Some Nigerian nurses in the U.K are being investigated for their alleged involvement in a widespread qualifications fraud.

It’s been reported that over 700 nurses are entangled in this potential scandal, raising concerns from a former head of the Royal College of Nursing who warned of potential risks to NHS patients.

The scheme reportedly includes proxies posing as nurses and completing a critical exam in Nigeria, a requirement for registration and employment in the UK.

Peter Carter, the ex-chief executive of the RCN and ex-chair of three NHS trusts who described it as an “industrial-scale fraud” said; 

“It’s very, very worrying if … there’s an organisation 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 praised 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 the necessity for proper qualifications for nurses working in the UK, given their crucial responsibilities in administering medication, managing intravenous infusions, and responding to emergencies like cardiac arrests.

Currently, 48 of these nurses are employed within the NHS, as the Nursing and Midwifery Council (NMC) lacks the authority to revoke their registration without a directive from an independent panel following a hearing. Although the NMC has instructed them to retake the test to demonstrate their proficiency, it cannot suspend them in the interim.

These 48 individuals are scheduled for individual hearings, commencing in March, during which they will be required to account for how they seemingly completed and passed the computer-based test (CBT) of numeracy and clinical knowledge administered at the Yunnik test center in Ibadan. If found responsible, the panel may instruct the NMC to remove them from the register. The rapid completion times recorded have raised suspicions, as they are among the shortest observed by the nursing regulator.

The Nursing and Midwifery Council (NMC) is pursuing more decisive measures concerning a second group comprising 669 Nigerian healthcare personnel, predominantly nurses but also including fewer than five midwives, whose test results have been determined to have been obtained fraudulently. Most of them have already relocated to the UK, according to sources.

However, their situation differs from the aforementioned 48 individuals, as they are believed to be primarily employed as healthcare assistants in the NHS and care facilities. This is because the NMC has not sanctioned their inclusion in its register while it investigates the widespread impersonation occurring at the Yunnik test center.

Of the 669 applicants, approximately 80 nurses have undergone a new CBT test and applied for registration with the NMC to assume nursing roles. Nonetheless, the nursing regulator has declined nearly all of these applications due to “serious concerns” regarding their integrity and reliability.

Andrea Sutcliffe, the NMC’s chief executive and registrar, stated that the organization had taken necessary and rigorous action after being alerted by Pearson VUE, the contractor for the Yunnik test center, about “widespread fraudulent activity” last year, involving a “proxy tester” assuming the identity of a nurse.

“This is the first instance where we have encountered evidence of widespread fraud at a test center,” she remarked, adding that it constitutes the largest-scale fraud the NMC has encountered to date.

The fraud uncovered at the Yunnik test center has prompted the Nursing and Midwifery Council (NMC) to invalidate the Computer-Based Test (CBT) results obtained by 1,955 Nigerian-trained healthcare professionals. All of them, including the 1,238 individuals for whom the regulator cannot definitively prove involvement in fraud, have been given three opportunities to retake the CBT test or face expulsion or exclusion from the register.

“We have concerns that 48 individuals already registered obtained their test results fraudulently. We will hold hearings where an independent panel will determine whether these individuals gained fraudulent entry to our register. If so, they are likely to be removed from the register,” stated Sutcliffe.

“We have similar fraud concerns regarding 669 applicants to the register. We are carefully reviewing each application in accordance with our guidance on health and character. The majority of the 80 applications we have assessed thus far have been refused entry to the register, and those individuals have the right to appeal.”

The future of the 717 nurses remains uncertain. The GMB union is apprehensive that those denied entry to the NMC register will be repatriated to Nigeria. The union asserted that nurses had been “exploited” in Nigeria, urged the NMC to allow all individuals with questionable test results the opportunity to retake the test in the UK, and emphasized the healthcare system’s need for their skills to help alleviate the nationwide nursing shortage.

The GMB expressed concern over the cases of two Nigerian women, both members of the union, whose applications for Nursing and Midwifery Council (NMC) registration were denied despite their insistence that their test results from Yunnik were genuine. Subsequently, both women were terminated from their positions at a private care home pending clarification of their status. They now fear deportation to Nigeria along with their families.

“The individuals in charge at this center have exploited the aspirations of workers seeking nursing opportunities in the UK, leaving our members in dire circumstances,” remarked Louise Gilmour, the GMB’s Scotland secretary.

“While it’s imperative to uphold the profession’s standards of integrity, these prospective nurses were ill-advised, first to enroll at this center and then to provide questionable accounts of their experiences there,” she added. “They deserve another opportunity and should be permitted to work if they successfully pass the required tests in the UK.

“These individuals, predominantly women, have demonstrated their willingness to relocate and contribute to the healthcare and social care sectors in a nation grappling with a crisis in staff recruitment and retention.”

The Nursing and Midwifery Council (NMC) has ceased utilizing 40 out of the 800 test centers globally that it previously employed, including the Yunnik center, following the exposure of fraud there.

A spokesperson from the Department of Health and Social Care stated: “We are cognizant of the Nursing and Midwifery Council’s (NMC) investigations into fraud involving nurses who passed their computer-based test at a center in Nigeria. We have been informed that the NMC is implementing all required measures to safeguard the integrity of its register and ensure patient safety.”