The UK’s scandal-hit nursing regulator is still failing to address problems years after a “toxic” culture was first revealed by The Independent.
A review of the Nursing and Midwifery Council (NMC) in 2023-24, by the Professional Standards Authority (PSA) which regulates the body, found it had wrongly approved more than 350 “fraudulent” or “underqualified” nurses to work in the UK.
That followed an expose by The Independent, which uncovered whistleblower allegations of a “toxic” and bullying culture within its ranks that had allowed rogue nurses were free to work in the NHS unchecked, prompting an overhaul of its leadership.
Despite the changes at the top of the organisation, and pledges by its new chief Paul Rees to do better, the PSA’s annual review of 2024-25 said it had not seen evidence of “substantial and sustained improvement”.
The damning assessment comes a day after the NMC admitted more than a dozen rogue nurses who should have been struck off had been free to work in the NHS for up to 12 years after a major vetting failure.
The Nursing and Midwifery Council said 15 workers on its register should have been banned because they had criminal convictions or health concerns, which meant they were not safe to work with patients.
The “astounding failure” emerged after it was forced to review 18,060 applications made by nurses and midwives over a 12-year period to join or stay on its register – which is required to practice in the UK – after a staff whistleblower raised concerns in February.
The PSA carries out performance reviews of all professional regulators in the UK. Its 2024-25 review of the NMC, published on Thursday, found the regulator had met just nine out of 18 standards that it measures – down from 11 in 2023-24.
The watchdog said while it recognised that the NMC has taken significant steps to understand the issues within the organisation and improve, progress has been mixed, and in some areas it has taken very limited action.
In addition to the failures to vet hundreds of registrants, the PSA said that it was concerned over the NMC’s regulation of nursing and midwifery education standards, including its ability to manage the quality of education provided by university training courses, which were highlighted by the watchdog last year.
The review said NMC fitness to practice investigations against nurses were still taking too long to process, and that the PSA only had “limited assurance” over the quality of the decisions when first screening cases.
The audit found the NMC had also failed to meet equality and diversity standards and the standard for transparency, with the PSA noting that its reporting of issues was lacking when compared to other regulators.
A PSA spokesperson said: “The overall performance of the NMC is a mixed picture of some improvements, actions yet to yield consistent benefits, and areas where too little action has been taken.
“This has been exacerbated by the registration issue recently identified. So while the new leadership has taken encouraging steps, in the period under review, we have not seen evidence of substantial and sustained improvement. In our report, we have highlighted some of the areas where we expect the organisation to urgently focus its attention.”
Paul Rees, chief executive and registrar, for the NMC said the report reflected historical issues, which had held back its progress to improve and had added to the scale of turning the organisation around.
He said the major vetting problem was identified because of the NMC’s transformation programme, which spans three years.
He added: “We’ll continue to leave no stone unturned as we work to fix this and other legacy issues – we’re determined to turn this organisation around once and for all.
“Only once we’ve transformed our culture, regulatory performance and uncovered and fixed all these legacy issues will we be in a position to meet all the PSA’s important standards of good regulation – we’re committed to working closely with the PSA to provide the assurance it needs that change at the NMC is lasting and meaningful.”
The regulator is now carrying out checks of all of its regulatory areas.
