Systematic Expulsion of Black and Overseas Nurses: How Employers Are Weaponising the NMC Referral Process

At Equality 4 Black Nurses (E4BN), we have identified a deliberate and calculated pattern where employers systematically refer Black and overseas nurses and midwives to the Nursing and Midwifery Council (NMC) as a method of forced removal from the UK workforce. A case we identified previously HERE which had a monumental outcome and demonstrated how the system is weaponised, However, this tactic is not just an unfair employment practice - it is a hidden form of racialised workforce control, disproportionately affecting Black and overseas nurses and midwives.

The pattern follows a predictable sequence (as highlighted below), which we have seen repeated across multiple cases:

1. Black and overseas nurses and midwives arrive in the uk on a skilled worker tier 2 visa - Colleagues and patients may not like the Nurse or midwife and He/She may be deemed to not "fit in"

2. Senior Matrons and those with influence engineer NMC referrals with severe allegations

3. Senior staff (Disproportionately white) frame allegations strategically, exaggerating or escalating minor issues into serious misconduct claims.

4. These referrals are deliberately and expertly worded to maximise the likelihood of an NMC interim suspension order.

5. The employer bypasses internal procedures, using NMC intervention as a first resort, rather than conducting fair workplace investigations.

6. NMC suspension causes the nurse or midwife to breach their Tier 2 visa skilled worker agreement because they are often demoted to a support worker position or put on a long term suspension from work whilst an NMC investigation takes place. The nurse or midwife is therefore no longer regarded as a skilled worker which often subsequently triggers an Immigration process and the right to remain in the uk is revoked - The nurse/midwife is then given 30/60 days notice to leave the country

How the system works

Racial bias plays a role - NMC’s 2024 Culture Review confirms that Black and overseas nurses and midwives are disproportionately referred.

On receiving a referral to the Fitness to practice team, the NMC calls an interim hearing and disproportionately imposes a suspension. The NMC’s threshold for interim orders is lower for serious allegations, making suspensions highly likely. Instead of placing the nurse under practice conditions that are workable and can ensure the overseas nurse/midwife remains qualified to stay at their job, the NMC instead imposes a full suspension, completely barring them from working. The speed at which these decisions are made denies nurses the opportunity of having a fair defence, leading to immediate job loss as a nurse.

Employers use NMC suspension to justify termination as per contractual obligations, registered nurses and midwives must hold an active NMC PIN to remain employed. Once the NMC suspends a nurse/midwife, the employer claims they have “no choice” but to terminate their employment, framing it as a procedural requirement rather than a discretionary decision. By relying on regulatory suspension instead of direct dismissal, employers sidestep employment laws and avoid potential unfair dismissal claims.

The immigration consequence: visa curtailment and forced removal under Home Office Tier 2 visa regulations, an employer must report contract termination within 10 days. The nurse/midwife’s visa is then curtailed, typically within 60 - 90 days, leaving them with little time to appeal or find alternative sponsorship. This creates a direct pipeline from NMC referral to deportation, effectively ensuring the nurse/midwife is removed from the UK workforce and the country altogether.

Example letter received

Black and overseas nurses/midwives face additional barriers in securing new employment due to the stigma of an ongoing NMC investigation, even if the allegations were unfounded.

Financial Toll of Defending an NMC Case and the Domino Effect

The domino effect

Once referred to the NMC, a nurse/midwife is faced with crippling financial costs in attempting to defend themselves:

• Legal Fees: Solicitors and barristers specialising in NMC cases can charge anywhere from £5,000 to £50,000, depending on the complexity of the case.

• Loss of Income: A suspended nurse/midwife loses 100% of their earnings, often for 12 to 18 months or longer whilst awaiting a final decision.

• Visa Sponsorship Barriers: Overseas nurses and midwives cannot seek new employment because their immigration status is linked to their employer, forcing them into financial ruin.

  
  

This triggers a domino effect - legal fees pile up, savings run out, housing situations become unstable and many nurses are forced to take out loans and depend on food banks to survive. This financial ruin makes it nearly impossible for nurses/midwives to continue defending their case, ultimately leading to withdrawal from proceedings and, in many cases, deportation.

How the Loophole Ensures Deportation

• Prolonged NMC Investigations: The average NMC investigation takes 12 to 18 months, ensuring that the nurse remains unemployed for an extended period.

