Nurses accused of rape and child abuse as shocking report reveals ‘toxic culture’ puts patients at risk

A devastating report has exposed a “dysfunctional culture” underlying nursing supervision as serious allegations of physical, sexual and racist abuse were not taken seriously.

Serious public safety concerns have been raised by a review which found it took the Nursing and Midwifery Council (NMC) seven years to strike a nurse off the register accused of rape and sexual assault.

According to the authors of an independent review of the regulatory agency’s organizational culture, employees broke down in tears “as they recounted their frustration with protecting decisions that put the public at risk.”

The review team highlighted a “toxic culture” at NMC, with one former employee describing his section of the organisation as a “hotbed of bullying, racism and toxic behaviour”.

One former employee described his section as a “hotbed of bullying, racism and toxic behavior”

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The report also highlighted suicides of nurses caught up in lengthy fitness to practice investigations, as the report highlighted that some nurses have been under investigation for almost 10 years.

The authors point to an NMC backlog of 6,000 cases, which means some nurses are being forced to wait four or five years for investigations to be completed, even though some cases are “unfounded complaints that require no further action”.

Some of the cases are detailed in a report prepared by attorney Nazir Afzal and Rise Associates.

“In one case, a nurse was accused of sexually assaulting female patients and raping a colleague after spiking their drinks,” the report said.

“She was locked up because the rape occurred outside of work, following a social event, and the sexual assault on the patient occurred outside the hospital because a nurse had organised a meeting.

“The nurse was also accused of soliciting patients to go on dates and asking for their phone number. Seven years after the NMC first received complaints, the nurse was finally struck off in 2024.”

The NMC said an interim order was made against the nurse in January 2018 which “restricted her ability to practise until she was removed from the register”.

Meanwhile, one employee told the report: “I am astonished that a registrant can possess category A child pornography and we determine that it is part of their private life so we take no action.”

However, the NMC said officials had “been looking into the matter and have not yet found any which have been affected by the closure decision”.

The review highlighted cases that were “dismissed” because the alleged incidents occurred outside the workplace. One NMC lawyer told the review team: “Racism cases are dismissed in screening because they occur outside the workplace and the view is, and I am paraphrasing, ‘people are entitled to be racist in their own time’ because they do not involve patients.”

Staff told the authors that the regulatory system “was not adequately designed to distinguish between serious and minor problems.”

An independent review has found six cases of suicide or suspected suicide among nurses between April 2023 and April 2024 while undergoing a fitness to practice assessment.

“We spoke to several people who said that lengthy investigations were a contributing factor to six nurses taking their own lives last year,” the report said.

“We have also seen correspondence from a mother who directly blamed the NMC for her daughter’s death, due to an incompetent and biased investigation.”

Report sheds light on suicides of nurses caught up in long-running fitness to practice investigations

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The report also highlighted a “dysfunctional culture” at the regulator, including allegations of racism within its ranks.

The authors said there was “dangerous groupthink” at the regulator and stressed that management did not take safety warnings “seriously”.

They said too many workers were “struggling” and “angry, frustrated and exhausted.”

They also heard staff talk about “anti-depressants, dealing with hair loss and insomnia due to bullying and mismanagement”.

“At virtually every level of the organization… we witnessed dysfunction that caused emotional suffering to staff and prevented the proper functioning of the organization,” the authors wrote.

One member of staff told the review team: “There was a fitness to practise case that we handled really badly and children were hurt because we didn’t intervene and apologise. We ask professionals to be honest but we can’t apologise. Because the NMC won’t do that.”

Mr Afzal, who led the review, said: “The culture is dysfunctional and it is having a huge impact on employees, but it is also having an impact on their work. We found a workforce that is really struggling and an environment where poor judgement, toxic behaviour and paralysis are influencing decision-making.

“Good nurses get investigated for years for minor problems, while bad nurses get away with it because the system doesn’t work as well as it should.”

He added: “We have found some truly disturbing examples of safeguarding failures and the culture of burnout, bullying, racism and deliberate blindness needs to be addressed urgently.

“There is a dangerous groupthink that has gone unchallenged for too long.”

In response to the report, the NMC said the review would be a “turning point” for the organisation and promised to deliver a “culture change programme”.

NMC chairman Sir David Warren said: “This is a deeply disturbing report to read. First of all, my condolences go to the family and friends of anyone who committed suicide during a fitness to practise inquiry.

“Our head of security is urgently revisiting these matters and examining the impact of our processes on all those involved.

“I am deeply saddened by the testimony of colleagues across the NMC who have shared their painful experiences of racism, discrimination or bullying. On behalf of the council, I assure you that addressing this will be a key focus of change for the NMC.

“I also apologise to nurses, midwives, nurse associates, employers and members of the public who have taken too long to make fitness to practise decisions. Nazir Afzal’s recommendations, together with our current improvement plan, will deliver the transformation in experience they expect and deserve.”

Asked specifically about the case in which a nurse was accused of rape, an NMC spokesman said: “This was a complex and serious set of concerns about the same individual. Some of those concerns were initially closed but were reviewed by one of our assistant registrars who recommended they be investigated further.

“The individual was the subject of an interim order which restricted his ability to practise his profession until he was struck off the register at a hearing.”

A Department of Health and Social Care spokesman said: “Bullying and racism are unacceptable.

“It is important that whistleblowers feel free to speak out, knowing that they will be supported, their concerns will be heard and appropriate action will be taken.

“The review made clear recommendations to the NMC and we expect the NMC board to respond to them with swift and decisive action.”