The Nursing and Midwifery Council (NMC) has been working ‘at pace’ to implement the recommendations of a damning review into its culture and to make ‘enduring change’ within the organisation, a council meeting has heard.
The regulator’s executive director of strategy and insight, Matthew McClelland, outlined the NMC’s ‘overall approach’ to responding to a highly damning independent review that exposed a ‘dangerously toxic culture’ in which bullying, racism and burnout were putting nurses and the public at risk.
Speaking during a council meeting this morning he said the regulator was committed to ‘more detailed planning work’ which will ‘iterate and resolve over the coming months’.
The review detailed 36 recommendations for the NMC, of which it accepted.
‘We’ve been working at pace to plan how we address those recommendations and indeed to make enduring change in the organisation,’ said Mr McClelland.
He acknowledged that there was a ‘very clear and understandable’ desire for ‘rapid progress’, but cautioned that changes should avoid repeating past failings.
‘One of the clear lessons of the report is that we haven’t made sufficient sustainable change in the past, and we therefore need to do things differently this time around,’ Mr McLelland said.
Regulatory performance at the NMC has ‘fluctuated across the years’, he said, adding: ‘When that has happened, we’ve increased our resources, but we haven’t always successfully tackled the underlying causes and the cultural issues.
‘The report is very clear that culture and regulatory performance are intertwined, and so to deliver sustainable change, we have to make sure that all of our colleagues are operating in an inclusive and performing environment, and we have to tackle the root causes of the low productivity and poor experiences.’
He added: ‘And that means things like unacceptable behaviours, discrimination, low trust, micromanagement and lack of focus on how we deliver outcomes – we started tackling these issues with urgency, but it will take time.’
Mr McClelland outlined some of the changes that the regulator has made so far, with the NMC Council having ‘reviewed and refined’ the NMC’s ‘practise improvement programme’ which received a £30 million investment in April.
The programme aims to deliver more ‘person-centred’ fitness to practise (FtP) referrals which are completed in a ‘timely’ and ‘considerate’ way, he said.
The council also heard how ‘significant work’ has been made on the NMC’s people framework, which was one of the key recommendations of the Afzal report.
In paper’s accompanying today’s council meeting, the NMC said it will continue to ‘refine’ its response to this review and two upcoming reports into the regulator up to the first quarter of 2025.
Following this, the regulator will begin to implement changes following the reports up to the final quarter of 2026, it said.
The delay to changes was raised as a point of concern by lay member and council vice chair Anna Walker, who stressed that council will require ‘interactive governance arrangements’ to meet more regularly with the executive and ensure necessary changes are being introduced.
Ijeoma Omambala KC’s upcoming independent investigations into the NMC will focus on FtP and the handling of whistleblowing concerns and are due to be published later this year.