Raising concerns, and why the NMC has said sorry

On 15 September 2026 the NMC published its response to the report of the Thirlwall Inquiry, which examined events at the Countess of Chester Hospital and how the organisations around that hospital answered concerns raised about a nurse. The regulator accepted that it got things wrong.

Its chief executive said he was truly sorry for failings in how the case was handled, stretching back to 2016, and the NMC set out what it should have done instead: pressed the hospital harder on the information it had been given, considered the possibility of deliberate harm sooner, understood the hospital's own safeguarding arrangements, and moved faster to restrict the nurse's practice while it looked into the matter.

This is not an exam announcement and nothing you are revising changes because of it. It is here because raising concerns is one of the things the computer-based test asks you about, and reading a question about it is a different experience once you have seen what the failure looks like.

What the Code actually asks of you

The duty is not conditional. If you believe patient safety is at risk, you act. You raise it with the right person, you record what you saw and when you saw it, and if nothing happens you take it further. None of that waits until you are certain, and none of it waits for somebody senior to agree with you first.

The cautious option is usually the wrong one

This is where candidates most often go astray. Given a concern and four things to do about it, the attractive answer is the careful sounding one: gather more evidence, watch and see whether it happens again, mention it to a colleague and find out what they think.

It is the one the Code does not support. The reason for escalating early is that you are not the person who has to establish what is going on. You are the person who has to make sure somebody does.

A concern that went nowhere is not finished

This is the second thing the report puts a line under. A concern already raised, with nothing come of it, is still yours. It goes up, and if the route above you is itself the problem it goes outside, to the employer's own speaking up route, to the regulator, to the commissioner, to whoever is in a position to act. A question about this is usually asking whether you know that the chain carries on past the first person who shrugged.

Where this sits on the exam

Three parts of it touch the same material. Platform 1 is accountability, which includes the duty of candour and acting on a risk you can see. Platform 6 is safety and quality, where incident reporting and learning from error sit. And one of the two written OSCE stations is a professional values station, which can put a scenario of exactly this kind in front of you and ask what you would do and why.

One thing to say plainly, since this is a revision site rather than a commentary. Nothing here is a view about the criminal case, which has its own process and is not ours to discuss. The NMC's statement is public and is what to read if you want the detail. What is useful to a candidate is narrower and more durable than any of it: the Code asks you to act on a concern, and an inquiry report is a long and expensive account of what happens when nobody does.

Accountability and the Code and safety and quality are where the questions sit, and the professional values station is where you would have to say it out loud.