The UK’s nursing regulator admits to significant failings and culture issues following controversy over delayed action in Lucy Letby’s case, with calls for urgent reforms to restore public trust.
The Nursing and Midwifery Council (NMC), the UK’s regulator responsible for nearly 800,000 nurses, midwives, and nursing associates, has come under intense scrutiny following a series of failings revealed by independent investigations and media exposés. In a landmark national interview, Paul Rees, the newly appointed chief of the crisis-hit NMC, conceded that the organisation had “completely got things wrong” in its handling of serious misconduct cases, notably those involving sexual assault and patient safety. Rees issued a public apology for past mistakes, including the controversial decision not to investigate off-duty sexual misconduct and the failure to suspend psychiatric nurse John Iwuh promptly, who was later jailed for 16 years for rape and voyeurism.
One of the most glaring examples of the regulator’s mishandling centred on Lucy Letby, the neonatal nurse convicted and sentenced to 14 whole-life orders for murdering seven babies and attempting to murder six others at the Countess of Chester Hospital between 2015 and 2016. The NMC admitted it had a loophole in its guidance at the time, which prevented the immediate suspension of Letby after her initial arrest. It was only a year later, after formal charges were brought, that the NMC took action to suspend her, a delay that has been widely criticised. Following revelations by The Independent, the NMC changed its guidance to clarify that investigators can now issue temporary suspension orders as soon as an arrest is made in exceptional cases involving serious criminal wrongdoing.
Despite her conviction, Letby did not oppose the application to be struck off the nursing register but maintained her innocence. The NMC panel formally found her “unfit to practise” nursing and confirmed she remains suspended from the register as regulatory processes continue. This case is emblematic of broader systemic issues within the NMC, where an independent inquiry led by Nazir Afzal KC, known as the Rise review, identified a “dysfunctional” and “toxic” culture within the organisation. The review exposed evidence of racism, sexism, and resistance to feedback at the leadership level, which ironically contributed to failures in safeguarding public safety.
Paul Rees indicated that the NMC has undergone significant leadership changes since the public backlash, with six senior leaders, including former chief executive Andrea Sutcliffe and former chair Sir David Warren, having left the organisation. These changes reflect a strong desire to reshape the regulator’s culture and operations, although Rees warned it could take years to fully turn around the organisation. He highlighted ongoing improvements, such as a reduction in case processing times from 60.8% to 71% of cases resolved within 15 months as of recent data, although hundreds of referrals from 2021 or earlier remain open.
Alongside Letby’s case, the NMC is also investigating claims against Alison Kelly, Letby’s former nursing director at the Countess of Chester Hospital, who has been suspended from her current role following accusations of ignoring concerns about Letby. The NMC has referred Kelly to the fitness to practise process, which had been previously paused pending the outcome of the criminal trial.
Notably, the NMC has experienced considerable internal turmoil, with whistleblowers raising serious safeguarding concerns. Some staff who spoke out have left the organisation, and at least one senior leader who made allegations has departed amid ongoing disputes. A recent report by two barristers suggested no detriment had been suffered by the whistleblower who initially raised concerns, although the whistleblower has contested this, alleging the NMC maintained a culture aimed at covering up misconduct and protecting reputations, a claim the regulator denies.
The cases of Letby and John Iwuh starkly underline the critical importance of robust and proactive regulation in the healthcare sector, where failures can have devastating consequences for vulnerable patients. As Mr Rees acknowledged, “We should’ve acted faster” in these cases, a recognition that comes amid wider calls for greater openness, accountability, and reform to restore public confidence in the NMC.
📌 Reference Map:
- [1], [2] (The Independent) – Paragraphs 1, 2, 4, 5, 6, 7, 8, 9, 11, 12
- [3], [4], [5] (Evening Standard) – Paragraphs 3, 4
- [6] (Evening Standard) – Paragraph 7
Source: Noah Wire Services
Noah Fact Check Pro
The draft above was created using the information available at the time the story first
emerged. We’ve since applied our fact-checking process to the final narrative, based on the criteria listed
below. The results are intended to help you assess the credibility of the piece and highlight any areas that may
warrant further investigation.
Freshness check
Score:
10
Notes:
The narrative is recent, published on 8 November 2025. The Independent is a reputable UK news outlet. The article presents new information, including an interview with Paul Rees, the newly appointed chief of the Nursing and Midwifery Council (NMC), and his admissions regarding past failings. There is no evidence of recycled content or republishing across low-quality sites. The narrative is based on a recent interview, which typically warrants a high freshness score. No discrepancies in figures, dates, or quotes were found. The article includes updated data and new material, justifying a higher freshness score.
Quotes check
Score:
10
Notes:
The direct quotes from Paul Rees, such as “We have to be honest about things that have gone wrong. And things have gone wrong in the past,” and “We should’ve acted faster,” are unique to this article. No identical quotes appear in earlier material, indicating potentially original or exclusive content. No variations in quote wording were found.
Source reliability
Score:
10
Notes:
The narrative originates from The Independent, a reputable UK news outlet. The NMC is a legitimate organisation responsible for regulating nurses and midwives in the UK. Paul Rees is the newly appointed chief executive of the NMC, and his statements are verifiable. The article cites specific dates and events, such as the publication of the Rise review in June 2024 and the NMC’s change in guidance in August 2024. All entities mentioned are verifiable online.
Plausability check
Score:
10
Notes:
The claims made in the narrative are plausible and supported by recent events. The NMC has faced criticism for its handling of serious misconduct cases, including those involving Lucy Letby and John Iwuh. The Rise review, published in June 2024, identified a “dysfunctional” and “toxic” culture within the NMC. The NMC’s change in guidance in August 2024 aligns with the narrative’s claims. The tone and language used are consistent with typical corporate and official communications. There is no excessive or off-topic detail unrelated to the claim. The narrative lacks specific factual anchors, such as names, institutions, and dates, which is typical for this type of reporting.
Overall assessment
Verdict (FAIL, OPEN, PASS): PASS
Confidence (LOW, MEDIUM, HIGH): HIGH
Summary:
The narrative is recent, original, and originates from a reputable source. The claims made are plausible and supported by recent events. No significant issues were identified in the checks conducted.
