Nursing regulator concedes delay in Letby case was a serious failure

The Nursing and Midwifery Council (NMC) has publicly acknowledged significant failings in its handling of the Lucy Letby case, admitting it should have suspended the former neonatal nurse far earlier.

Letby, now serving 15 life sentences for the murder and attempted murder of infants at the Countess of Chester Hospital, remained on the NMC register without restrictions until she was formally charged in November 2020—despite being arrested years earlier.

Paul Rees, appointed Chief Executive of the NMC in early 2025, has led a series of candid interviews in which he apologised for the regulator’s slow response and outdated guidance. “We should’ve acted faster with Lucy Letby,” Rees said, acknowledging that the NMC failed to pursue an interim suspension order when police investigations began.

At the heart of the issue was the NMC’s previous stance that misconduct outside of clinical practice—such as criminal behaviour in a nurse’s personal life—fell outside its remit. Rees has now called that position “completely wrong,” stressing that “what you do outside of work is just as important as what you do at work.” The regulator has since revised its guidance to ensure serious criminal allegations, regardless of context, trigger immediate regulatory action.

The Letby case is not the only example of delayed intervention. Rees also cited the case of psychiatric nurse John Iwuh, who was allowed to continue working with patients for a year after police informed the NMC of an investigation into rape and voyeurism. Iwuh was later jailed for 16 years.

The NMC’s admission comes amid broader scrutiny of its internal culture. An independent review led by Nazir Afzal KC—commissioned after whistleblower allegations—found the organisation to be “dysfunctional” and resistant to criticism, with evidence of racism and sexism within its ranks. Rees has pledged to overhaul the leadership and restore public trust, though he warned that meaningful reform could take years.

A public inquiry led by Lady Justice Thirlwall is expected to deliver its final report in 2026, examining the systemic failures that allowed Letby to remain in clinical roles despite repeated warnings from consultant paediatricians.

The NMC is likely to face further criticism in that report, although Rees has said the regulator is now better prepared to act swiftly in future cases.

Disclaimer: The accuracy and information of news stories published on this website is accurate on the date of publishing. We endeavour to update stories if information change. You can contact us with change and update requests. Where possible, we will link to sources. Content on this website is for guidance purposes only. We cannot accept any responsibility or liability whatsoever for any action taken, or not taken. You should seek the appropriate legal advice having regard to your own particular circumstances.