Revealed: NHS regulator’s ‘culture of fear’ that leaves rogue nurses free to abuse patients

Exclusive: Leaked internal document lays bare concerns of ‘toxic’ issues within watchdog that mean whistleblowers’ warnings are ignored — and the public put in danger — in disturbing echoes of Lucy Letby case, writes health correspondent Rebecca Thomas

(Getty Images)

Nurses and midwives accused of serious sexual, physical and racial abuse are being allowed to keep working on wards because whistleblowers are being ignored, a damning new report has found.

Staff are too scared to report their concerns to the nursing regulator because of a “culture of fear” within the watchdog, documents seen by The Independent reveal.

One whistleblower, speaking to this publication, drew parallels with the Lucy Letby case, accusing the Nursing and Midwifery Council (NMC) of being defensive and trying to protect their own reputation.

They claim “deep-seated toxic conduct” within the NMC is leading to skewed and failed investigations.

A review of NMC guidelines was launched after The Independent highlighted concerns earlier this year by speaking to staff who complained that the NMC was leaving nurses accused of sexual assault and domestic violence free to work unchecked.

An internal document, sent by a senior whistleblower, lays bare a litany of concerns including:

• The case of a male nurse in Coventry who admitted sharing indecent images of children but was only struck off three years after the complaint was first raised
• A male nurse in Kent who groped a patient and was allowed to practise with no restrictions for eight months after his case was reported
• A female nurse convicted of racially abusing members of the public who faced no sanctions – a decision later overturned

The Independent has also found a case in which a member of staff treated a female patient’s genitals “as a puppet” but escaped with only a caution.

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Speaking to The Independent, the whistleblower said their concerns, flagged to the NMC, were met with “the same defensive management culture, prioritisation of its own reputation over its legal obligations, and poor treatment of whistleblowers that has recently been criticised as the reason for Lucy Letby not being prevented from practising earlier”.

They added: “I and other colleagues have repeatedly escalated our concerns internally, but the NMC has failed to demonstrate the reflection and insight it expects of the nurses, midwives, and nursing associates on our register.

“I believe that urgent intervention is needed to protect the health and safety of members of the public. I fear a failure to address the deep-seated cultural issues at the NMC will leave professionals who are not fit to practise on our register.”

Approached over the bombshell findings, Andrea Sutcliffe, the head of the NMC, said it had launched an investigation into the allegations.

Culture of fear

An internal report from last year, kept secret by the NMC, details interviews with 41 staff members, as well as multiple exit interviews, between April 2021 and March 2022.

The conclusions, seen by The Independent, found:

• A “culture of fear” within the NMC in which staff are scared “of making mistakes” and afraid to be honest when errors are made
• Staff under pressure over the “huge” backlogs of investigations and given “unachievable” targets
• One worker said they were “scared of raising [their] head above the parapet” as they did not think concerns would be acted on
• Another said: “We’re drowning, we’re struggling, we’re telling people: we can’t cope with pressure”
• Serious concerns raised over racism within the NMC, including the alleged bullying of Black women
• Staff claiming sexism and misogyny, including pregnant women being treated unfairly

The report said a lot of people “wouldn’t feel confident to challenge inappropriate behaviour”, adding: “The phrase a lot of people used was that there was a ‘fear of consequences’.”

‘Rape Tape’

The whistleblower has raised concerns with the Professional Standards Authority and the Charity Commission, both of which oversee the NMC.

They claimed in one 2017 incident that a male investigator was dismissed after telling female NMC colleagues he had a “rape tape”. Another investigator was dismissed in 2018 for referring to someone as a “n*g nog”.

The NMC said it had a “zero tolerance” to all forms of discrimination and will always act when concerns are raised.

Current figures show the NMC has a backlog of 5,339 conduct cases. In its latest report into the NMC, the PSA said it was still taking “too long” to investigate. More than 700 have been left open for three years.

In an email to the NMC, PSA and the Charity Commission, the whistleblower said the “desperation” to clear the backlog had “led to dangerous decisions being made to close cases at all costs”.

Lucy Letby was convicted of killing seven babies (Chester Standard/SWNS)

“This includes failing to fully investigate cases, failing to address the discriminatory application of policies, rewarding speedy but poor-quality work, lacking transparency with members of the public raising concerns, and systematic harassment of staff who challenge practices in any way,” they wrote.

“I fear a failure to address the deep-seated cultural issues at the NMC will leave professionals who are not fit to practise on our register.”

In January 2023, senior managers were alerted to a case by the whistleblower in which a nurse in Coventry had applied for voluntary removal from the nursing register after admitting sharing indecent images of children in 2019, evidence seen by The Independent shows.

The male nurse allegedly said in a police officer interview it was for a sexual purpose but he was not charged. In 2020, the NMC’s investigation team decided there was “no case to answer” and he was eventually struck off three years later, having been able to work without restrictions.

In 2018, a male nurse was accused of sexual misconduct with a patient. The case was referred to the NMC and an interim order was placed on his ability to practice. However, this was removed between February to August 2018 and he was free to practise before being struck off eight months later.

In another case this year, a white nurse was not sanctioned after she was convicted of “racially aggravated intentional harassment”.

Under current guidelines, the NMC recommends that a nurse accused of sexual assault should not be investigated by the watchdog unless the complaint has been reported to the police.

It is currently reviewing all its guidance on sexual misconduct, domestic violence, domestic abuse and safeguarding cases, but no changes have been implemented.

Andrea Sutcliffe NMC chief (NMC)

Ms Sutcliffe, chief executive for the NMC, said: “It’s essential that we have a culture at the NMC where people feel able to speak up. I’m grateful that these concerns have been raised with us and I take them extremely seriously.

“Our priority is always the safety of people who use health and care services, and ensuring that is central to our fitness to practise work.”

Ms Sutcliffe said they had taken steps to improve but acknowledged it had much more to do. The regulator said it would investigate concerns raised after The Independent’sreporting and be transparent with the findings.

“I want to reaffirm my personal commitment to developing a safe and inclusive working environment where all our colleagues are supported to thrive so we can effectively deliver on our primary purpose to protect the public,” he said.

“Again, we have made progress over the years but I am resolutely focused on continuing to improve.”

The PSA and Charity Commission, which regulate the NMC, are yet to launch any investigations. The Charity Commission told The Independent it was assessing the allegations and the PSA said it was monitoring the NMC’s own probe.