A toxic culture of bullying, racism and groupthink within the nursing regulator has left the public at risk, an independent review has concluded.
The report found that widespread dysfunction at the Nursing and Midwifery Council (NMC) had contributed to criminal behaviour being excused and unfit staff allowed to escape sanction.
In one case, a nurse accused of drugging and raping a colleague and sexually assaulting patients was not struck off until seven years after a complaint was received.
Serious cases where “nurses posed a danger to the public” were scrapped during a screening process while spurious investigations were left languishing in the huge backlog, the report said.
Unnecessary delays have left the regulator struggling to clear 6,000 disciplinary cases, with some taking up to five years to conclude.
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The delays have been linked to a series of suicides by nurses subject to “drawn-out” investigations. In the year to April 2014, six nurses killed themselves while awaiting the outcome of their fitness-to-practise cases. One parent directly blamed the regulator for their daughter’s death.
An NMC lawyer told the review that allegations of racism were often thrown out during preliminary investigations. “Some people don’t perceive racism to be a problem,” the lawyer said.
Other staff claimed colleagues were openly racist. One recalled hearing a fellow staff member on a recruitment panel saying, “Look at the rubbish we’ve got today,” while reading through a list of foreign-sounding names.
Some disciplinary cases have been thrown out by the regulator because the allegations related to events in nurses and midwives’ private lives, which the authors of the report said had contributed to serious safeguarding concerns.
In one case, a member of NMC staff claimed that a registrant had faced allegations of accessing category A child abuse images, the most serious category, but this was not acted upon.
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The NMC responded that it had looked for the case but had not found it.
The report also said that in the past year several “serious event reviews” had been instigated to examine the NMC’s potential failure to appropriately handle allegations of physical and sexual abuse against children outside clinical settings.
The NMC, one of the largest healthcare regulators in the world, has been plagued by criticism for more than 15 years. Claims of bullying and racism were investigated by the Department of Health as far back as 2008.
The independent review was commissioned by the NMC after serious questions were raised about its internal culture by a whistleblower last year. It was led by Nazir Afzal, the former chief prosecutor for northwest England.
The review team said they received responses from more than 85 per cent of NMC staff. Although more than half had a positive view of working there, many others were “angry, frustrated and exhausted”. Some cried and recounted how bullying by their managers had left them taking antidepressants, suffering sleepless nights and with their hair falling out.
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The review team highlighted a “toxic culture” at the NMC, with one former employee describing their section of the organisation as a “hotbed of bullying, racism and toxic behaviour”.
Afzal, who carried out the review with the concultancy Rise Associates, said: “We found some really worrying examples of safeguarding failures and a culture of burnout, bullying, racism and wilful blindness [that] urgently needs to be addressed. There is a dangerous groupthink that has gone unchallenged for too long.”
Responding to the report, the NMC said it would be a “turning point” for the organisation and promised to deliver a “culture change programme”.
Sir David Warren, the NMC chairman, said: “This is a profoundly distressing report to read.” He expressed condolences to families of those who had killed themselves and said their cases were being revisited.
He added: “I am extremely sorry to hear the testimony of NMC colleagues who have shared their distressing experiences of racism, discrimination or bullying. On behalf of the council I give my absolute assurance that addressing this will be front and centre of change at the NMC.”
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The report made more than 30 recommendations, including a new safeguarding hub and better screening processes, which have been accepted by the NMC. The NMC said that the nurse accused of rape had been placed under an interim order in January 2018 which “restricted their practice until they were struck off”.
