NMC financial reserves will hit ‘unsafe levels’ without fee rise

The Nursing and Midwifery Council (NMC) has warned that its financial reserves will fall to ‘unsafe levels’ by the summer of 2027 if plans to increase registration fees do not go ahead, according to newly published council meeting papers.

The regulator said that without an increase to its annual fee, reserves would be ‘seriously depleted’ within the next two years, raising concerns about its long-term financial resilience.

Papers prepared for the latest NMC Council meeting show the regulator currently holds £58m in reserves, measured by cash and investments. This represents a £25m reduction in the nine months since the end of March 2025.

‘This rapid reduction of our reserves highlights the critical need for us to deliver on our recently announced cost-saving initiatives no later than from the beginning of the next financial year,’ the papers said.

The document added: ‘Without an increase to our fees our reserves would therefore reach unsafe levels by summer 2027.

‘If the proposed fee increase goes ahead, we would expect our reserves to stand at around £27 million in March 2027.’

The rapid decline has been attributed to a decade-long freeze on registration fees combined with an expansion of the NMC’s workforce to manage growing volumes and increasing complexity of work, especially around its fitness to practise (FtP) operations.

The papers state that reserves stood at £101m in March 2024 but are forecast to fall to around £46m by 31 March 2026.

The regulator acknowledged that the £46m forecast for March 2026 represents an improvement on earlier projections, largely due to the decision to delay some unbudgeted project spending.

This includes investment intended to further support improvements in fitness to practise processes.

However, the council papers stress that rebuilding reserves is essential to ensure the NMC’s long-term financial resilience and to protect its ability to deliver core regulatory functions.

The documents also highlight the ‘critical need’ to deliver recently announced cost-saving initiatives from the start of the next financial year.

The warnings come as a 12-week consultation on proposals to raise the annual registration fee draws to a close today.

‘Neither affordable nor fair;

UNISON national nursing officer Louie Horne said nursing and midwifery staff ‘should not be expected’ accept this additional cost.

‘They’re already under huge cost-of-living pressures and have endured years of real-terms pay cuts.

‘This mandatory fee rise is neither affordable nor fair, and risks pushing people out of the workforce. The move will further damage confidence in a regulator that many staff already feel isn’t delivering value for money,’ she noted.

The NMC is proposing to increase the fee from £120 to £143 per year, equivalent to an additional £1.92 per month.

Registrants who pay quarterly would see their payments rise by £5.75 every three months, while those who pay basic rate tax and claim tax relief would see their effective annual fee increase to £114.40, around £1.53 more per month.

Nurses, nursing associates and midwives have been encouraged to share their views before the NMC Council makes a final decision in spring of this year.

When the proposals were first announced towards the end of 2025, the regulator said the increase was necessary to maintain essential regulatory services after a decade-long fee freeze and to support ongoing improvements at the organisation.

The decision to consult on a fee rise was approved at an NMC Council meeting in October, with the proposals first revealed by Nursing in Practice.

In November, the regulator said registration fees account for around 97% of its income and are central to its role in protecting the public, maintaining confidence in the professions and upholding standards.

It also noted that freezing the fee for the past 10 years had effectively imposed a real-terms cut in fee income of more than 28% over that period.

The NMC has been introducing a series of cultural changes following a review into the regulator by Nazir Afzal and Rise Associates which in 2024 exposed a ‘dangerously toxic culture’ in which bullying, racism and burnout are putting nurses and the public at risk.

The consultation on the fee is open to professionals on the register as well as members of the public, with responses accepted until 11.59pm today.

NMC financial reserves will hit ‘unsafe levels’ without fee rise

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