Independent culture review

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.

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.

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.

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.

• We will appoint an equality, diversity and inclusion (EDI) advisor to the Executive Board to support decision making.
• We will work to increase the diversity of the Executive Board.
• The Freedom to Speak Up Guardian is now available to colleagues to raise concerns and get independent support from a trained professional.
• Listening circles facilitated by trained professionals are now available for all colleagues to enable them to openly discuss and decompress about issues raised in the report.
• We’ve invested in a partner to improve psychological safety in teams, starting in our Professional Regulation directorate which includes fitness to practise, and registration and revalidation.
• We are extending the offer of decompression support to any colleagues working on sensitive casework. This involves professional counselling from a trained psychologist.
• We are doubling the amount we spend on learning and development. By October, this investment should enable us to start rolling out improvements in leadership and line management, safeguarding, casework and tackling some of the behaviours in the report such as microaggressions.
• An external equality, diversity and inclusion (EDI) partner is undertaking a review of our EDI learning and making further recommendations to improve our mandatory training.
• We are actively working on a new behavioural framework to support recruitment, development, career progression and performance management, for launch in September.