The head of the United Kingdom’s nursing regulator, Paul Rees, has acknowledged significant past failures in handling allegations against nurses, particularly those accused of serious misconduct outside their professional duties. This admission marks a significant shift for the Nursing and Midwifery Council (NMC), which has faced criticism for allowing nurses accused of sexual assault to continue working within the National Health Service (NHS).
In a candid interview, Rees stated that the NMC had been “completely wrong” in its previous approach to investigating claims against nurses for actions outside of their employment. This change follows investigative reports by The Independent, which highlighted cases of nurses who had escaped scrutiny for serious allegations, including sexual assault and domestic violence. In response to public outcry and media reports, the NMC updated its guidelines on sexual misconduct, acknowledging that it had previously rejected calls to investigate such matters, claiming they fell outside its jurisdiction.
A pivotal moment in this shift was the independent inquiry led by Nazir Afzal KC, which criticized the NMC’s leadership for a “wilful deafness to criticism.” The inquiry underscored the organization’s reluctance to engage with whistleblowers who raised concerns about safety and professional standards.
In his first major interview since taking the helm, Rees expressed regret for the NMC’s inadequate response to previous scandals. He cited the case of psychiatric nurse John Iwuh, who was sentenced to 16 years in prison in July 2025 for rape and voyeurism. Iwuh was permitted to work with patients for over a year after the NMC was informed of the police investigation against him in 2022. Rees stated, “The issue was that the guidance stated where nursing and midwifery professionals did something outside of their working life, it was outside of our concerns – that was completely wrong.”
Rees emphasized the necessity of recognizing that a nurse’s conduct outside of their professional role is equally critical to their fitness to practice. He expressed a strong commitment to reforming the NMC, stating that he is “determined to fix the challenges” and to “turn the ship around,” although he cautioned that substantial change may take years.
The NMC plays a crucial role in maintaining public trust in the NHS, alongside the General Medical Council and the Care Quality Commission. Patients must feel confident that the healthcare professionals responsible for their care are qualified and trustworthy. The previous NMC stance—disregarding nurses’ private lives—was a notable departure from the standards expected of a regulatory body.
Transparency and a culture of openness are essential for the NMC’s future effectiveness. As stated by former Health Secretary Jeremy Hunt, a culture of safety is built on transparency, honesty, and a readiness to learn from past mistakes. The NMC’s previous defensiveness regarding its standards has been viewed as unacceptable and detrimental to patient safety.
Despite the changes implemented under Rees’s leadership, concerns remain. A whistleblower associated with the NMC, currently engaged in an employment dispute with the organization, has claimed that the “same defensive, dishonest culture” persists. In response, an NMC spokesperson dismissed these claims as “simply incorrect.”
The path forward for the NMC is critical. Rees’s willingness to confront past failures is a necessary step toward rebuilding trust. Patients and healthcare professionals alike are hopeful that the NMC can cultivate an environment where accountability is prioritized, paving the way for a safer and more transparent healthcare system. As Rees himself noted, addressing these issues is vital for ensuring that patients can trust the nurses who provide their care.
