The Nursing and Midwifery Council has admitted that it failed to consistently complete health and character checks on registrants for twelve years, potentially allowing individuals with serious criminal convictions or unmanaged health conditions to remain on the official nursing register. The regulator's chief executive, Paul Rees, has issued a public apology and described the failure as completely and utterly unacceptable.

The failure came to light after a staff member raised concerns following the launch of a speak-up programme, which itself was introduced in the wake of a damaging independent culture review published in July 2024 that found the regulator was affected by bullying, harassment, racism, and systemic failures. The disclosure is the latest in a sequence of serious institutional problems at a body that has been under sustained scrutiny for several years.

The NMC said that applications which included health and character declarations had been reviewed by a specialist team but were not consistently referred to an assistant registrar in line with its stated process. That omission, running across more than a decade of registrations and revalidations, means the full assessment process was not reliably applied to individuals who declared relevant information about their backgrounds.

More than 400 nursing and midwifery professionals are being contacted to provide further information for a more detailed assessment, and it is estimated that up to 15 registrants may need to be removed from a register that currently holds 867,935 professionals. That figure represents 0.002 per cent of the total register, though the broader concern is not simply the number of cases likely to result in removal but the years during which the process was not operating as it should have been.

The patient safety implications are direct. Professionals with a criminal record for a serious offence or with an unmanaged health condition could potentially have been kept on the register inappropriately and continued working in clinical settings during that period. The register is the statutory mechanism through which the public is meant to have assurance that nurses and midwives are fit to practise.

The Royal College of Nursing has responded with particular force. RCN Chief Nursing Officer Professor Lynn Woolsey said it was an astounding failure of the NMC's primary purpose to safeguard the public, and that a vague apology would not suffice. The RCN has called for an independent investigation into the regulator's governance and has said it will put tough questions to the NMC on behalf of the nursing workforce.

The question of how this lapse went undetected for so long is harder to answer than the admission itself. Internal audits, government oversight, and the regulatory board all had opportunities to identify that health and character declarations were not being fully processed. Rees acknowledged the organisation had been "turning over stones" and said the discovery of this historical problem was itself a product of the measures now in place, framing the disclosure as evidence that the new leadership is doing what previous leadership did not. That argument is likely to receive a mixed reception given the severity and duration of the failure.

A Department of Health and Social Care spokesperson said the government was supportive of the NMC's new leadership addressing the historic issues it had inherited, and that ministers would continue working across all four nations to ensure the highest standards of patient safety.

Rees was appointed on an interim basis in January 2025 and confirmed as permanent chief executive in July 2025, having been brought in specifically to address the cultural and operational failures identified in the 2024 review. A rapid review of all affected cases was commissioned in February, after the nature of the issue was shared with the senior leadership team. Whether that review will be considered sufficient, or whether external pressure results in an independent inquiry with broader scope, will depend on what it finds.

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