NMC unveils ‘anti-racism’ principles for nursing practice and education

The Nursing and Midwifery Council (NMC) has unveiled a series of ‘anti-racism principles’ to help strengthen cultural safety, curiosity and respect within nursing practice and education.

The nursing regulator said its new principles are designed to ‘advance meaningful, sustained anti-racist, bias aware practice’.

Driven by concerns around maternal health – in which the NMC pointed to Black, Asian and minority ethnic women and their children being more likely to die, or suffer harm during pregnancy, childbirth or after birth – the principles are split into four areas.

These include: Culture, equity and inclusion; Learning, education and workforce development; Community and person-centred practice; and Assurance, accountability and sector improvement.

They set out some of the ways educators, organisations, registrants and employers can address the growing concerns around inequities in care and racism across health and social care practice, education, and regulation.

The regulator said its principles are intended to ‘drive real change’ ahead of its updated NMC Codie, due to by ready in 2027, which will ‘expressly set the expectations of all nursing and midwifery professionals to recognise, challenge and disrupt racism’.

‘In the meantime, the principles will help to strengthen anti-racism, bias awareness, cultural safety, curiosity and respect, and equitable care in midwifery and nursing education and practice,’ the NMC said.

‘They will be judged by whether the actions taken improve safety, belonging, fairness, equity, accountability, and trust for service users, students, and the midwifery and nursing workforce.’

NMC chief executive and registrar Paul Rees said: ‘Tackling racism is vital for us, as we build the new NMC.

‘We know that Black, Asian and ethnic minority patients can experience poorer health outcomes than others, sometimes driven by negative racist stereotypes such as: “Black women don’t feel pain”.

‘We know that Black, Asian and ethnic minority registrants are on the receiving end of bias in their work – referred disproportionately into fitness to practise, and increasingly facing 1970s and 1980s style racism from patients on the frontline.’

He pointed to issues within the regulator itself, as highlighted in a damning independent review in 2024, which highlighted concerns around bullying, harassment and racism.

‘As a result of all of these factors, it’s incumbent upon us to confront the racist stereotypes and everyday biases that can lead to unfair treatment at every turn,’ said Mr Rees.

‘Our new anti-racism principles are a progressive step towards tackling health inequalities – helping to ensure all nursing and midwifery students learn about anti-racism, bias awareness, and cultural curiosity, safety and respect.

‘From the autumn of 2027, we’ll go even further with a revised Code that will enshrine anti-racist, culturally safe practice through strengthened behavioural standards.’

Jonah Atos, International Nurse Coordinator Northern Ireland and an internationally educated registered nurse, who acted as a critical reader during the design of the principles, said: ‘Drawing from my experience as an internationally educated nurse, educator, and leader supporting workforce integration, I have seen first-hand how inequities in recognition, progression, and support impact both staff wellbeing and patient care.

‘Cultural safety and anti-racism must be embedded not only in values, but in systems, structures, and opportunities.

‘The launch of the NMC’s anti-racism principles for midwifery and nursing education and practice is an important step towards recognising the value, skills, and experiences that internationally educated nurses and midwives bring to the workforce.’

Jodie Deards, health equity leader and a registered nurse, who also acted as a critical reader during the design of the principles, said: ‘These principles are needed because everyone deserves to feel safe, heard, respected and treated fairly when receiving care, learning, or working in health services. They are about helping to ensure that no one experiences harm or disadvantage because of racism, bias or discrimination.’

The principles were welcomed by the NHS Race and Health Observatory’s director of implementations Dr Nandi Simpson who said: ‘Poor and unequal outcomes for people from Black, Asian and ethnic minority backgrounds continue to reinforce the role of racism as a determinant of health.’

She commended the NMC for its ‘leadership’ and said she looked forward to ‘working with them to help move from statements of intent to action and accountability’.

The news comes after the super-regulator found several ‘weaknesses’ within the regulatory functions of the NMC in a new review which found the regulator only met half of its expected standards.

A review of the NMC’s performance in 2025 left the Professional Standards Authority (PSA) with ‘considerable concern’ and shows the nursing regulator has ‘a lot more work’ to do to bring about improvements required.

Specifically, it highlighted that while it recognised some efforts to improve equality, diversion and inclusion (EDI), the PSA said it had seen ‘limited evidence of the impact of the changes the NMC has made with respect to EDI in this reporting period’.

It was also revealed last week that the NMC had failed to ‘consistently’ assess health and character concerns of those on its register – such as those with a criminal record for a serious offence or with an unmanaged health condition – for more than a decade.