• Visa Curtailment Traps Nurses and midwives in Limbo: Once their employer reports contract termination, nurses/midwives have only 60-90 days to find another sponsor.

• Impossible Employment Prospects: With the stigma of an NMC investigation hanging over them, nurses very often cannot secure alternative employment, making deportation almost inevitable.

  
  

The domino effect of NMC referral → job loss → visa curtailment → financial collapse ensures that by the time a nurse/midwife is finally cleared by the NMC (if they ever are ), their visa has expired, their savings are depleted, and they very often have no choice but to leave the UK.

This Follows a Pattern of Racialised Workforce Control Seen in Other UK Scandals

The GMC Scandal: Disproportionate Referrals of Black and Overseas Doctors The General Medical Council (GMC) has faced longstanding criticism for disproportionately referring and sanctioning Black and overseas doctors. A 2019 study found that overseas-trained doctors were twice as likely to be investigated and sanctioned compared to their white UK-trained counterparts. In 2023, the case of Dr Arora, an Indian doctor who was struck off for a minor offence whilst white doctors received no sanctions for similar actions, sparked public outrage. The GMC’s pattern of harsher regulatory decisions against Black and overseas doctors mirrors the NMC’s treatment of Black nurses.

The Windrush Scandal: Systemic Removal of Black British Citizens The Windrush scandal exposed how the UK government wrongfully detained, deported, and denied rights to Black British citizens under hostile immigration policies. Many Windrush victims were stripped of their jobs and livelihoods due to bureaucratic failings, leaving them financially and emotionally devastated. This scandal is directly comparable to the NMC referral process, where Black and overseas nurses are unfairly removed from the workforce through regulatory weaponisation and subsequent visa curtailments.

The Disproportionate Disciplinary Action Against Black NHS Staff Reports have repeatedly shown that Black and Minority Ethnic (BME) NHS staff face harsher disciplinary action compared to their white colleagues. The 2024 NMC Culture Review confirmed that Black and overseas nurses are disproportionately referred, whilst the NHS Workforce Race Equality Standard (WRES) 2019 report revealed that BME staff were more likely to enter formal disciplinary proceedings. These structural patterns demonstrate a concerted effort to push Black healthcare workers out of the system under the guise of disciplinary action.

This is a Deliberate Strategy by Employers

The cycle of deportation

This is not a coincidence or isolated misconduct by employers - it is a structural loophole being deliberately exploited.

Employers understand that the NMC’s interim process can be weaponised.  They exploit this process to remove overseas nurses and midwives without facing legal consequences for direct dismissal. By shifting the responsibility onto the NMC whereby employers bypass employment protections and accelerate workforce removals.

We Will Not Allow This Injustice to Continue Unchallenged

This is not a regulatory safeguard - it is an institutionalised pipeline of racialised exclusion and dehumanisation. Employers are weaponising the NMC referral process to manufacture dismissals, leading to career destruction and forced removal from the UK of Black and overseas nurses/midwives who were called to the UK to address the shortage of nursing staff in the British Health and social care system.

At Equality 4 Black Nurses (E4BN), we are collecting evidence across multiple cases to expose this injustice by challenging both employers and the NMC for their role in systemic and often institutional discrimination. We are fighting to ensure that Black and overseas nurses and midwives receive fair and just treatment.

We will not remain silent whilst this hidden system of racial workforce control continues to harm our nurses and midwives. This injustice must be exposed, and those responsible must be held accountable.

📢 Have You Been Affected by This Pattern? Share Your Experience with E4BN

If you are a Black or overseas nurse or midwife who has experienced a suspicious or unjust referral to the NMC, or are you a white nurse/midwife who has noticed this pattern in your place of work?

If yes, we want to hear from you.

We will protect your identity and you will remain anonymous

Employers are exploiting this loophole to force overseas nursing staff out of their jobs and the UK, and we are actively collecting evidence to expose the worst offenders.

🔴 Have you been referred to the NMC over minor or exaggerated allegations?

🔴 Did your employer immediately terminate you following NMC suspension?

🔴 Was your visa curtailed as a result of an NMC referral?

📩 Contact Equality 4 Black Nurses (E4BN) and share your experience.Your story will help us identify patterns and hold employers accountable for their actions.

✉️ Email us at: www.equality4blacknurses.com or 0208 050 2598

Together, we can fight back against this systemic injustice. 🚨