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The PSA publishes its review of the Nursing and Midwifery Council’s performance for 2023/24
19 Jun 2025
We have published our annual performance review of the Nursing and Midwifery Council (NMC). During 2023/24, in accordance with our schedule, we conducted a more detailed periodic review of the NMC’s performance against the Standards of Good Regulation (the Standards).
Background
We were originally due to publish our report by September 2024, covering the reporting period 1 July 2023 to 30 June 2024. However, we delayed our review when, in Autumn 2023, the NMC commissioned three independent reviews to look into issues raised in whistleblowing disclosures. We extended the reporting period to 31 December 2024 to allow us to take account of these reviews.
The first of the three independent reviews, the Independent Culture Review (ICR), was published in July 2024. The other two reviews (led by Ijeoma Omambala KC) have not yet been published. The remaining reviews will enquire into the NMC’s handling of the fitness to practise cases identified through the whistleblower’s concerns and the NMC’s handling of the whistleblowing disclosures.
We believe it is in the public interest for us to report on the NMC’s performance in a timely way and as the remaining reviews have been delayed, we are publishing our report now without waiting any longer. Our report is based on the information we have already gathered, including findings from the ICR where relevant. We will consider any recommendations from the Omambala KC reviews in detail when they are available.
Findings
From the period 1 July 2023 to 31 December 2024 the NMC has met 11 out of the 18 Standards. During the review, we identified weaknesses in multiple regulatory functions leading us to conclude that the NMC has not met the following Standards:
- Standard 2 (clarity of purpose): we identified performance issues across a number of the NMC’s regulatory functions, and this was reflected in the NMC’s own strategic risk register. Moreover, the ICR concluded that ‘… the NMC had strayed from its central mission’ and recommended that ‘The NMC needs to retain a focus on its core regulatory purposes, and how best to deliver its mandate to protect the public within a changing environment.’
- Standard 3 (Equality, Diversity and Inclusion (EDI): the NMC did not meet Outcome 1 under this Standard because of limited evidence about the impact of the work that has been undertaken to embed EDI throughout the organisation. It met the other three Outcomes and we identified examples of good practice. The ICR made numerous critical findings about the extent to which EDI is embedded in the NMC’s work and whether policies are followed in practice. The Omambala KC reviews are likely to make findings relevant to this Standard, and we will consider these when available as part of the next review period.
- Standard 4 (reports on performance and addresses concerns): we saw considerable evidence of routine public reporting, however we identified inconsistencies in the NMC’s fitness to practise reporting. Also, there are significant gaps in respect of the NMC’s ability to report on its education quality assurance function. The ICR found that the NMC has failed to implement and embed some of the findings and recommendations of previous reviews, and the NMC accepted that it has not addressed all the recommendations from previous reports. The PSA established the Independent Oversight Group in 2024 to monitor the work of the NMC in addressing all the recommendations of the ICR.
- Standard 9 (quality-assuring education providers): we identified significant concerns about the NMC’s ability to effectively monitor and quality assure Approved Education Institutions (AEIs). The NMC is in the process of developing an education quality assurance improvement plan, however this had not been finalised by the end of the review period.
- Standard 10 (maintains an accurate register): we were not sufficiently assured about the NMC’s ability to ensure the integrity of the register during the period under review.
- Standard 15 (fitness to practise timeliness): the NMC is investing significant money and resources in trying to improve the timeliness of its fitness to practise function, and there are some areas of improving performance. However, cases are still taking too long to process, and it continues to have a significant backlog. The NMC has not met this Standard since 2018/19.
- Standard 17 (identifies & prioritises most serious cases): the ICR highlighted significant concerns around safeguarding, and an NMC internal audit showed that there has been a failure to identify and act on safeguarding concerns. The NMC has taken steps to strengthen its safeguarding capabilities, however safeguarding remains the NMC’s highest-rated strategic risk.
In line with our escalation policy, we have written to the Secretary of State for Health and Social Care and the Chair of the House of Commons Health and Social Care Committee to make them aware of our concerns (these letters can be downloaded below).
The NMC recognises these issues and has committed to taking steps to address them. Since the end of the review period on 31 December 2024, the NMC has recruited a new interim Chief Executive and permanent Chair of the organisation. It also published its culture transformation plan in March 2025. The PSA will be monitoring closely the actions taken by the NMC to improve its performance and will report on these as part of its performance review for 2025.
Assessing and monitoring
The judgements we make against each Standard incorporate a range of evidence to form an overall picture of performance. Meeting a Standard means that we are satisfied that a regulator is performing well in that area. It does not mean there is no room for improvement. Similarly, finding that a regulator has met all of the Standards does not mean perfection. Rather, it signifies good performance in the 18 areas we assess.
Our oversight does not stop when we publish our report. It is an ongoing, continuous process and, where we have identified areas for improvement, we pay particular attention to these as we continue to monitor the NMC’s performance.
Find out more about the NMC’s review in our Periodic Report (download below). Find out more about how we review the regulators here.
ENDS
Professional Standards Authority for Health and Social Care
Contact: media@professionalstandards.org.uk
Downloads
Notes to the editor
- The Professional Standards Authority for Health and Social Care (PSA) is the UK’s oversight body for the regulation of people working in health and social care. Our statutory remit, independence and expertise underpin our commitment to the safety of patients and service-users, and to the protection of the public. There are 10 organisations that regulate health professionals in the UK and social workers in England by law. We audit their performance and review their decisions on practitioners’ fitness to practise. We also accredit and set standards for organisations holding registers of health and care practitioners not regulated by law. We collaborate with all of these organisations to improve standards. We share good practice, knowledge and our right-touch regulation expertise. We also conduct and promote research on regulation. We monitor policy developments in the UK and internationally, providing guidance to governments and stakeholders. Through our UK and international consultancy, we share our expertise and broaden our regulatory insights.
- Our values are – integrity, transparency, respect, fairness and teamwork – and we strive to ensure that they are at the core of our work.
- The Independent Culture Review (ICR) on NMC was published in July 2024. Its findings included serious concerns about the NMC’s culture and governance, and it made 36 recommendations, which the NMC accepted. In response to the findings of the ICR, we set up an Independent Oversight Group (IOG) to monitor the NMC’s work to address the findings and recommendations. Further information about the IOG, including its terms of reference and summary notes of meetings, can be accessed here.