What do we know about NMC registration fee proposals so far?
Earlier this month Nursing in Practice exclusively revealed that the Nursing and Midwifery Council (NMC) is proposing to increase its registration fee for the first time in 10 years. Madeleine Anderson explores why this is, when a rise could be expected and how nurses have reacted to the situation.
What is the NMC consulting on?
After receiving the greenlight from its governing council last week, the NMC is set to launch a public consultation on increasing its registration fee – a move which would see fees rise for the first time in a decade.
The annual fee is currently £120 and can be paid either annually or quarterly.
For international registrants the initial registration fee is £153, with follow up payments of £120.
The NMC has said that if it had increased the annual registration fee in line with inflation over the last decade, it would now stand at £166.
‘We have, effectively, imposed on ourselves a cut in fee income in real terms of more than 28% over that period,’ the NMC explained in its most recent council papers.
The regulator says this would be ‘equivalent to foregoing’ around £180m in income since 2015 to March 2026.
How long will the consultation period last?
The consultation period is expected to launch this autumn and last 12 weeks. Nursing in Practice has asked the NMC to confirm exactly when the consultation will begin.
Any fee increase agreed is expected to come into place on 1 October 2026, after scrutiny from its governing council.
Why is the NMC proposing a free increase?
The NMC says its workload has ‘grown significantly’ over the 10-year period.
The number of professionals on the NMC’s register has increased by 24% over this time, from 686,811 in 2015 to 853,707 today.
This is equal to around 1 in 50 of the entire working age UK population.
At the same time, fitness to practise (FtP) referrals have also risen by 21%, from 5,415 in 2015/16 to around 6,539 in 2024/25.
The NMC’s workforce has grown in line with rising demand, almost doubling from 681 in 2016/17 to 1,400 today.
The NMC says that increasing demand for its services, alongside investment in improvement programmes, have both been paid for using NMC reserves.
The regulator has budgeted for a £27 operating shortfall of £27m in 2025/26.
‘Keeping the fee at £120 would result in a continuing deficit over the period 2025/2030, which would take our reserves below the minimum safe levels for any prudent and well-run organisation of the size of the NMC.
‘It could impair our ability to deliver our core regulatory functions and fulfil our statutory objective to protect the public,’ the regulator has said.
Growth of the NMC register has slowed in the past two years and the regulator projects register growth to be below 2% annually from 2026 onwards.
The NMC now believes that the income from a slower rate of growth will not be enough to keep up with inflation.
‘We now need to begin to bridge this gap by increasing the registration fees.
‘This will also allow us to return to our £30-£60 million target range for reserves consistently from March 2028, ensuring that we have the financial resilience long-term to deal with uncertainty and invest in the future,’ the regulator has explained.
When speaking exclusively to Nursing in Practice last month the NMC chief executive and registrar, Paul Rees, said the NMC needs to make sure its work is ‘sustainable’.
‘I think what people want in the sector is a strong and independent regulator. So, we need the organisation to be able to do that job of work.
‘We need to make sure that we’re being as frugal as possible, but the registration fee has been kept flat for 10 years and that’s no longer sustainable,’ he warned.
What will the money be spent on?
If introduced, the NMC says the fee will be used to ‘invest in critical change and improvement programmes’.
When speaking to Nursing in Practice, Mr Rees explained that the increase would be used to support ‘ongoing transformation of the NMC’ – including its work to improve FtP timeliness, and its education and standards, and fix its culture to ensure it is an ‘anti-racist organisation’.
He said that measures had been taken to ensure that the fee increase consulted on would be ‘kept as low as possible’, including through proposing the removal of 145 staff roles and other non-staff cost cuts amid a projected ‘financial gap’ of £24m this year.
What has the response been from nurses?
The union Unison has warned nurses would be ‘hit hard’ by an increase to the registration fee.
Unison head of health Helga Pile said earlier this month: ‘Forcing nurses and midwives to pay higher fees simply to do their jobs when inflation and food prices squeeze their earnings is unfair.
‘Any increase will place an extra financial burden on an already undervalued and underpaid nursing workforce.’
She pointed to news that the NMC is also planning to cut almost 150 jobs at the regulator as part of further cost-saving measures.
‘Those on the register will understandably question their confidence in the regulator,’ added Ms Pile.
Many nurses have also taken to social media to express their concern and disappointment over the fee proposals.
One Nursing in Practice reader commented on Facebook: ‘No incentives to stay in the profession more. They are making it so difficult for nurses. Low pay and now increased fees! Disgusting. No wonder so many are or thinking about leaving.’
Another demanded ‘full transparency’ from the NMC on ‘where and how our registrant fees are spent’. ‘This proposal is abysmal,’ they added.
Another nurse said: ‘Absolutely disgusting if they decide to increase it. Surely the NMC should be encouraging staff to stay on the register and be trying to entice people to come into the nursing career – not put them off with silly annual fees.’
What are the next steps?
Following a 12-week consultation, the NMC Council will be asked to ‘consider a consultation analysis report and to agree the final figures for the fees increase and the rules for the new fees in late Spring 2026’, according to NMC council papers.
The NMC then expects any changes to the fee rise to be approved by the Privy Council and laid in Parliament during the early summer of 2026.
Exact timescales are unclear as parliamentary recess dates remain are yet to be set.
The NMC has partnered with a research organisation, Thinks, to help manage the consultation.
Thinks will support the regulator ‘to identify and fill any gaps’ in consultation responses, like from groups sharing a protected characteristic or ‘seldom heard’ groups.
The NMC has said its consultation document will show the regulator’s plan to have smaller and more regular fee rises in the future.
‘However, as we have not yet developed specific proposals for future rises, we are not in a position to consult on them at this stage,’ the regulator said.
Explaining its decision not to invite more general feedback on future registration fee plans, the NMC said this risked ‘adding a layer of complexity’ for professionals responding to the consultation request and for the NMC when analysing responses.
‘Furthermore, the gains to be made from gathering views on our future approach are limited by the fact that we will need to consult again before any further rises are implemented,’ the NMC said.
‘We have, however, indicated that we think good practice will be more frequent but smaller increases.’
