The former head of the Royal College of Nursing announced that NHS patients could be at risk as they are still being treated by more than 700 nurses caught up in an "industrial-scale" qualifications fraud scandal and are currently under investigation.

The scam is regarding a key test that should be taken in Nigeria by nurses allowing them to be registered and work in the UK, which allegedly, in this case, were taken by proxies pretending to be nurses.

The ex-chief executive of the RCN and ex-chair of three NHS trusts Peter Carter stated, “It’s very, very worrying if … there’s an organization that’s involving themselves in fraudulent activity, enabling nurses to bypass these tests, or if they are using surrogates to do exams for them because the implication is that we end up in the UK with nurses who aren’t competent."

He further commended the Nursing and Midwifery Council (NMC) for taking action against those involved “to protect the quality of care and patient safety and the reputation of nurses”.

Carter emphasized that nurses wanting to work in the UK must be well qualified as they play a vital role in administering drugs, intravenous infusions, and responding to emergencies such as cardiac arrest.

A deeper dive into the scandal

The NMC is unable to revoke the registration of 48 of the nurses already working in the NHS so it has requested them to retake the test to prove their skills meet NHS standards. It is noteworthy that one cannot work as a nurse or midwife in Britain without being registered. 

Starting in March, the 48 nurses will go through individual hearings, having to elaborate on how they took and passed the computer-based test (CBT) of numeracy and clinical knowledge at the Yunnik test center in the city of Ibadan noting that their results are extremely peculiar as the times recorded were among the fastest the nursing regulator had ever witnessed.

Sources revealed that the NMC is taking more direct action against another 669 Nigerian health staff most of which are nurses with fewer than five midwives whose results were also obtained through fraud with most in the UK already. However, their situation differs from that of the 48 as they are majorly working in healthcare assistant positions in the NHS and care homes as NMC has not accepted their applications yet to be registered pending the investigation's conclusion.

Even though about 80 nurses out of 669 applicants have taken a new CBT test and requested to join the NMC register, the nursing regulator has banned almost all of them due to “serious concerns” about their honesty and trustworthiness.

The NMC stated, “This is because even with a new CBT there remains character concerns given what happened at Yunnik and what the data appeared to show about these individuals."

Andrea Sutcliffe, the NMC’s chief executive and registrar, said that a warning from Pearson VUE previously operating at the Yunnik test center informed her of "widespread fraudulent activity" in which a "proxy tester" impersonated a nurse prompted the NMC to take immediate action.

She labeled this as the biggest-ever fraud case the NMC has seen to this day after stating “This is the first time we’ve found evidence of widespread fraud at a test center."

NMC revealed that the CBT test results obtained by 1,955 Nigerian-trained health professionals were invalid. The latter in addition to 1,238 with no evidence of fraud, according to the regulator, have been given three chances to retake the CBT test or face de-registration. 

Sutcliffe added, “We have concerns that 48 people already on the register obtained their test results fraudulently. We’ll hold hearings where an independent panel will decide whether those individuals gained fraudulent entry to our register. If so, they’re likely to be removed from the register."

“There are 669 applicants to the register about whom we have the same fraud concerns. We’re reviewing each application carefully in line with our guidance on health and character. We’ve refused entry to the register for the vast majority of the 80 applications we’ve considered so far, and those individuals can appeal," she emphasized.

The future of 717 nurses remains unclear

The GMB union is concerned for those who were rejected from the NMC register as they may be sent back to Nigeria where nurses had been “exploited”. It urged the NMC to allow all those with suspicious test results to retake the test in the UK arguing that the health service demanded their skills to help deal with the UK-wide shortage of nurses.

Two Nigerian women whose test results from Yunnik were legitimate according to the GMB union, had their NMC applications rejected and were fired by the private care home where they were working until a clear status was determined instilling in them the fear of being deported to Nigeria with their families.

“Those in charge at this center have exploited the hope of workers wanting to nurse in the UK and left our members in a desperate situation," GMB's Scotland secretary Louise Gilmour stressed “The profession’s high standards of integrity must be enforced but these aspiring nurses were badly advised, firstly to enroll at this center and then give questionable accounts of what happened there."

“They should be given another chance and allowed to work if they pass the necessary tests in the UK," Gilmour urged “These are workers, mostly women, willing to uproot their lives and settle here to work in a health and social care service that is suffering a crisis in staff recruitment and retention.”

The NMC has halted 40 of the 800 test centers worldwide it had previously used before the Yunnik fraud, including Yunnik itself.

A Department of Health and Social Care spokesperson stated: “We are aware of the Nursing and Midwifery Council’s (NMC) fraud investigations into nurses who passed their computer-based test in one center in Nigeria," adding “We are advised that the NMC is taking all necessary steps to ensure the integrity of its register and that patient safety is protected.”