Updated: Aug 24
In our work at Equality 4 Black Nurses, we have identified that White Nurses receive fewer referrals to the NMC and often receive more favourable treatment within internal workplace disciplinary processes.
As a result of their preferential treatment, they may face less severe consequences for similar Nursing competence issues than people of other races. As a result, racial bias can influence allegations against Black Nurses, referrals to the NMC and sanctions, resulting in disproportionate and unjust outcomes. Did you know that the NMC regulates over 758,000 nurses? However, their data from their 2019-2020 inclusion data shows that a shocking 15.3% of new fitness-to-practice referrals were made against black nurses, while black nurses make up only 8.5% of the entire NMC register.
International nurses, in particular, suffer the most, and the recent scandal involving Nigerian nurses' Computer Based Test (CBT) is troubling.
A letter from Andrea Sutcliffe, the NMC's Chief Executive and Registrar, claims "unusual and concerning" data from one of its third-party test centres in Ibadan, Nigeria. The letter stated this had raised concerns about the integrity of the tests taken at this centre. Due to this potential computer irregularity, the NMC has targeted and profiled 512 Nurses on their register and informed them that the NMC would open fraud or incorrect entry cases to review all these profiled Nurses using a one-size-fits-all blanket approach. Blanket approaches can lead to discrimination.
The CBT consists of a numeracy and clinical theory test undertaken in their country, followed by a practical exam called the objective structured clinical examination (OSCE) in the UK. At first glance, our Nigerian Nurses seem to be treated as guilty by association with the affected test centre.
Andrea Sutcliffe rightly states in her announcement that opening cases does not mean every individual has "fraudulently or incorrectly" joined the register. However, the individual letters to the 512 nurses put them on notice that the NMC will be contacting all their employers who, as a result of this information shared, might wish to discuss this matter with these Nigerian Nurses.
This disclosure has had a detrimental effect on these nurses, with some already being singled out and lined up for suspension pending the outcome of the NMC investigation.
When we consider that none of the 512 nurses has been named individually as suspects, nor do any of the chosen few have any previous fitness-to-practice concerns. The NMC should have gathered evidence and provided supporting information to corroborate the claims before requesting participation in their investigations and making such an announcement.
Surprisingly, the NMC has petitioned that all the Nurses (at this early stage) inform their managers and discuss the NMC concerns without consideration of any adverse effects, including the risk of potential discrimination and prejudice towards these vulnerable Nurses who have come to the UK to help to rebuild our crumbling National Health Service.
We also find it troubling that The NMC suggests all 512 Nigerian Nurses must retake the test without telling them why. However, If a nurse retakes and passes, this pass won't guarantee they can continue working as a Nurse in the UK. Such an attitude appears to be discriminatory. On what basis is the NMC declaring such a position?
For racist employers, this public announcement has served them meat on a platter, an excuse and reason to target Black Nurses that they may no longer want in the working environment.
The NMC's responsibility is to investigate nurses once they have qualified, and they rely on universities and training centres to identify potential issues. Nevertheless, any cheating and plagiarism among nurses and student Nurses in Britain is a serious concern. An allegation of fraud undermines the Nursing profession's credibility and poses potential risks to patient care.
At this early stage, we cannot say for sure that race contributes to how the NMC has treated Nigerian nurses in the CBT issue. However, we hope they use this opportunity to look at the issue more widely and not only focus on or reserve their efforts for Nigerian Nurses because similar matters are of concern in the UK.
Cheats can be found all over the world. An example of a cheating Student Nurse who benefited from her fraud by becoming a fully-fledged Nurse is the case of a British-trained Registered Nurse who worked at a nursing home in Sussex. She purposely bought an essay from a dodgy website and later submitted it during her Nurse training at the University of Surrey. As a result, she graduated without being detected, but her luck ran out. As a result of her dishonesty, the NMC took her through the Fitness-to-practice process and handed down a six-month suspension order for Serious Professional Misconduct. However, in mitigation, the Nurse submitted that she felt under pressure. As a result, the NMC accepted and forgave her misdemeanour, and she's now back on the NMC register and continues to work in her chosen profession without a scar to her name.
Like many other countries worldwide, Nigeria has faced significant challenges and negative connotations linked to subjects surrounding fraud and corruption. The negative portrayal of Nigeria has led to unfair stereotypes, generalisations and assumptions about its people, which can be harmful and result in discrimination.
During a conversation with the former Queen of England some years ago, David Cameron, the former Prime Minister, was caught on camera describing Nigeria as one of the most corrupt countries in the world. Yet, he made this statement with such confidence and no fear.
However, unfortunately, his privilege allowed him to make such a bold statement and reinforce the damaging and discriminatory stereotypes without repercussions or consequences.
This mindset of racist stereotypes, assumptions and tropes sits subconsciously in the minds of those in power within UK institutions because they reflect our society. Sadly, this mindset and way of thinking include the Nursing and Midwifery Council (NMC), Trade Unions and the National Health Service (NHS).
It's also essential for the NMC to understand how the statement by the former Prime Minister about Nigerian people can exacerbate racial stereotypes and generalisations and feed into white supremacy ideology. This compounding factor is interlinked and could impact the outcomes and the management of fitness to practise cases against Black and Brown Nurses.
The NMC needs to consider that exposure to negative racial stereotypes about individual groups of people can lead to prejudice, and unconscious bias is more likely to occur.
Representation helps challenge and dismantle stereotypes, biases, and prejudices that arise from ignorance or limited exposure to other cultures. However, It's worrying that the NMC's top council team only includes one member from a Black and minority background, while the additional 11 are all white. Furthermore, over 80% of the senior leadership team throughout the organisation are white colleagues, which (in our opinion) makes the organisation out of touch with the realities of the lived experiences of Black Nurses.
Equality 4 Black Nurses has committed to ensuring that Nigerian nurses and concerned colleagues affected by the NMC's announcement are adequately supported and have access to proper representation.
Therefore on behalf of all the 758,000 on the NMC register, E4BN is currently seeking advice on potential collective action, and we encourage any Nurse involved or concerned to contact us and/or complete the attached form to help us start gathering crucial information and continue our work to amplify the voices of all Nurses.