The PSA publishes NMC performance for 2023/24

The Professional Standards Authority (PSA) has raised significant concerns about the Nursing and Midwifery Council’s (NMC) performance in its latest review, finding that the regulator failed to meet nearly 40% of its key regulatory standards during a turbulent 18-month period.

In its detailed performance assessment, which covered 1 July 2023 to 31 December 2024, the PSA concluded that the NMC met just 11 of the 18 Standards of Good Regulation, highlighting persistent issues in areas including fitness to practise, safeguarding, and quality assurance of education providers.

The review was delayed to allow the PSA to consider findings from three independent reviews commissioned by the NMC in response to whistleblowing disclosures. However, with only the Independent Culture Review (ICR) published to date, the PSA decided not to wait further before issuing its findings. Two reviews led by Ijeoma Omambala KC remain outstanding.

Among the most serious concerns flagged were:

• A lack of clarity in the NMC’s regulatory purpose, with the ICR finding it had “strayed from its central mission.”
• Weaknesses in embedding equality, diversity and inclusion (EDI) practices throughout the organisation.
• Continued failure to meet fitness to practise timeliness standards—unmet since 2018/19—despite increased investment.
• Ongoing safeguarding risks and a failure to act promptly on previous internal audit recommendations.
• Insufficient assurance in maintaining an accurate register and effectively monitoring education providers.

In response to these concerns, the PSA has written directly to the Secretary of State for Health and Social Care and to the Health and Social Care Committee, drawing attention to the scale of the problems.

While acknowledging these failings, the NMC has taken initial steps to address them, including appointing a new interim Chief Executive and publishing a culture transformation plan in March 2025. The PSA confirmed it will continue to closely monitor progress through its Independent Oversight Group.

The report notes that meeting the PSA’s standards does not signify perfection but rather reflects acceptable regulatory performance. However, the PSA cautioned that the NMC must show measurable improvement in the coming year to regain confidence in its ability to protect the public and support nursing and midwifery professionals.

Paul Rees MBE, NMC Interim Chief Executive and Registrar, said:

“The PSA’s latest report reflects a dark period in the NMC’s history, and we expected to fall short on meeting some of the Standards of Good Regulation.

“I recognise that our performance in 2023-2024 was not good enough and since joining the NMC in January, I’ve committed to turning the organisation around – ensuring that we build a positive, empowering and inclusive culture for our people, and improve the regulatory experience for the public and nursing and midwifery professionals.

“Radical change is underway and we have made significant strides through the delivery of our Culture Transformation and Fitness to Practise plans. In the coming days we will publish ambitious EDI targets, to ensure we achieve equity for our colleagues and everyone involved in our processes.”

Ron-Barclay-Smith, NMC Chair of Council, said:

“It is clear that 2023–2024 was a particularly difficult year for the NMC, with significant, high-profile issues during that period, which the organisation has since started to address at pace.

“Whilst the report reflects the past, we are not complacent. We continue to learn and improve so as to be the best we can be.

“As Chair of Council, I am determined to guide, challenge and support the NMC Executive so that the organisation is fit for purpose, and can promote the safe and effective nursing and midwifery care everyone has the right to expect.”

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