How the NMC proposes to transform its culture and regulatory performance

The review found serious failings in our culture and regulatory work. We and our Council have apologised and accepted all 36 of the review’s recommendations.

To deliver sustainable change, we recognise that we must prioritise our colleagues and culture. Eliminating the problems and transforming our culture successfully will take time. We are proposing a multi-year culture transformation programme alongside significant improvements, at pace, to our regulatory casework in order to improve outcomes for the public and professionals.

Transforming colleagues’ experience of working at the NMC

We want equality, diversity and inclusion (EDI) to be at the heart of everything we do which means we need to get better at eliminating poor behaviours, including racism and other forms of discrimination at the NMC.

We’ve now completed two commitments which help to address the fact that it isn't always easy to speak up: we’ve introduced an Independent 'Empowered to Speak Up' Guardian and designated 12 colleagues who have completed initial training to become Empowered to Speak Up Ambassadors. Colleagues can speak to them if they're experiencing or witnessing something that isn’t right. This is part of our commitment to creating spaces where everyone feels safe and supported to raise concerns.

We’ve also appointed external EDI experts, The Equal Group, to review our EDI learning, improve mandatory training and identify any gaps in our policies and approach to tackling bullying, harassment and discrimination.

We are in the process of revising our existing EDI and People Plans, taking account of the review’s recommendations and colleagues’ testimony. We aim to publish the updated plans by the end of the year. Alongside this we are also in the process of appointing an EDI advisor to the Executive Board.

Making a step change in fitness to practise (FtP)

The review demonstrates that our regulatory performance and our organisational culture are inextricably linked. We can only regulate well if our colleagues are operating in an inclusive, high-performance environment where they can thrive.

In March our Council approved a £30m, 18-month improvement plan to make a step change the timeliness of our FtP decision making. As well as refining this plan following the independent culture review, we are also investing urgently in additional external resources and expertise. Initially this will help us to get screening timeliness – the initial assessment stage of our process – back to a two-month average in 2025/26. We also aim to get investigation timeliness to an average of seven months in 2026/27.

Crucially, our plan will remain flexible in order to incorporate further feedback from stakeholders, and learning from other sources. This includes the upcoming review of FtP cases by Ijeoma Omambala KC, as well as the next annual performance review by our oversight body, the Professional Standards Authority (PSA).

Elevating safeguarding within our regulatory work

Our regulatory work brings us into contact with many people in difficult or vulnerable circumstances, and we need to elevate the focus on safeguarding within our casework. We have now established a safeguarding hub, which means that from September, every referral received in screening will now be looked at through a safeguarding lens. This will be rolled out to our wider fitness to practise team by the end of this calendar year.

Engagement

Good communications, engagement and collaboration internally and externally will be fundamental to rebuilding trust and to the success of our plans. We will deliver a significant programme of engagement and collaboration with colleagues and stakeholders to diagnose, design, and deliver culture transformation.

We are extremely grateful for the many offers of support which we have received from our partners. We will discuss these offers with these individuals and organisations in further detail and as we develop the scope of the programme, we will agree how we can best work together and when.

Ensuring transparency, accountability and oversight

We will provide comprehensive updates at our open Council meetings, with progress papers and meeting minutes published online.

The PSA’s oversight and support group will also receive regular updates. This group of key stakeholders including Chief Nursing Officers (CNOs), trade unions, the Department of Health and Social Care (DHSC) and devolved administrations and patient groups, will be invited to scrutinise the impact of our actions to improve our culture and performance.

Helen Herniman, Acting Chief Executive and Registrar, said:

“We are committed to improving trust and confidence in the NMC with both members of the public and our stakeholders. They need to see swift progress in the changes we're embedding and that they are sustainable.

“We’re prioritising actions that will positively impact people both internally and externally. This includes improvements in equality, diversity and inclusion, alongside urgent investment in our fitness to practise handling so that we can minimise the anxiety to all parties. We have also been investing in safeguarding resources to ensure that we can fulfil our primary purpose of protecting the public.

“We will enable improvements in our internal culture by tackling bad behaviours including discrimination, enabling and empowering leaders, and ensuring clearer accountability for our regulatory performance.

“Importantly, we’ll move forward in a spirit of collaboration. People inside and outside of our organisation can continually ‘test and challenge’ the steps we take as we collaborate on what a new, better NMC looks and feels like.”

Find out more about the Council meeting on 24 September

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