Nursing and Midwifery Council: 'Dysfunctional' culture at nursing regulator where staff suffer 'bullying, racism and burnout', report says

The UK independent regulator for nurses and midwives has a "dysfunctional" culture, where staff suffer "bullying, racism and burnout", a damning report has said.

Nursing and Midwifery Council (NMC) members are "really struggling", an independent culture review by former chief prosecutor Nazir Afzal has found, as it warned of an environment where "poor judgment, toxic behaviours, and paralysis is affecting decision-making".

Those failings are causing "considerable distress among staff and impacting on safeguarding decisions" as well as "putting the public at risk and endangering nurses and midwives".

An urgent turnaround plan is needed, the report said.

The NMC regulates more than 808,000 nursing and midwifery professionals in the UK and holds the register of nurses and midwives who can practise in the country, as well as nursing associates who can practise in England.

Its registered professionals deliver care in a wide variety of settings including hospitals, GP practices, care homes, maternity units, community services, prisons, and in education.

"Good nurses," Mr Afzal warned as he launched the review on Tuesday, "are finding themselves being investigated for years over minor issues and bad nurses are escaping sanction because of a system that's not functioning as well as it should".

Mr Afzal, who described the council on social media platform X as "arguably the world's largest health regulator", said his team was aware that six nurses had taken their lives in the past year while under investigation by the NMC and at least one parent blamed the NMC for their daughter's death.

Some staff also expressed serious concerns that safeguarding cases were flawed and criminal behaviour was excused because it was said to be a private matter, the report added.

One member of staff told the team: "I am amazed that a registrant can be in possession of category A child pornography and we determine that's part of their private life so no action is taken."

In the last year, there have been multiple serious event reviews relating to the potential failure of the NMC to appropriately handle allegations of physical or sexual abuse against children occurring outside of clinical settings.

The review team also saw serious sexual assault cases where staff were furious at inexcusable delays that were protecting predators.

In one example, complaints about serious sexual misconduct and rape were made in 2017 and it took until 2024 before the nurse was finally struck off.

The report said: "We found some really worrying examples of safeguarding failures and a culture of burnout, bullying, racism, and wilful blindness urgently needs to be addressed."

"There is a dangerous groupthink that has gone unchallenged for too long," it added.

More than 30% of staff said they felt emotionally drained from their work while more than half said it was either unlikely or very unlikely that they would be able to fulfil their career aspirations at the NMC.

Approximately 10% were reporting long-term mental health absences, the report compiled by Mr Afzal and Rise Associates said.

In the last month, the NMC's chief executive Andrea Sutcliffe resigned due to ill health and her successor Dawn Broderick stepped down just four days into her job.

Read more:
Ethnic disparities in infant mortality rate 'disgusting'
Good maternity care 'the exception, not the rule', study finds
Woman awarded £575,000 after 'rushed childbirth' trauma

NMC chair Sir David Warren called it "a profoundly distressing report to read".

He said: "First and foremost, I express my condolences to the family and friends of anybody who has died by suicide while under fitness to practise investigation. Our safeguarding lead is urgently revisiting those cases and examining the impact of our processes on all those who are involved in them.

"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.

"I also apologise to those nurses, midwives, nursing associates, employers and members of the public for whom we have taken far too long to reach fitness to practise decisions.

"Nazir Afzal's recommendations, together with our existing improvement plan, will make the step change in experience they expect and deserve."

Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.