Pressure grows on Wes Streeting to act after damning nursing watchdog review

Health secretary Wes Streeting is under pressure to launch an inquiry following a damning review into the UK’s nursing and midwifery watchdog.

On Tuesday a review into the Nursing and Midwifery Council (NMC), prompted by The Independent’s reporting of whistleblower concerns, found the safety of the public, nurses and midwives was at risk.

The review, by former public prosecutor Nazir Afzal, found a “dysfunctional” culture within the NMC. It highlighted that nurses accused of sexual assault and rape have been allowed to continue practising due to a flawed and delayed investigation process.

The report found that six nurses took their own lives last year while under investigations that were delayed for four to five years.

Now a body representing around 400,000 nurses in the UK, the Queen’s Nursing Institute (QNI), has written to the new health secretary calling for him to launch an independent inquiry into the NMC’s regulation processes more broadly.

In a letter to Mr Streeting on Tuesday, QNI chief executive Crystal Oldman and chair John Usworth said: “Such a review is essential to restore public confidence and the confidence of the profession. It should include how the NMC manages fitness to practise cases, engages with the profession on standards and how standards are assured for individual entry to the register.

“We are concerned that the NMC will do little to address the issues highlighted by the whistleblowers; the NMC has already spent a considerable sum of money employing a reputation management company to help them manage the fallout from their own review of their culture. This suggests that they are more concerned about how the organisation is perceived than how it operates.”

They said an independent review of how the NMC operates is the only way to demonstrate to the public and nurses that the health secretary recognises the issues and is prepared to take action to restore confidence.

A Department of Health and Social Care spokesperson said: “This review is deeply concerning and must be acted upon by the independent Nursing and Midwifery Council. Ministers will be meeting with the NMC to discuss the review and their response to it.

“Bullying and racism are unacceptable. It is vital that whistleblowers are free to speak up, knowing that they will be supported, and their concerns will be listened to and acted upon.”

The NMC accepted all 36 recommendations in Mr Afzal’s review and said it will invest £30 million from its own funds to address problems identified, including improvements to how it investigates and screens complaints against nurses and midwives.

NMC chair Sir David Warren said the report was a “profoundly distressing report to read”.

He apologised to nurses and midwives impacted by the problems and said addressing the concerns over the NMC’s own culture would be “front and centre”.

Sir Warren added: “The NMC commissioned Nazir Afzal and Rise Associates to do this review because we knew they would not hold back. We now have clear recommendations to take the organisation forward. I’m grateful to all our colleagues who have spoken up about these issues. I know that what matters to them now is action, not words.”

In response to Mr Afzal’s report, NHS chief nurse Ruth May said she has been raising concerns with the NMC for some time and that she is deeply concerned by the findings. She said the NMC must urgently address and implement the report’s recommendations.

The report recommended the Professional Standards Authority (PSA), which is responsible for overseeing all regulators in the UK, should carry out more detailed annual reviews of the NMC, including the inspection of randomly selected cases.

Last year, in an annual report about the nursing regulator, the PSA said it had met 17 out of 18 of its standards.

In a statement to The Independent, the PSA said it would consider the implications of Mr Afzal’s review and closely monitor the NMC’s response.

A second review by Ijeoma Omambala KC, commissioned after The Independent’s report, will look at specific cases raised by the whistleblower, as well as the treatment of them by the NMC. It is due to be published later this summer.

The PSA said that when the second review is published it will consider whether to escalate the issue to the health secretary and parliament’s Health and Social Care Committee.

Chief executive for the Royal College of Nursing Nicola Ranger said: “Today’s report makes for distressing reading and shows the NMC is failing in a number of its core duties.

“The recognition of the failings in this report is a start. However, the trust of nursing professionals and patients will only be re-established through immediate and ongoing action. We are committed to ensuring that, in future, the NMC represents the modern reality and interests of nursing, midwifery and patients.”

She said there can be no further delay in resolving the deep-rooted issues facing the NMC.

This story was updated at 17:37 with a response from The Department for Health and Social Care.