NMC pilots more person-centred approach to fitness to practise referrals

The Nursing and Midwifery Council (NMC) has launched a pilot programme aimed at improving the experience of registrants at the point they are referred to the fitness to practise (FtP) process. The initiative, known as First Contact, introduces a more supportive and personalised approach to initial communication, with the goal of reducing distress and enabling more constructive engagement.

Under the current process, registrants typically receive an email informing them of a referral—often without prior warning or support. Feedback from professionals has highlighted how isolating and distressing this can be. In response, the NMC’s pilot replaces this with a staged approach that prioritises empathy, clarity, and early access to support.

The First Contact process begins with a neutral email that does not mention fitness to practise directly. Instead, it invites the registrant to arrange a phone call at a convenient time. During the call, the NMC informs the registrant that a referral has been made, but does not disclose the specific concern. The focus is on understanding the registrant’s communication preferences, support needs, and whether they require reasonable adjustments.

Registrants are also signposted to wellbeing resources and practical advice. A key part of the conversation involves checking whether the registrant has representation from a union or professional body. Those who do are encouraged to seek immediate support, while those without representation are made aware of available options.

Following the call, the NMC sends a tailored written summary of the discussion, reiterating the support available and confirming next steps. Only at this stage are the details of the concern shared. This approach does not alter the formal fitness to practise process but aims to ensure that registrants are better prepared and supported from the outset.

Lesley Maslen, Executive Director of Professional Regulation, said:

“It’s fundamental that Fitness to Practise is a person-centred process. We’ve listened to registrants’ feedback about how it feels to find out they’ve been referred – which is why our new pilot is designed to improve our initial interactions with people. We’re focusing on understanding individual needs and signposting to support – so people feel informed, respected and able to take part.”

The NMC will evaluate the pilot using feedback from registrants and representative bodies, with the aim of embedding a more compassionate and effective approach to fitness to practise referrals in the future. 

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