The UK super regulator has intervened to try and improve the way fitness-to-practise cases involving sexual misconduct are handled by regulators, including the Nursing and Midwifery Council (NMC).
The move comes after the NMC has come under fire in recent years for failing to properly deal with cases involving rape and other types of sexual abuse.
“We are currently looking at ways to strengthen our handling of such cases”
Lesley Maslen
The PSA’s new report – Improving the handling of sexual misconduct cases in fitness to practise – aims to strengthen regulators’ approach to investigating, managing and making decisions in such cases.
One of its recommendations was for regulators to ensure their guidance covered incidents of sexual misconduct that happen outside the work environment, where relevant.
Back in 2023, the NMC faced a revolt from its own staff, who raised various concerns about the work of the regulator, including that it was failing to deal with cases of sexual misconduct among registrants seriously enough.
A following independent review published in July 2024 backed up these concerns, finding that cases of inappropriate behaviour and sexual assault had not been acted upon properly by the NMC.
In one case, a nurse was referred for allegedly sexually assaulting patients and raping a colleague, but the NMC initially “closed down” the complaint because the incidents happened off hospital grounds. The nurse was eventually struck off seven years later.
Meanwhile, in its report, the PSA – which oversees the health and social care professional regulators – noted how “power imbalances” between perpetrators, victims and witnesses needed to be considered when dealing with cases of sexual misconduct.
The report highlighted a case study in which a senior doctor sexually assaulted a nurse at 3am on an isolated hospital ward.
The case went before the General Medical Council (GMC) and the GMC accepted the nurse’s version of events, but the doctor was only suspended for 10 months.
The PSA later appealed the decision and got the doctor struck off, with the power imbalance between the doctor and nurse being flagged as a reason for a higher sanction being needed.
Other recommendations by the PSA were for regulators to treat sexual misconduct allegations as “high-risk cases” that should be promptly dealt with, and for investigators to adopt a “trauma-informed” approach to gathering evidence.
The PSA said it had seen a rise in sexual misconduct cases where it had needed to step in and appeal the decisions made by regulators.
These cases accounted for 11% of appeals in 2021-22, rising to 33% in both 2023-24 and 2024-25. In 2025-26, nine of the 35 appeals (26%) brought by the PSA involved sexual misconduct-related charges.
Nursing Times asked the PSA if the problems raised with the NMC’s handling of sexual misconduct cases had played a part in its decision to publish the report.
In response, a spokesperson said: “This is a subject we have been exploring from a number of angles over the past two years, through discussions with stakeholders, researchers and subject matter experts.
“It has arisen from issues in the handling of cases across the regulators that we oversee, changing societal awareness of the issue, and growing interest in the prevention of harm as opposed to action after the fact.”
Lesley Maslen, executive director of professional regulation at the NMC, said it welcomed the PSA’s recommendations.
She added: “We are currently looking at ways to strengthen our handling of such cases, including ensuring that we apply trauma-informed approaches consistently.
“We also remain committed to working with our partners in health and care to uphold a culture of zero-tolerance towards sexual misconduct.”
She noted how NMC data showed that when sexual misconduct allegations were found to be proven against a nurse, midwife or nursing associate, they were “highly likely” to be struck off, and added that support was offered to victims and witnesses.
More on the NMC’s culture review
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