The Nursing and Midwifery Council Independent Culture Review (9 July 2024)

Summary

An independent review of the Nursing and Midwifery Council (NMC)'s culture has highlighted safeguarding concerns, and found that people working in the organisation have experienced racism, discrimination and bullying. We take this extremely seriously and will deliver a culture change programme rooted in the review’s recommendations.

The NMC commissioned Nazir Afzal OBE and Rise Associates to carry out the review after concerns were raised about the organisation’s culture, including racism and fear of speaking up. Over 1,000 current and former NMC colleagues, plus more than 200 panel members who sit on fitness to practise hearings, shared their lived experiences as part of the review. The NMC accepts the report’s recommendations.

Content

What the review found

Safeguarding people involved in our processes

• Our casework brings us into contact with members of the public, employers and professionals on our register, and we have a responsibility to recognise if anyone has any vulnerabilities that we need to consider.
• As highlighted in the report, since April 2023, six people have died by suicide or suspected suicide while under, or having concluded, fitness to practise investigation. We offer our sincere condolences to their relatives.
• We are expanding resources for our safeguarding team. We are increasing knowledge and training, alongside strengthening our operating procedures. This builds on work to better understand how we can improve our processes to reduce the impact and risk of harm to people.

Culture and regulation are intertwined

• The independent report is clear about the link between regulatory performance and our culture. One affects the other and this has created a pressurised environment for our people, which has contributed to poor behaviours and concerning case outcomes in some areas. It has seriously undermined our collective efforts to reach quick, fair and safe decisions across all our casework.
• We offer our sincere apologies to anyone involved in a case who has waited too long for a decision, or who hasn’t been treated at all times with fairness and kindness – whether they are professionals on the register, employers or members of the public.

An organisation of multiple cultures

• The review has held a mirror up to life at the NMC. At one point, it observes that two people passing each other in a corridor can have very different experiences of working here – some have had experiences of racism, discrimination and bullying, which come across vividly in this report. We apologise sincerely for what those colleagues have been through.

Senior leaders commit to doing better

• Among the report’s findings is a failure of senior leadership to rise to the challenges facing the NMC. Culture is shaped by what leaders tolerate. It’s clear some people have behaved in completely unacceptable ways that should have been called out and tackled much sooner. We accept this has contributed to colleagues feeling uncomfortable or even unsafe to speak up, or unconfident that appropriate action will be taken if they do.