Today, the Nursing and Midwifery Council (NMC) has published the damning findings from an independent review into the organisation’s culture which highlights endemic racism and a failure to act on the concerns raised repeatedly by whistleblowers. The NMC has a duty to protect the public and operate to the highest standards that it expects of its own registrants. However, the report catalogues numerous counts of bullying, racism and sexual harassment within the NMC and an unacceptable backlog of fitness to practise casework. As highlighted in the report, since April 2023, sadly six people have paid the highest price and died by suicide or suspected suicide while under, or having concluded, fitness to practise investigation.

Following repeated concerns raised by senior nursing leaders and whistleblowers about the organisation’s culture, including racism and fear of speaking up, the NMC commissioned Nazir Afzal OBE and Rise Associates to carry out the review. 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 has published a formal statement in response to the “Independent Culture Review”.

The NMC “apologised and promised action to address safeguarding concerns, and found that people working in the organisation have experienced racism, discrimination and bullying. The NMC takes this extremely seriously and will deliver a culture change programme rooted in the review’s recommendations [… ] Racism, discrimination and bullying should never have had any place at the NMC. Where it has been raised in the past, the organisation hasn’t taken enough action to address it and hold people to account. The report’s recommendations will help to address this and move the NMC towards achieving racial equity for its people […]  The NMC accepts the report’s recommendations.”

The iHV is joining with other nursing charities in calling for an urgent independent review of the NMC and the performance of its regulatory functions. 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.

Crystal Oldman, CEO of the Queen’s Nursing Institute, stated in an open letter to the Rt Hon Wes Streeting MP, the new Secretary of State for Health and Social Care:

“We are concerned that the Nursing and Midwifery Council 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. We consider that an independent review is the only way to demonstrate to the public and the profession that the serious nature of the longstanding internal issues are not only recognised, but also that you are prepared to take immediate action to start to restore the NMC to a regulatory body in which the profession and the public can have full confidence.”

Alison Morton, iHV CEO, stated:

“Changes within the NMC are long overdue. This damning report shines a light on the human cost of years of failure to grapple systemic cultural issues within the NMC. Too many people have been bullied, harassed and subject to racial discrimination – this needs to stop! The learning from this review also extends beyond the NMC, highlighting inadequate wider system levers to hold regulators to account despite concerns being raised by senior nursing leaders, including the Chief Nursing Officers in all four nations. In order to regain the respect of the professions that it regulates and the public that it is intended to protect, it is vital that the NMC takes these findings seriously and deliver on all the recommendations in this report. Our thoughts are with the victims over so many years – and we extend our thanks and admiration to the tenacious work of nursing leaders and advocates who have campaigned tirelessly for change.”

Rt Hon Andrea Leadsom MP has been asked by the Prime Minister to chair a major new review of early years services on behalf of the Government. The review will look at reducing inequalities in young children from conception to age two and a half, aiming to ensure every baby is given the best possible start in life. It will build on the conclusions from the Inter-Ministerial Group on Early Years Family Support which Andrea chaired whilst Leader of the Commons from 2018-2019.

Dr Cheryll Adams CBE, Executive Director iHV, commented:

“We are delighted that Rt Hon Andrea Leadsom MP has been invited to chair a review into the first 1001 days of life and particularly that it will have a special focus on reducing inequalities in childhood. Andrea is ideally place to lead this review, with her longstanding work in this policy area and her commitment to the need for improved investment in the early years . The work of the All Party Parliamentary Group for the First 1001 Critical Days has already led to important learning and outcomes, such as the 1001 Critical Days manifesto signed by many cross-government MPs (2014).

“We look forward to working with Andrea on her inquiry and hope very much that this will finally lead to very urgent action to ensure that each and every child born in England is given the best possible start in life. It could not be more timely.”

The review will seek to show how to reduce disparities in low birth weight, social and emotional development in early years, and reduce impacts of vulnerability and adverse childhood experiences in this stage of life. It will also look to understand lessons learnt from COVID-19, including minimising the risks from the pandemic to very young children, and better using technology.


iHV Fellow, Sharin Baldwin, publishes Systematic Review on First Time Fathers’ Mental Health and Wellbeing and accompanying editorial on the importance of men’s mental health to coincide with International Men’s Day (19 November) – a worldwide celebration of the positive value that men bring to the world, their families and communities.

They both are open access publications.

Sharin Baldwin

Sharin Baldwin

 Systematic Review on First Time Fathers’ Mental Health and Wellbeing

The findings from the systematic review on first time fathers’ mental health and wellbeing  revealed that fathers wanted:

  • More guidance and support to prepare them for parenthood, specifically to better prepare them for subsequent relationship changes with their partner
  • Access to tailored information and to be equally included in consultations and contacts with relevant health professionals.

The synthesis of the international evidence has important implications for healthcare professionals working with families in the early years, with particular reference to the need to consider the mental health and wellbeing of mothers and fathers. The review also highlighted that healthcare professionals need a greater understanding of the dilemmas and challenges that new fathers face to better support their mental health and wellbeing during this crucial transitional period.

Evidence from our systematic review adds further support for an urgent review of how we plan, provide and resource maternity and early years services, in order to recognise the impact that pregnancy and birth may have on a father’s mental health, as well as the essential role fathers play in supporting their partner and infant. If the aim of health research is to improve outcomes through the implementation of evidence and use of evidence-based practices, we should ask ourselves why barriers persist to address and recognise paternal mental health needs. Now is the time to use this evidence to change practice towards supporting both parents and provide more equitable care and use of resources.

Editorial piece on the importance of men’s mental health

Further information

For further information on Sharin’s research, please see her study website.

Sharin Baldwin RN, RM, RHV, QN, FiHV, HV Research Champion, BSc (Hons), PG Dip, MSc

NIHR Clinical Doctoral Fellow, King’s College London

Clinical Academic for Community Nursing, London North West University Healthcare Trust

This review brings together recent evidence on improving health and wellbeing before, during, and after pregnancy from studies funded by the National Institute for Health Research (NIHR).

It brings together research for factors that can be modified before, during and after pregnancy. the research covers smoking, healthy diet and weight, alcohol and drugs, mental health, violence against women, and supporting families using multifaceted approaches.

Better Beginnings is not a comprehensive review of all evidence on improving health for pregnancy which is a broad area of knowledge and practice.  It focuses on building health for women to support pregnancy and the future health of their children.

This review complements other initiatives, drawing on best evidence, including guidance and quality standards from the National Institute for Health and Care Excellence (NICE). Further sources of information and resources for each topic are signposted in this report.