The world’s largest nurses’ union, the Royal College of Nursing (“RCN”), which represents nursing staff in the UK and internationally, has been labelled “an organisation which at its top, is riddled with division, dysfunction and distrust” in a report by Bruce Carr KC.

The RCN commissioned the report in September 2021 as a part of its “commitment to change” following an initial investigation into its governance by KPMG. The KPMG report called for significant change and made 25 recommendations to drive this into action. Carr’s subsequent investigation, during which he interviewed 60 anonymous witnesses regarding events from 2018 until the present day, centred on sexual harassment allegations, equality and inclusion inadequacies, and flaws in the RCN’s decision-making and financial management processes.


  1. Sexual harassment: Carr’s report addressed a culture of sexual harassment, following an August 2021 announcement by the RCN that its annual conference would be moved online due to “serious allegations of sexual harassment” at in-person events in previous years. Carr found that the annual conferences were “seen by many as an opportunity to engage in sexual activity which will carry with it a substantial risk that a line will be crossed so as to become exploitative."
  2. Equality and inclusion: Carr said that the RCN was perceived as a “bullying and misogynistic environment in which women and those from the [Black, Asian and minority ethnic] BAME community are not welcome.” Carr noted that while 90% of the RCN’s membership are female, at least 60% of the RCN Council are male. Carr also said that the Council was “not reflective of the fact that around 45% of RCN members are from the BAME Community.” Carr denounced the RCN council as dominated by “loud and abrasive male voices.”
  3. Decision-making and accountability processes: Carr found that a £35m strike fund, which was created in response to the government’s recommendation of a 1% pay award in March 2021, was set up without “any proper consideration of the feasibility or mechanics of setting up such a fund, or how it would operate in practice.” During the investigation, he was informed by a member of the college that the executive team did not approve the decision to set up the strike fund.


Carr noted that his report supported KPMG’s recommendations but went further to include rectification of a substantial trust gap between the RCN’s council and executive. He also recommended the creation of new harassment policies and procedures, which “should extend not just to sexual harassment but harassment by reference to other protected characteristics, such as sexuality or disability.”

Next steps

Pat Cullen, the RCN’s General Secretary & Chief Executive, has apologised for past conduct on behalf of the RCN and accepted the recommendations of the report. She announced that the RCN has also launched immediate investigations into Carr’s findings in a bid to “leave no stone unturned”. The RCN will now consider whether it may need to take any action against individuals within the organisation who are found to have acted wrongfully.

Key takeaways

Our key takeaways from this are:

  • Culture reviews are really valuable ways to understand what is going on in an organisation, but can often escalate into a multi-phase set of investigations, with different aspects carried out by different parties. In the RCN’s case, the broader KPMG investigation into the organisation’s governance raised issues which were then investigated further by Carr. Similarly, specific matters identified by Carr’s review will now be investigated internally by the RCN. The series of investigations illustrates how a general review can lead to further lines of enquiry, which then need to be addressed separately.
  • Culture issues may be prevalent not only in an employee-employer context, but also within membership associations and trade unions, where the provisions of the Equality Act 2010 will still be applicable and must be understood.
  • When it comes to regulated professions (e.g. medical practitioners, legal services practitioners, and financial services, to name a few), the outcome of an investigation can have regulatory repercussions. If a business is undergoing an investigation and it employs regulated employees, it should be prepared to report anything significant to the relevant regulator. In this case, the Nursery and Midwifery Council (the profession’s regulator) has said it is now making direct contact with Carr to discuss regulatory action.

If you would like to discuss how to investigate an instance of bullying, harassment, discrimination, or a wider culture problem within your organisation, please speak to your usual Lewis Silkin contact to discuss how we can help.