Narrative

Our vision is safe, effective and kind nursing and midwifery practice that improves everyone’s health and wellbeing. As the independent regulator of more than 826,000 nurses and midwives in the UK and nursing associates in England, we have an important role to play in making this vision a reality.

We’re here to protect the public by upholding high professional nursing and midwifery standards, which the public has a right to expect. That’s why we’re improving the way we regulate, enhancing our support for colleagues, professionals and the public, and working with our partners to influence the future of health and social care.

Our role

Our core role is to regulate. We set and promote high education and professional standards for nurses and midwives across the UK, and nursing associates in England and quality assure their education programmes. We maintain the integrity of the register of those eligible to practise. And we investigate concerns about professionals – something that affects very few people on our register every year.

To regulate well, we support nursing and midwifery professionals and the public. We create resources and guidance that are useful throughout professionals’ careers, helping them to deliver our standards in practice and address challenges they face. We work collaboratively so everyone feels engaged and empowered to shape our work.

We work with our partners to address common concerns, share our data, insight and learning, to influence and inform decision-making and help drive improvement in health and social care for people and communities.

Our context

We’re in a period of challenge and change. We’ve heard concerns about our culture and effectiveness as a regulator and we’re committed to improving as we listen, learn and act.

We aim for people to be at the core of everything we do, but we know we need to do better for all those we interact with, and we’re challenging ourselves to improve.

We’re making significant investments in fitness to practise to improve the timeliness and quality of our decision-making. We’re focussing on shifting our culture to become a learning organisation that is person-centred and fit for the future and which offers an environment where all colleagues can thrive.

This will make us a better regulator; improving how we protect the public by supporting safe, effective, and kind nursing and midwifery care that improves everyone’s health and wellbeing in a changing world.

The bigger picture

The contemporary health and social care landscape across the four UK nations presents an increasingly challenging environment for those providing, accessing and receiving care. Workforce pressures, an ageing population and rising demand for health and social care - including complex, individual needs and choices - requires agility and adaptation from nursing and midwifery professionals when caring for people and their families.

As a regulator we must also be agile and adapt our approach to do our best for the professionals on our register, the public we serve and each other.

Where we’re heading

We’ve identified five priority outcomes between now and 2026 focusing on the most significant risks to our work. These are also the areas where improvement will have the biggest positive impact on people’s experiences of our role, whether they’re the professionals on our register, the public, our partners or our colleagues. By making critical changes and improvements to key areas of our work; our culture and our interactions, people and communities will ultimately have better experiences of care.

We will monitor and review our progress against these outcomes, remaining agile to the wider landscape and adapting where needed to ensure that we continue to deliver our regulatory duties.

Progress fitness to practise referrals in a safe and timely way

We want our fitness to practise process to be person-centred, considerate, and straightforward for everyone involved. Referrers and professionals need to have their cases dealt with effectively and in a timely way, employers should understand when to refer their employees and our people should feel proud to work for the NMC and be able to make a positive difference.

We know that fitness to practise cases are taking too long to resolve, causing additional stress to referrers, witnesses and their families as well as the professionals under scrutiny. Our new plan commits £30 million to fitness to practise over the next three years, with a particular focus on investment and improvement over the next 18 months. It will deliver significant change in capabilities and systems, improving how we work, so that we’re making quality decisions that keep people safe. Decisions will be made with a focus on wellbeing and safeguarding in the most timely and considerate way possible, that’s also sustainable, long into the future. Our people are key to the successful delivery of this plan, and vital in prioritising this work across the organisation.

Build a high-performance learning culture

We want a professional culture that is free from discrimination, advances equality, celebrates diversity, promotes inclusion and prioritises openness and learning in the interest of colleagues, professionals, and the public. A culture that aligns with our values of kindness, fairness, ambition and collaboration and that positively impacts every aspect of our work so that our governance and regulatory decision-making is fair, sound, timely and safe.

We know creating and sustaining the right culture is a key enabler to us regulating and supporting professionals well. We know that we’ve got things wrong and will learn from the current independent investigations into recent concerns raised about our regulatory decision-making and culture, including colleagues’ safety to speak up. We will improve opportunities for all colleagues to learn and develop, with access to high quality learning and inclusive and supportive policies. As part of our Equality, Diversity and Inclusion (EDI) plan, we’ll improve fairness and equality in the workplace and in our regulatory decision-making including through our next Ambitious for Change review.

Modernise our systems, tools, policies and processes

We will have better, safer regulation for the benefit of the public with an improved register that’s easier to use and understand. We will strengthen our safeguarding measures to support colleagues, professionals, and the safety of the public. Our regulatory digital systems will be updated to improve the experience of customers and colleagues, making it easier for people to connect with us and NMC colleagues to do their jobs, supporting nursing and midwifery professionals to deliver safe, person-centred care. Everyone will have confidence and trust that we’re keeping their information safe and secure.

We will work with the Department of Health and Social Care to deliver flexible, modern legislation that enables better, safer regulation for the public. We will build a new case management system to help progress fitness to practice cases in a timelier way and provide a more seamless customer service to the people we work with - benefitting the professionals we regulate, the public we serve, and each other.

Contribute to the workforce strategies and support professionals in the four nations

Partners and the wider sector will benefit from our insight and be able to use it to inform and implement plans to address workforce challenges and improve care for people. The way we regulate will help nursing and midwifery professionals adapt to future challenges, including the changing needs of people who use services.

We will share our data and insight to help inform future workforce planning across the UK which includes highlighting the impact inequality, racism and discrimination is having on professionals and communities receiving care.

We will support government and health partners with plans to expand the nursing associate role into Wales, and beyond if requested. We are developing a range of approaches to additionally regulate advanced nursing and midwifery practitioners who are increasingly taking on complex, autonomous and expert roles - in the best interests of people receiving care. Meanwhile, we’ll successfully complete our review of practice learning which will help us continue to ensure the students of today have the right environment and opportunities to be the best nursing and midwifery professionals of tomorrow.

Strengthen the integrity of the register

We, the public and the professionals on our register will be able to trust and have confidence in the quality of education, skills and competency of registered nurses, midwives and nursing associates to deliver safe, effective and kind care for people and their communities.
We will strengthen our quality assurance model for ensuring all education programmes meet our standards and protect the public. We will also improve our processes and controls for how international applicants apply to and join the register, so that the public can continue to have complete confidence in the competency of those providing their care.