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 new watchdog report has found.
PSA Review Highlights Ongoing Failures
A review of the Nursing and Midwifery Council (NMC) for 2024-25 by the Professional Standards Authority (PSA) found it had wrongly approved more than 350 'fraudulent' or 'underqualified' nurses to work in the UK. This follows an earlier expose by The Independent that uncovered whistleblower allegations of a 'toxic' and bullying culture within the NMC, allowing rogue nurses to work in the NHS unchecked and prompting a leadership overhaul.
Despite changes at the top and pledges by new chief executive Paul Rees to do better, the PSA's annual review said it had not seen evidence of 'substantial and sustained improvement'. The damning assessment comes a day after the NMC admitted that 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 due to a major vetting failure. The NMC said 15 workers on its register should have been banned because they had criminal convictions or health concerns, making them unsafe to work with patients.
Astounding Failure in Vetting
The 'astounding failure' emerged after the NMC was forced to review 18,060 applications made by nurses and midwives over a 12-year period to join or stay on its register, following a staff whistleblower raising concerns in February. The PSA's 2024-25 review, published on Thursday, found the regulator had met just nine out of 18 standards 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 and improve, progress has been mixed, and in some areas very limited action has been taken. In addition to the vetting failures, the PSA expressed concern over the NMC's regulation of nursing and midwifery education standards, including its ability to manage the quality of university training courses, highlighted last year. The review said NMC fitness-to-practice investigations against nurses were still taking too long, and the PSA had only 'limited assurance' over the quality of decisions when first screening cases.
Equality and Transparency Concerns
The audit also found the NMC had failed to meet equality and diversity standards and the standard for transparency, with its reporting of issues lacking 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.'
NMC Response
Paul Rees, chief executive and registrar of the NMC, said the report reflected historical issues that had held back progress and added to the scale of turning the organisation around. He said the major vetting problem was identified because of the NMC's three-year transformation programme. 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 its regulatory areas.
