKGROUND
  Nurses and midwives form the largest clinical group in the NHS. There is little evidence, however, about poor performance and its management in nursing and midwifery literature.
  
  
  METHODS
  The present study comprised a literature search, analysis of recent Nursing and Midwifery Council (NMC) data and observation at NMC fitness to practice hearings.
  
  
  RESULTS
  Nurses and midwives are the clinical groups most likely to be suspended in the NHS; Trusts do not report data on suspensions therefore no data 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, the significant financial cost to the NHS and the personal cost to those suspended; there is evidence that inexperienced, poorly trained, or poorly supported managers use suspension inappropriately. Our observation supported this.
  
  
  CONCLUSIONS
  There is a need for robust data gathering and research in the field of NHS managerial practice.
  
  
  CONCLUSIONS
  Managers should refrain from adopting punitive forms of performance management. Frontline staff and management need better training and support for dealing with poor performance.
authors: School of Health and Social Sciences, Middlesex University, London, UK.
authors: Katie
authors: K
authors: Stone
authors: Michael
authors: M
authors: Traynor
authors: Dinah
authors: D
authors: Gould
authors: Jill
authors: J
authors: Maben
mesh_terms: D002983:Clinical Competence; D005260:Female; D006801:Humans; D008880:Midwifery / Q000458:organization & administration* / Q000592:standards; D015401:Nursing Administration Research; D009740:Nursing Staff / Q000458:organization & administration* / Q000592:standards; D011247:Pregnancy; D013222:State Medicine / Q000458:organization & administration* / Q000592:standards; D006113:United Kingdom