Nursing and Midwifery Council
Established in 2002, the Nursing and Midwifery Council (NMC) is a statutory body set up by the Parliament of the United Kingdom through the Nursing and Midwifery Order 2001. The NMC is the UK regulator for nursing and midwifery professions with a stated aim to protect the health and wellbeing of the public. The NMC maintains a register of all nurses, midwives and specialist community public health nurses eligible to practise within the UK. It sets and reviews standards for their education, training, conduct and performance. The NMC also investigates allegations of impaired fitness to practise (i.e. where these standards are not met).
In addition to being a statutory body, the NMC is also a charity registered with the Charity Commission, charity number 1091434 and in Scotland with the Office of the Scottish Charity Regulator, charity number SC038362. All Council members are trustees of the charity.
- 1 Role
- 2 From UKCC to NMC
- 3 Council
- 4 Activities
- 5 Changes to healthcare regulation
- 6 Criticism
- 7 Other UK healthcare regulators
- 8 See also
- 9 References
- 10 External links
The NMC’s role is to:
- protect the health and wellbeing of the public
- set standards of education, training, conduct and performance so that nurses and midwives can deliver high quality healthcare consistently throughout their careers
- ensure that nurses and midwives keep their skills and knowledge up to date and uphold the NMC’s professional standards, and
- have clear and transparent processes to investigate nurses and midwives who fall short of the NMC’s standards.
From UKCC to NMC
In 1983, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) was set up. Its core functions were to maintain a register of UK nurses, midwives and health visitors, provide guidance to registrants, and handle professional misconduct complaints. At the same time, National Boards were created for each of the UK countries. Their main functions were to monitor the quality of nursing and midwifery education courses, and to maintain the training records of students on these courses.
This structure survived with minor modifications up to April 2002, when the UKCC ceased to exist and its functions were taken over by a new Nursing and Midwifery Council (NMC). The English National Board was also abolished and its quality assurance function was taken on board by the NMC. The other National Boards were also abolished, but new bodies were created in each country to take over their functions.
The NMC Council has two key roles: setting the strategic direction for the NMC and overseeing the work of senior NMC staff.
The Council ensures that the NMC complies with all relevant legislation, including the Nursing and Midwifery Order 2001 and the Charities Act 1993.
The Council is made up of 12 lay and registrant members, including one member from each of the four UK countries. They are appointed by the Privy Council. Registrant members are from a nursing or midwifery background; lay members are selected for their expertise in various fields and strategic experience.
The current Council took office on 1 May 2013.
The NMC has an annual income in excess of £52 million and employs over 400 staff.
The NMC set standards, guidance and requirements for nursing and midwifery education across the UK. These standards help to shape the content and design of programmes and state what a registered nurse or midwife needs to know and be able to do.
The NMC approves higher education institutions to deliver programmes. They currently accredit 1000 programmes in 79 education institutions across the UK.
When students successfully complete their programme, their education institution will let the NMC know that they have met the education and practice standards and are of good health and good character. If they are deemed fit to practise they will then be eligible to apply to join the register. Each year the NMC receives over 22,000 newly qualified nurses and midwives from education institutions.
Registering nurses and midwives
There are 670,000 nurses and midwives on the NMC register, meaning the NMC is the body responsible for regulating the largest number of healthcare professionals in the UK. Nurses and midwives must be on the NMC register in order to practise in the UK. Anyone is able to search the NMC register. The annual registration fee to the NMC is an allowable expense for UK income tax, however a survey by the NMC discovered that more than 75% of NMC registrants do not claim tax relief on their registration. 
In April 2008, the NMC launched its new 'code' to replace its existing 'Code of Conduct'. The code details the standards of conduct, performance and ethics required of nurses and midwives. Nurses and midwives must meet the standards set out in the code in order to be considered fit to practise.
The introduction to the code states the following.
“The people in your care must be able to trust you with their health and wellbeing.
To justify that trust, you must:
- make the care of people your first concern, treating them as individuals and respecting their dignity
- work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community
- provide a high standard of practice and care at all times
- be open and honest, act with integrity and uphold the reputation of your profession."
The NMC has committed to developing and implementing a system of revalidation for nurses and midwives.
Revalidation will require every nurse and midwife to confirm that they:
- Continue to remain fit to practise by meeting the principles of the revised Code.
- Have completed the required hours of practice and learning activity through continuing professional development (CPD).
- Have used feedback to review and improve the way they work.
- Have received confirmation from someone well placed to comment on their continuing fitness to practise.
The NMC ran a public consultation on how revalidation can be applied in practice from January to March 2014. A second consultation is due to take place later in 2014 before revalidation is launched in December 2015.
Managing complaints about nurses and midwives
The NMC handles complaints made about nurses and midwives, and investigates allegations where appropriate. The NMC has the power to restrict a nurse or midwife’s practice or strike them off their register.
The NMC produced guidance for nurses and midwives on raising concerns which aims to help them take action in the public interest when needed. It includes information on legislation that offers protection to whistleblowers and information on organisations nurses and midwives can go to for further advice.
Helene Donnelly, ambassador for cultural change at Staffordshire and Stoke-on-Trent Partnership NHS Trust, spoke to NMC Council about raising concerns and gave her support to the guidance.
