Nursing and Midwifery Council

Did You Know?

• The NMC Council is made up of twelve members: six lay people and six nurses or midwives, appointed by the Privy Council.
• The Professional Standards Authority for Health and Social Care (PSA) oversees the nine UK healthcare regulators, including the NMC.

History

The NMC's predecessor was the General Nursing Council (GNC) for England and Wales, established by the Nurses Registration Act 1919. In 1983, the GNC was succeeded by the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC), created under the Nurses, Midwives and Health Visitors Act 1979. Both bodies maintained a register, provided guidance, handled misconduct complaints, and approved training courses. The UKCC's structure continued with minor changes until April 2002, when it was replaced by the NMC under the Nursing and Midwifery Order 2001. The English National Board was abolished, and its quality assurance function transferred to the NMC; other National Boards were also abolished, with new bodies created in each country.

Activities

The Nursing and Midwifery Council funds its work through registration fees paid by its members, generating an annual income of over £52 million and supporting more than 1,200 employees. Across the UK, the NMC establishes the standards, guidance, and requirements that shape nursing and midwifery education, determining what knowledge and skills a registered professional must possess. It approves higher education institutions to run programmes, currently accrediting 1,000 courses across 79 institutions.

Once students finish their programme, their institution confirms they have met the required education and practice standards and are of good health and good character; if considered fit to practise, they can then apply for registration. Each year, more than 22,000 newly qualified nurses and midwives come from these institutions. As of March 2025, the register holds 788,074 nurses and midwives, making the NMC the regulator overseeing the largest group of healthcare professionals in the UK.

Practising as a nurse or midwife requires being on this register, which anyone can search. The NMC’s revised Code, effective from 31 March 2015, sets out the professional standards of practice and behaviour that all registrants must follow. Its four main sections require nurses and midwives to prioritise people, practise effectively, preserve safety, and promote professionalism and trust. Updated from the 2008 version, the Code now includes new requirements on fundamentals of care, duty of candour, raising concerns, and social media use.

The introduction states that by joining and renewing their registration, nurses and midwives commit to these standards, and the NMC can take action—including removal from the register—if they fail to uphold them.

Legislation

On 2 April 2014, the Law Commission published its draft bill, Regulation of Health and Social Care Professionals, aiming to replace outdated decision-making processes and give healthcare regulators more autonomy. The NMC's Chief Executive and Registrar Jackie Smith welcomed the draft bill but stated that the NMC needs it to become law quickly to modernise and become efficient. Under its current legislative framework, the NMC spends nearly 80% of its income on fitness to practise hearings. The revised Mutual Recognition of Professional Qualifications (MRPQ) Directive, effective 19 January 2016, introduced changes to facilitate free movement of professionals within the EU, including amendments to language controls, enabling the NMC to ensure on a case-by-case basis that EU nurses or midwives have sufficient English for safe practice.

Criticism

On 11 March 2008, two Members of Parliament, Jim Devine and John Smith, accused the NMC of bullying and racism in the House of Commons. The NMC denied the accusations, and the government set up an independent inquiry by the Council for Healthcare Regulatory Excellence and the Charity Commission. The NMC has also been accused of nepotism by its members and Nursing Standard in 2017, due to senior NMC members also being the instigating officer in cases against nurses from the same NHS Trust; one nurse was struck off for a data issue while another who witnessed assaulting patients was suspended for one year.

In July 2024, an independent review of the NMC's culture highlighted safeguarding concerns and found that people working there have experienced racism, discrimination, and bullying; the new chief executive resigned after four days, and the governing council apologised. On 16 April 2009, nurse Margaret Haywood was barred from practising after an NMC Conduct and Competence committee panel ruling, following her contribution to a BBC Panorama programme exposing care deficiencies at the Royal Sussex County Hospital.

The public and media response was generally antagonistic toward the NMC, with the Royal College of Nursing describing the decision as 'unduly harsh'. On 12 October 2009, the striking off order was dropped and replaced with a one-year caution. In early July 2012, the Council for Healthcare Regulatory Excellence (CHRE) critically examined the NMC's leadership. Later that month, Mark Addison was appointed as new chair by the privy council, a move criticised by the NMC Council for lacking an open, transparent, and equal opportunities process; the CHRE expressed pleasure at the appointment.

On 26 June 2015, the Professional Standards Authority reported that the NMC had made overall improvements in their performance.