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Professional Regulation

Concerns raised over the ‘fairness and transparency’ of NMC Fitness to Practice cases

While the Nursing and Midwifery Council achieved 22 out of 24 core standards, it fell short in two main areas.



nursing and midwifery council
David R Gee / Alamy

The NMC has ‘made progress’ but is still failing to meet important Fitness to Practice standards.

A review of the Nursing and Midwifery Council (NMC) by the Professional Standards Authority (PSA) found the regulator was failing to meet key standards in its handling of Fitness to Practise (FtP) cases.

The PSA found that while the regulator was achieving 22 out of 24 core standards it fell short in two main areas – the transparency and fairness of FtP cases and keeping the involved parties involved in FtP cases updated.


Concerns were also raised over how the NMC handled complaints about registrants who have conducted Personal Independent Payment (PIP) assessments. It said; “the NMC did not systematically consider all the concerns raised by complainants, relied on the views of employers as reasons to close cases, without proper scrutiny and did not obtain sufficient evidence to reach its decisions.”

It was noted that the NMC had made progress on addressing concerns around how the organisation communicates with families and patients – which included setting up its public support service. The NMC is also said to be looking at the “tone of voice” it uses when corresponding with members of the public.

The regulators new chief executive has promised sweeping changes across the organisation – promising they can ‘be nice and regulate well’.

The PSA said it was “pleased” the regulator had instituted a plan of work to address the concerns raised but recognised it may take some time to implement.

‘We have not always got things right’.

Responding to the review, Andrea Sutcliffe, NMC Chief Executive and Registrar, said; “Today’s report reiterates just how important it is to treat people with fairness and respect and to ensure we consider all concerns raised in referrals to us. We know that in the past we have not always got those things right.

“Encouragingly, the report recognises the significant progress we have made in more recent years, and how, through the introduction of our new public support service and our changing approach to fitness to practise we continue to improve, ensuring people are at the heart of our work.

“I’m sorry that our approach to a small number of PIP related cases fell short of what is expected. Our failure to fully address the concerns of some people making complaints and the lack of clarity in our decision making was not good enough.  Since 2018 we have taken action. This includes additional training for those making and communicating case decisions, as well as a new quality assurance approach to the way we initially review cases.

“The report also highlights the positive impact some of our key initiatives are making in supporting better, safer care, including the development of new education standards and our review of overseas registration requirements.

“But we’re not complacent and know that there is much more we can and must do. We’re grateful to the PSA for carrying out this review and for their feedback. We will continue to address the issues raised in this report and the PSA’s lessons learned review and build on the good progress that has been made over the last twelve months as we embark on the development of new five year strategy.”

Professional Regulation

NMC launches an emotional support helpline for staff involved in fitness to practise cases

The helpline is part of the NMC’s bid to become a “person-centred” regulator.



Female with Telephone

The helpline will provide emotional and practical support for staff involved in the fitness to practise processes.

Nurses, midwives and nursing associates involved in fitness to practise can now benefit from a new, free and confidential support service.

The NMC’s Careline, operated by an independent provider, will provide emotional and practical support is also available 24 hours a day, 365 days a year for nurses and midwives across the UK, and nursing associates in England, who are involved in the fitness to practise processes.


Staff can contact the service via phone, live chat or email, to discuss concerns with specially trained counsellors who are experienced in handling sensitive topics.

Launching less than a year since the NMC set up its support service for members of the public who raise concerns when things go wrong with their nursing or midwifery care, the 12-month CareLine pilot launched on World Mental Health day.

Becoming a ‘person-centred’ regulator.

Andrea Sutcliffe CBE, Chief Executive and Registrar at the NMC, said: “Following the launch last year of our Public Support Service for people affected by poor nursing or midwifery care, I’m really pleased we’re now able to offer this new pilot resource for professionals.

“The Careline marks another important step forward in truly humanising how we operate and becoming the person-centred professional regulator that the NMC is determined to be with everyone we interact with.

“Less than one per cent of around 700,000 professionals on our register are engaged in our fitness to practise procedures, but we know that it can have a profound effect on those that are. The impact on someone’s physical and mental wellbeing as a result of being under such scrutiny mustn’t go unrecognised.

“I hope the Careline, and our forthcoming remediation guidance, further encourages support and learning when things do go wrong in nursing and midwifery care. Together, let’s help ensure that all those involved in our processes are treated with kindness and respect.”

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Professional Regulation

NMC to ensure overseas nurses can ‘join the register quickly as possible’

Overseas nurses will now be able to apply to join the register through an online system.



Nurse chest child

The Nursing and Midwifery Council say they have streamlined the process for overseas nurses.

From today, nurses and midwives applying to join the Nursing and Midwifery Council (NMC) register will now be able to apply through an online system allowing them to track their progress instantly.

This follows a number of changes in recent years made by the NMC to better support applicants through the registration process, which included allowing candidates to only re-sit only the portion of an OSCE they failed, improved preparation materials including a mock examination and marking criteria and updated English language requirements.


As part of the professional regulator’s commitment to improving its approach to overseas registration, the latest changes have been designed to offer a more efficient and streamlined experience and help ensure qualified nursing and midwifery professionals can get into practice where they are needed.

‘Join the UK workforce as quickly as possible’.

According to the NMC, these changes will ensure that highly-skilled nursing and midwifery professionals can join the UK workforce as quickly as possible in order to carry out their role of delivering better, safer care for people using health and care services.

Emma Broadbent, Director of Registration and Revalidation at the NMC, said: “We have listened to people’s feedback and I’m pleased to announce that from today nurses, midwives and nursing associates from abroad will benefit from this improved process.

“We want to make sure that those who meet our requirements are able to join our register as quickly and efficiently as possible. We are hopeful that by simplifying the application process, we will continue to make the UK an attractive option for those coming from abroad.

“This is another example of how the NMC is committed to positively addressing nursing and midwifery shortages that exist in health services, adult social care services and within local communities across the UK.”

Making nurses ‘feel as welcome as possible’.

The NMC says it has seen a significant increase – rising from 2,720 last year to 6,157 in March this year – in the number of nurses and midwives joining the register for the first time from outside of the EU.

Health and Social Care Secretary, Matt Hancock said: “Nursing and midwifery is at the heart of our NHS and the social care sector, and it is important that we make those joining the health service, whether from at home or abroad, feel as welcome as possible.

“With an increasing number of applicants from around the world, this secure and efficient online service from the NMC will make it quicker for highly trained midwives, nurses and nursing associates to be able to provide compassionate care to their patients.”

“My grandmother worked in the NHS as a nurse, and I so know just how much commitment nurses put in to caring for their patients every day and night.”

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