Nurses accused of rape and child abuse allowed to practice freely while ‘toxic’ regulator looks the other way, investigation finds

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A revealing review of the care regulator revealed a toxic and dysfunctional culture at “every level” and an organisation that ignores serious sexual, physical and racial abuse.

Shocking failures by the Nursing and Midwifery Council (NMC) include a seven-year delay in striking off a nurse who was accused of raping a colleague and sexually abusing a patient.

Another finding is that the NMC – which is responsible for regulating more than 800,000 staff – took no action despite being aware that nurses and midwives had been accused of accessing Category A child sexual abuse images.

The investigation, conducted by Nazir Afzal KC, was commissioned after a series of reports from The Independent revealed allegations from an internal whistleblower.

Former prosecutor Afzal said he was close to tears when he heard the testimony of hundreds of employees interviewed for his report.

He praised the publication for bringing the issue into the spotlight and said: “Many thanks to The Independent because you gave the whistleblower a voice. Everything the whistleblower said was confirmed by our findings.”

Former NMC chief executive Andrea Sutcliffe apologised to all those affected and described her experiences as “unacceptable”.

After a five-month investigation, the report accused the NMC leadership of failing to take concerns seriously and failing to address the problems it was aware of for 15 years.

Other shocking findings include:

In one case reported in 2018, the NMC allowed a nurse who had described colleagues as “lazy … javelin throwers” ​​to continue working.

The report makes 36 recommendations, including greater investment in staff, an accelerated complaints review process, the creation of a new central security office and an increase in the number of black and ethnic minorities in management.

The whistleblower who first made the allegations said The Independent: “Having endured gaslighting and workplace bullying for many years at the NMC, it is bittersweet to read Nazir’s conclusion that I had told him on numerous occasions my reported allegations of racism, of people being afraid to speak up, and of nurses accused of serious sexual, physical and racial abuse being allowed to continue working on the wards, and that everything I had documented was corroborated.”

They said they would like to thank Mr. Afzal and The Independent for giving them a voice and helping to bring to light “the serious public safety implications resulting from the toxic culture at the NMC.”

Mr Afzal said: “We found a workforce that was really struggling and an environment where poor judgement, toxic behaviour and paralysis were affecting decision-making.

“The NMC is in its last chance phase and the Chair has assured us that his priority is to deliver urgently needed changes to restore trust, protect the public and ensure all nurses and midwives are treated fairly.”

Are you affected by this issue? Email [email protected]

“This is not for us”

He added: “There are good nurses and midwives who get stuck in years of investigations, whose lives are destroyed and in the end nothing ever comes of it. But there are also bad nurses who are allowed to continue working because the system is full of delays.”

A key issue identified by the reviewers, and revealed in this January 2023 publication, was that the NMC’s policies allowed staff to get away with verbal abuse or racism when it occurred outside the workplace.

One employee quoted in the report said: “The reasoning was: ‘This is not for us’, they can do whatever they want outside of work. That made me sick.”

In the case of a nurse accused of sexually harassing patients and raping a colleague after slipping alcohol into their drinks, the NMC decided not to intervene because the alleged assaults did not occur in the workplace. This nurse was reported seven years ago through multiple reports but was not removed from the register until 2024.

When asked by an employee why managers had closed complaints against nurses and midwives accused of accessing indecent images of children, they reportedly replied: “That’s our policy.”

“Dysfunction at all levels”

The review found that previous reports on the NMC had identified a long history of a “toxic culture” dating back to at least 2005, but there are now concerns that the problems are widespread.

Mr Afzal warned that the NMC was plagued by systemic problems, with staff reporting needing antidepressants and losing their hair due to bullying and poor leadership.

The NMC’s leadership is problematic, he added: “We have witnessed dysfunction at virtually every level of the organization, in all directorates, which has led to emotional stress among employees.”

Executives were also criticised for treating the original whistleblower as a “source of irritation”, which the report warned reflected a “conscious deafness to criticism”.

Humiliation of black staff

Examples of racism are cited throughout the report. Staff were bullied and humiliated. One shocking revelation was that some black and ethnic minority staff were told they had been put on a list of people who could not be promoted.

The report uncovered further cases of ethnic minority employees being humiliated through bullying, as well as stories of “sadistic managers who appeared to take pleasure in reducing their employees to tears”.

One staff member said: “White men have humiliated me. I am a black woman… I have never had to complain to other professionals that the way they treated me was degrading and demeaning. In two years at the NMC I have had to do this twice.”

The NMC accepted all recommendations and pledged to invest £30 million of its funds in improving the situation of employees.

Sir David Warren, chairman of the NMC, said: “It is deeply disturbing to read this report. First and foremost, I would like to offer my condolences to the families and friends of those who have died by suicide during a fitness to practice assessment. Our head of child protection is urgently re-examining these cases and examining the impact of our processes on everyone involved.”

Ms Sutcliffe, who resigned last week after five years as NMC chief executive due to health reasons, said: “Some colleagues have clearly had experiences at the NMC which are unacceptable and should not be tolerated. I am devastated that this happened under my watch and I apologise to all those affected, our colleagues, the professionals on our register and the public.”

She said the NMC needed a “gradual change” in its culture.

The Department of Health and Social Care did not comment on whether it would take action in response to the damaging findings, despite promises by Health Secretary Wes Streeting to protect NHS whistleblowers.

It continues: “Bullying and racism are unacceptable. It is vital that whistleblowers have the freedom to speak out, knowing that they will receive support and that their concerns will be heard and acted upon.”

“This review contains clear recommendations for the NMC and we expect its council to respond swiftly and vigorously.”

If you are feeling distressed or are having difficulty coping, you can speak to the Samaritans in confidence on 116 123 (UK and ROI), email [email protected] or call the Samaritan website to find details of your nearest branch.

Rape Crisis provides support for victims of rape and sexual abuse. You can call them on 0808 802 9999 in England and Wales, 0808 801 0302 in Scotland and 0800 0246 991 in Northern Ireland or visit their website at www.rapecrisis.org.uk.

If you are a child and need help because something has happened to you, you can call the NSPCC free on 0800 1111. You can also call the NSPCC if you are an adult and are worried about a child on 0808 800 5000. The National Association for People Abused in Childhood (Napac) offers support for adults on 0808 801 0331