NHS failed to spot sex abuse by male nurse

David Britten worked at the Peter Dally clinic in Pimlico and was today described in a damning report as a "manipulative predator" .

He is known to have sexually abused at least 23 vulnerable women, some as young as 16, suffering from anorexia and bulimia over 20 years but there may be 100 more victims.

An independent investigation has found the abuse could have been stopped earlier but senior managers failed to identify the fact he was grooming vulnerable patients behind the doors of his treatment room.

The report said Britten, now 57, repeatedly violated professional boundaries but went unchecked because monitoring systems were inadequate and staff repeatedly missed obvious signs.

The Nursing and Midwifery Council was singled out for criticism because it took two years to suspend Britten despite receiving complaints. An investigation by his employer the Riverside Mental Health Trust was also described as "seriously flawed".

Investigation chairwoman Alison McKenna said: "He deliberately targeted patients for his own sexual gratification."

Described by his victims as a " cultlike" figure, Britten worked first at the Gordon Hospital then as manager of the Peter Dally clinic. Patients ended up self-harming, taking overdoses or even attempted suicide when he threatened to end their relationships because they would not agree to his sexual demands.

Britten was eventually struck off the nursing register in 2004 but a legal loophole has enabled him to evade prosecution because his patients were officially consenting.

NHS London said it accepted the report's findings "without reservation" but said it had now introduced a new model of eating disorder service.