Regulation of nurses and midwives in the United Kingdom - David Hubert

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  • Note: The trend of application from the EU has been growing steadily in the last 10 years. In the last two years we have seen a surge in applications from ‘old’ EU countries such as Ireland, Spain and Portugal, mainly for economic reasons. Ireland for example has had a freeze in its healthcare recruitment and large scale redundancies in the health sector.
  • The issue to note here is the very small number of individuals reported to FTP and subsequently struck off or subject to sanctions, as a proportion of the total number on the register.
  • Add contact information (for example, email address, phone number) if required


  • 1. Regulation of nurses and midwives in the United Kingdom David Hubert EU Policy Lead 17 November 2011
  • 2. About the NMC
      • We are the nursing and midwifery regulator for the United Kingdom
      • We exist to safeguard the health and wellbeing of the public
      • In order to practise in the UK every nurse or midwife must hold current registration with the NMC
  • 3. What we do
      • We set standards of education, training, conduct and performance so nurses and midwives can deliver high quality healthcare consistently throughout their careers
      • We ensure that nurses and midwives keep their skills and knowledge up to date and uphold their professional standards
  • 4. What we do
      • We ensure that midwives are safe to practise by setting rules for their practice and supervision
      • We have clear and transparent processes to investigate complaints made against nurses and midwives
  • 5. How we protect the public Nursing and Midwifery Council Employers and managers Nurses and midwives
  • 6. About the NMC register
      • We have over 660,000 nurses and midwives on the register
      • Around 33% of nurses and midwives hold more than one qualification
      • Almost 20% of people on the register are aged 55 years and over, and just 2% are aged under 25 years
      • 20,000 people on the register live outside the UK
  • 7. About the NMC register
      • 70250 individuals on the register were trained outside the EU. Top countries of origin are the Philippines, India, South Africa, Australia and New Zealand
      • 12293 individuals on the register were trained in the EU. Top countries include Ireland, Spain and Poland
      • In the last year the NMC has issued 8180 registration information packs to EU trained applicants and registered 2713 EU nurses and midwives
  • 8. Maintenance of registration
    • The NMC operates a system of periodic renewal of registration and continuous professional development:
      • All nurses and midwives must pay an annual registration fee of £76 GBP
      • All nurses and midwives must renew their registration every three years and declare that they have met the NMC practice and continuous professional development (CPD) standard
  • 9. NMC practice and CPD standard
    • At the three year renewal point all nurses and midwives must declare that they have:
      • Undertaken 450 hours of registered practice in the previous three years
      • Undertaken at least 35 hours of learning activity (CPD) in the previous three years
    • The 450 hours of practice can be met through administrative, supervisory, teaching, research and managerial roles as well as providing direct patient care
  • 10. NMC practice and CPD standard
    • Nurses and midwives who do not meet the NMC practice and CPD standard will not be able to work because their registration will lapse
    • In order to renew their registration such individuals will be required to undertake an NMC approved return to practice programme through a UK education institution
  • 11. The register and employers
    • The NMC does not issue a license to practice, instead the NMC register is the tool of public protection
    • Employers are required to check their employees registration status using the NMC registration confirmation service and by consulting the publicly available online register via the NMC website
  • 12. The NMC code
      • All nurses and midwives are required to abide by the NMC code
      • Nurses and midwives are personally accountable for their practice and must always be able to justify their decisions and actions
  • 13. Fitness to Practise
      • The NMC investigates complaints about individual nurses and midwives
      • It is concerned with issues of:
          • professional misconduct
          • convictions and cautions
          • lack of competence
          • health related problems
  • 14. Fitness to practise statistics
    • 2008-2009 2009-2010
    • On the register 663,656 (100%) 662,283 (100%)
    • Referrals 2,178 (0.3%) 2,988 (0.4%)
    • Investigation 1,759 (0.2%) 2,126 (0.3%)
    • Sanctions 740 (0.1%) 925 (0.1%)
    • Striking off 216 (0.03%) 202 (0.03%)
  • 15. Areas of development
      • Regulation of health care support workers. Current debate ongoing in the UK about the scope and nature of possible regulation
      • Additional material to support the NMC code of conduct. This will be formed of examples of best practice from nurses and midwives in using the NMC code
  • 16. Areas of development
      • Revalidation: the NMC is exploring the introduction of a new system to assure itself of nurses and midwives continuing fitness to practise and CPD
      • In 2010 the NMC launched a new set of standards for pre-registration nursing education. All nursing programmes will in future be at degree level. Quality assurance approval of new programmes is currently taking place.
  • 17. International work
      • The NMC has been proactively taking part in the review of EU Directive 2005/36 on the recognition of professional qualifications
      • In 2010 on behalf of the European Commission we co-ordinated the feedback of all nursing regulators in the EU on how the directive has been operating
  • 18. International work
      • The NMC is actively taking part in the following phases of the review of the directive to suggest changes. These include:
        • Updating the minimum training requirements for general nurses
        • A requirement on regulators to share fitness to practise information proactively
        • A requirement that regulators should be able to assure themselves of an individuals language competency.
  • 19. Online presence
      • Sign up to our email newsletter at
      • Join our Facebook page at
      • Follow us on Twitter at
  • 20. Thank you