Changes to healthcare regulation
On the 2 April 2014, the Law Commission published its draft bill, Regulation of Health and Social Care Professionals. The bill aims “to aim to sweep away the out-dated and inflexible decision-making processes associated with the current legislation.” The bill would give healthcare regulators in the UK more autonomy.
The NMC’s Chief Executive and Registrar welcomed the publication of the draft bill, but stated how the NMC needs the bill to become law quickly if it is able to modernise and become an efficient regulator. In its current legislative framework, the NMC spends nearly 80% of its income of fitness to practise hearings.
Accusations of bullying and racism
On 11 March 2008 two Members of Parliament Jim Devine and John Smith made accusations in the House of Commons of bullying and racism within the NMC. These accusations have been firmly denied by the NMC. The government set up an independent inquiry asking the Council for Healthcare Regulatory Excellence and the Charity Commission to investigate.
On 16 April 2009, nurse Margaret Haywood was barred from practising as a Nurse in the UK following a ruling by the NMC Conduct and Competence committee panel. This followed Haywood’s contribution to a BBC Panorama television programme, exposing significant deficiencies in care at the Royal Sussex County Hospital, an acute teaching hospital in Brighton, England. The public and media response was generally antagonistic towards the NMC, the response being described by the Royal College of Nursing as 'unduly harsh'. On 12 October 2009, the striking off order was dropped, and replaced with a one year caution.
In an early July 2012 report, the Council for Healthcare Regulatory Excellence (CHRE) critically examined the leadership of the Nursing and Midwifery Council. In late July 2012, a new chair for the NMC, Mark Addison, was appointed by the privy council, an appointment which was subject to criticism by the NMC Council, who described their "grave concern" with regard to what they claimed was a "lack of an open, transparent and equal opportunities process" in regards to the appointment. In contrast, the CHRE stated that they were pleased with the appointment of a new Chair, and that they would "look forward to working with Mark Addison".
In March 2013 the NMC was fined £150,000 by the Information Commissioner's Office after it admitted that personal data, including "highly sensitive" information about nurses and about vulnerable children, had been placed on DVD without being encrypted, sent by courier, and subsequently lost. The ICO said that "it should have been obvious ... that such a contravention would be of a kind likely to cause substantial distress to the data subjects due to the nature of the data involved".
Other UK healthcare regulators
The Professional Standards Authority for Health and Social Care (PSA), is an independent body accountable to the UK Parliament, which promotes the health and wellbeing of the public and oversees the nine UK healthcare regulators. These are:
- General Medical Council
- General Dental Council
- Health and Care Professions Council
- General Pharmaceutical Council
- General Optical Council
- General Chiropractic Council
- General Osteopathic Council
- Pharmaceutical Society of Northern Ireland
- Nursing and Midwifery Council
- "Our Role". Nursing and Midwifery Council. 9 June 2014. Retrieved 4 July 2014.
- "NMC Council". Retrieved 4 April 2014.
- "Strategic review of the Nursing and Midwifery Council: Final report". Council for Healthcare Regulatory Excellence. 3 July 2012. p. 7. Retrieved 2 August 2014.
- "NMC Register". Retrieved 4 April 2014.
- "NMC tax relief". Retrieved 21 June 2014.
- "NMC Code". Retrieved 4 April 2014.
- "Revalidation". Retrieved 4 April 2014.
- "Raising concerns". Retrieved 4 April 2014.
- "Helene Donnelly addresses NMC Council". Retrieved 4 April 2014.
- "Regulation of Health and Social Care Professionals". Law Commission. 2 April 2014. Retrieved 14 April 2014.
- "NMC Chief Executive and Registrar article". Retrieved 14 April 2014.
- "Statement in response to allegations by Jim Devine MP". Nursing and Midwifery Council. Archived from the original on 2008-03-18. Retrieved 2008-03-12.
- Carvel, John (2008-03-12). "Bullying and racism claims at nursing council". The Guardian (London). Retrieved 2008-03-12.
- "Nurse struck off register for confidentiality breach". Nursing and Midwifery Council. Retrieved 2009-04-28.[dead link]
- "Calls for whistle-blower review". BBC News. 2009-04-16. Retrieved 2009-04-28.
- "Over 15,000 sign petition to support struck off RCN member". Royal College of Nursing. Retrieved 2009-04-28.
- "Panorama nurse can return to work". BBC News. 2009-10-12. Retrieved 2009-10-12.
- "Strategic review of the Nursing and Midwifery Council Final report 3 July 2012". Retrieved 11 September 2012.
- "Appointment of Mark Addison as Chair of the NMC". Retrieved 11 September 2012.
- "‘Grave concerns’ over appointment of new NMC chair, Nursing Times 31 July 2012". Retrieved 11 September 2012.
- "NMC Chair appointment". Retrieved 11 September 2012.
- "Nursing watchdog fined £150k for confidential unencrypted DVD loss". The Register. 19 February 2013. Retrieved 22 March 2013.
- Nursing and Midwifery Council
- NMC YouTube channel
- Reclaiming Midwives: Backdrop to the Future Linda Janet Holmes speaks at the University of Wisconsin Health Sciences Learning Center