Record number of screening decisions in fitness to practise

In January 2025, we made more than 1,000 decisions across all stages of FtP – which included a record 797 cases at the screening stage either being closed or progressed for a full investigation. By improving the timeliness of our decision-making, we reduce the uncertainty and anxiety that long waits for a decision can cause. 

Our latest data shows other positive signs of progress: 

• For the first time since May 2024, our overall caseload decreased in January and again in February 2025 to 6,498. That’s despite receiving 588 and 574 new referrals in each of those months respectively   
• The number of cases resolved within our 15-month-target has reached 67.1 percent – up from 65.9 percent in January. 

April marks one year since we launched our fitness to practise plan – a comprehensive programme of more than 30 strategic and operational improvements. This was further refined last autumn to include recommendations from the independent culture review. The priorities within our plan are centred around ensuring we make swift, safe and proportionate decisions, by faster and fairer processes, so that we resolve cases as early as possible.  

To continue driving improvements, we recently introduced a few key initiatives: 

• Our new pre-referral checklist makes it easier for members of the public to understand whether we’re the right organisation to look into their concern. This means our screening teams can focus on concerns that we have the power to look into and those which are higher risk, and act quickly to protect the public more effectively  
• We have launched a Health Pilot at the investigations stage, to improve support to individuals whose FtP case relates to a physical or mental health need. For example, we provide bespoke, compassionate support for professionals experiencing conditions like dementia or substance misuse. Over the coming year, we will expand the pilot and use real-time feedback to ensure people receive the right support  
• We are co-developing additional solutions to improve our FtP process through our work with PwC. On a short-term basis, their specialists are also helping us to progress cases at screening. 

While recent progress is meaningful, we still have much more to do to equip our colleagues with the support and tools they need to consistently deliver effective regulation for the benefit of people and communities. 

We know it will take many more months before everyone involved in our process feels a real difference. However, we are encouraged by the progress so far and remain committed to building a sustainable system that truly delivers outcomes swiftly and fairly for everyone. 

Lesley Maslen, NMC Executive Director of Professional Regulation, said: 

“As we move into the second year of our fitness to practise plan, we’re seeing meaningful progress. The improvements in both timeliness and the number of decisions across several stages of fitness to practise are a testament to colleagues’ hard work - with a record-breaking month at the screening stage meaning more people are receiving decisions quicker.  

“We cannot afford to be complacent. High volumes of referrals continue to put our teams under significant pressure. That’s why we’ve realigned our plan to ensure we’re making prompt, proportionate decisions, managing referrals effectively, supporting vulnerable professionals and the public, and improving our culture.  

“While challenges remain, every improvement we make brings us closer to a regulatory process that is faster, fairer and supportive for everyone involved in fitness to practise.” 

Further information 

Referral: This is what we call a new concern submitted to us about a nursing or midwifery professional on our register 

Screening: This is the initial assessment stage when we receive a new concern about a professional on our register and decide whether it should go to a full investigation 

Investigations: If we've decided that a concern needs further investigation, the screening team will pass it onto the investigation team. The investigation team will then gather evidence and continually assess all the information they receive to decide what the next steps in the investigation should be. At the end of the investigation, the team will put together a report for our case examiners to look at 

Case examiners: If a referral has been made about a professional and we have investigated the case, our case examiners will decide whether there is a ‘case to answer’ 

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