NMC highlights progress on strengthening regulation and improving fitness to practise in a year of major transition

The Nursing and Midwifery Council (NMC) has published its Annual Report and Accounts for 2025–26, outlining a year defined by organisational change and targeted improvements to core regulatory functions — with fitness to practise (FtP) performance a central focus.

The regulator says it has taken “difficult decisions” to strengthen leadership, governance and culture, while addressing legacy issues that have affected public confidence. A new Chair, a new substantive Chief Executive and Registrar, and an almost entirely refreshed Executive team have set what the NMC describes as “the foundations for lasting change”.

The report emphasises several areas where the NMC has improved or reshaped its approach to FtP:

• Faster case progression: FtP cases were resolved at their quickest rate since late 2020, despite rising referral numbers. The NMC acknowledges that delays continue to impact registrants, witnesses and the public, but says the trend shows early signs of recovery in performance.
• Reducing bias and improving fairness: As part of its ambition to become an anti‑racist organisation, the NMC agreed 84 actions aimed at eliminating ethnicity‑ and gender‑based bias from the FtP process. This includes redesigning decision‑making principles, strengthening oversight, and embedding anti‑racism across education and practice.
• Improved safeguarding and regulatory assurance: The NMC reports progress in safeguarding within FtP and across wider regulatory functions, including clearer expectations for safety, respect and cultural awareness in midwifery and advanced practice.
• Strengthening standards and regulatory tools: Work continued on reviewing the Code and Revalidation to ensure they better reflect today’s health and social care environment — changes that will directly shape how concerns are assessed and managed in FtP.

Alongside these improvements, the NMC disclosed a historical failure in its registration process relating to health and character declarations over a 12‑year period. The regulator apologised and said the issue underscores the need for stronger systems and oversight — a theme echoed throughout the report.

Financial pressures also intensified, leading Council to approve the first registration fee increase in 11 years, subject to Parliamentary approval. The NMC says this decision was necessary to protect the sustainability of its reserves and maintain safe regulatory operations, including FtP.

Chair Ron Barclay‑Smith said the organisation has been “open about where we have fallen short” and is now building a “fairer, stronger and more independent NMC”. Chief Executive and Registrar Paul Rees MBE added that while progress has been made — particularly in FtP — “there’s still a long road ahead”.

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