The must-read stories and debate in health policy and leadership.

The Nursing and Midwifery Council has come under fire once again after a damning review concluded it had dysfunctionality at “virtually every level”.

A report into concerns at the regulator discovered a “fundamental disconnect between what the NMC embraces and what it practises” amid instances of bullying, racism, and discrimination.

Its findings come after the NMC commissioned a review in January following concerns raised by a whistleblower, who claimed a “deep-seated toxic culture” was leading to skewed and failed investigations.

The report said: “We heard staff talk about taking antidepressants, managing their hair falling out, and not being able to sleep because of bullying and bad management. And we heard staff angrily recount experiences of racism within the workplace.”

It highlighted the impact of delays in fitness to practise cases, heightened safeguarding risks, and the toll of years waiting for a decision.

In one case, a nurse who was accused of serious sexual misconduct and an alleged rape in 2017 was not struck off until 2024.

Meanwhile, six nurses have died by suicide while under investigation by the regulator.

The NMC has apologised following the report and committed to a change programme after accepting its recommendations.

Diversion tactics

One of England’s most challenged systems is diverting around 400 patients a week, mostly long waiters, away from its largest trust towards private hospitals and neighbouring NHS providers, after setting up a new “coordination centre”.

As HSJ reported yesterday, Sussex Integrated Care System was previously relocating only around 10-15 appointments a week before the new system went live earlier this year.

And independent experts agreed that while the coordination centre approach had been used elsewhere, the scale of patients being moved by the Sussex system was a lot larger than others.

They questioned whether the model could be pushed further in other systems to replicate Sussex’s returns to help better utilise elective capacity across whole systems and supported struggling trusts.

Read more about the model and reaction from experts here.  

Also on

We report that a supermarket chain executive has been named as the new chief commercial officer for the Department of Health and Social Care, and that health and social care secretary Wes Streeting has told his department and NHS England to work as “one team” to improve services – which includes relaying their “competing views and interests” to him.