Since I started working at the Nursing and Midwifery Council (NMC) I have taken opportunities to share what I call ‘things I wished I had known about the NMC when I was a senior nurse in the NHS’. This has helped me to understand the role of the NMC, and the limitations and the opportunities that we have to progress in several key areas.
The history is an interesting place to start:
The history of professional regulation in the UK was associated with the status and power of the established professions, such as medicine and law. Professions got to set their own standards and police the parameters of their professions and oversee action in response to concerns about members of their profession. This period ended decisively with a public inquiry into the GP Harold Shipman, who murdered at least 284 of his patients over 30 years. The chairman of the Shipman Inquiry, Dame Janet Smith, criticised the General Medical Council (GMC), saying that there is a perception that ‘the GMC acts, not in the interests of patients, but in the interests of doctors’ (Smith, 2005).
Changes since the Shipman Inquiry
Since the Shipman inquiry, several changes have been made. Statutory changes include:
Other changes include:
The overarching objective of the NMC is the protection of the public through the pursuit of the following, which is to:
The law is laid out in the Nursing and Midwifery Order 2001, which has various ‘articles’ that describe the ‘rules’. The principal functions of the NMC include to establish, from time to time, standards of education, training, conduct and performance for nurses, midwives and nursing associates, and to ensure the maintenance of those standards.
There is specific detail included in the various articles that describe how the NMC sets and monitors standards for education and continuing professional development and how the NMC maintains a register of nurses, midwives and nursing associates.
The Law Commission (2014) has concluded a review of the legislation governing professional regulation and concluded that it was not fit for purpose. It was considered that there was too much detail about how regulators should protect the public – making it hard to modernise or innovate in the public interest. The last government consulted on reforming legislation but did not implement its proposals. The NMC is waiting to hear what priority the new government will attach to this change.
Future developments
So, where are we now? There are key areas of significant development for our profession that are all well described on the NMC website, which I did not routinely look at before I started at the NMC. Aside from the improvement work that is in progress relating to the fitness to practise processes, the NMC frequently commissions independent research to consider the evidence base on which to engage and consult on key areas of work.
There are multiple opportunities for students, registrants, members of the public and others to influence the direction of travel, engage and feed into this work. For example, there have been consultations on the additional regulation of advanced practice (NMC, 2024).
As nurses, it is critical that we all have an input into the decision-making of our regulator on issues that will affect not only us professionally, but also the public, for many years to come. Some examples of current programmes include: