Changes to fitness to practise process will ‘improve efficiency' and 'reduce anxiety’

Proposed changes to the fitness to practise (FtP) process have been met with a ‘majority support’ because they could improve efficiency and ‘reduce anxiety for registrants’, the Nursing and Midwifery Council (NMC) has said.

The NMC has proposed seven changes to improve the FtP process (see box).

A 12-week consultation on the recommendations took place from 3 November 2025 to 26 January 2026, comprising an open survey, four focus groups and five stakeholder interviews with those involved in the FtP process.

The regulator said support for the recommendations has been ‘driven by a belief that proposals will improve the efficiency of the process and consequently reduce anxiety for registrants’.

In council papers, the NMC said responses to the consultation, which included 7,784 responses to the open survey, reveal a ‘majority support for the proposals’.

Levels of support were ‘particularly high’ for the recommendations to support vulnerable witnesses and for sharing information via an online account, the regulator said.

However, feedback from those involved in FtP proceedings, particularly panel members and legal assessors, was varied.

Some respondents cautioned that efficiency should ‘not come at a cost of making the process less fair for registrants, reducing transparency or adequate safeguards’.

Concerns were expressed about the impact of the changes on those who might need more support with the FtP process.

These include registrants who are unrepresented, those for whom English is not their first language, those who may be less able to navigate faster-paced, more digital or more discretionary processes without additional support, and those who may be vulnerable or unwell.

Concerns were also expressed about how the new powers will be implemented and exercised.

Addressing these concerns, the NMC said it is ‘delivering a programme of strengthened support for unrepresented registrants’, including establishing a Professional Support and Engagement function, updating signposting on the website, and completing a review of the registrant experience of its FtP process.

It also said concerns around impacts on those who need additional support with the process will be taken into account when designing process change, and support and guidance to panels. For example, the guidance will highlight that directions must be clear and proportionate and the factors to consider when fairly and justly dealing with non-compliance.

The proposed changes will be presented at the regulator’s council meeting next week. If approved, the new rules will come into force in October 2026.

Also going to the council for approval is a proposed fee increase for NMC registrants, from £120 to £140, despite consultation feedback describing it as ‘unreasonable’.

However, the regulator stated that it is in an ‘unsustainable financial position’ and that fees had not risen in line with inflation over the past 11 years.

Proposed changes to the FtP process

Powers to appoint legally qualified chairs: The rules would specify that legally qualified chairs would have the same qualification and experience requirements as specified for legal assessors under the Nursing and Midwifery Order 2001. Where the NMC does not appoint a legally qualified chair to a panel, it would be required to appoint a legal assessor to advise the panel, as now.

Strengthen case management powers: This would allow committee panels and legally qualified chairs to issue case management directions without a preliminary meeting, determine arguments on points of law or admissibility of evidence in advance of a meeting, and refuse to admit evidence not served in compliance with any direction.

Ability to send and share information via an online account or portal: This would be subject to safeguards, for example the registrant giving their explicit consent to information being shared in this way.

Increased flexibility for inviting representatives: In cases where it is apparent that no further regulatory action is necessary, the NMC will not invite further representations. This would allow case examiners to close cases more quickly and free up investigation resources.

Increased flexibility for timescales for representations: Aims to replace the fixed 28-day response period for providing representations with a more flexible requirement to give no less than 28days.

Increased flexibility for minimum notice of meetings or hearings: Aims to amend the minimum 28-day notice period for an FtP meeting or hearing, retaining this standard period in most cases, but introducing flexibility to shorten this in certain circumstances. This would happen where a registrant consents to a shorter notice period, or where a shorter period is justified in the public interest.

Supporting vulnerable witnesses to provide evidence: Aims to provide support for a broader range of witnesses than those prescribed with narrow and outdated language in the NMC’s current rules