An allegation of IEFE is likely to arise at one of three points:
- When a nurse, midwife or nursing associate first enters onto our register
- When a nurse, midwife or nursing associate renews their registration through revalidation
- When a nurse, midwife or nursing associate applies for readmission to our register
Below we set out some of our key registration, revalidation and readmission requirements with examples of potential IEFE concerns.
Approved qualification
We must have evidence that individuals applying to join the register hold an approved qualification and that the qualification, if awarded in the UK, was completed within five years of the application for registration. If the qualification was not awarded within the five year period, the person applying must have done additional education, training and experience in order to be registered.
An entry on the register may be fraudulent or incorrect if there is evidence that the person concerned:
- used false documents to get onto a university course
- didn’t hold an approved qualification when they were registered
- didn’t complete their course within five years of their application for registration and didn’t do the required additional education, training and experience.
Nurse C completed her university course in the UK in January 2020. She failed to register her qualification within five years, but an admin error meant that she was accepted to join the register in June 2025 without having passed our Test of Competence. Our legislation does not allow us to accept qualifications that are more than five years old without a Test of Competence so when Nurse C realises her mistake and contacts the NMC to advise them about the issue we investigate whether there has been an incorrect entry.
Health and character declarations
People will only be registered as nurses, midwives or nursing associates if they prove to us that they’re capable of safe and effective practice. This includes showing that they meet our health and character requirements.
We consider that in most cases concerning the health of a professional on our register, a fitness to practise referral will be the most suitable method for dealing with the matter.
There may be cases where it will be appropriate for us to investigate whether an issue relating to a health and character declaration means that a register entry is either incorrect or fraudulently procured.
Nursing associate D is convicted of driving whilst disqualified. He fails to disclose this when he completes his character declaration during revalidation. However, he later contacts the NMC to advise them of the conviction. He explains he didn’t realise he had to declare the conviction as he thought it was “just a motoring offence”. The NMC has already renewed his registration, so we then need to investigate whether his entry is incorrect or fraudulent.
If any of the information about the applicant’s health or character was wrong, their entry in the register may be incorrect. If the wrong information was provided with the deliberate intention to mislead, the entry may be fraudulently procured.
English language requirements
When professionals apply to register with us, we need to be satisfied they have the necessary knowledge of English to be capable of safe and effective practice.
There are three types of evidence that will satisfy us that they have the necessary knowledge of English to practise in the UK. There are further details in our guidance on language requirements.
A professional could have a fraudulent entry if they submit a falsified certificate showing they had achieved our language test scores.
Nurse E is internationally educated and has applied to join our register. As part of their application Nurse E provides us with a copy of their English language test certificate to demonstrate their English language proficiency which, after they have joined the register, we discover was falsified. This would give us grounds to investigate them for fraudulent entry.
Revalidation
In order to renew their registration by revalidating, nurses, midwives and nursing associates must declare that they have:
- undertaken the required number of hours of registered practice
- undertaken the required number of hours of continuing professional development (CPD)
- collected five pieces of feedback
- written five reflective accounts
- had a reflective discussion
- had a confirmation discussion
A nurse, midwife or nursing associate is incorrectly entered onto the register if any of these declarations are wrong. If there is evidence that a wrong declaration was made with the deliberate intention to mislead us, then the entry is fraudulent.
Midwife F completes a reflective discussion with Colleague G. They discuss four pieces of reflection and agree to meet up later to discuss a final piece of reflection. Midwife F prepares the fifth piece of reflection, but Colleague G is ill when they are supposed to meet to discuss it. Midwife F completes her online revalidation declaring that she has complied with all the revalidation requirements. This would give us grounds to investigate fraudulent entry.
Identity fraud
If the registration application contained deliberately misleading information about the identity of the applicant, the entry is fraudulent. This usually means that the person who applied and intended to practise deliberately made the application in the name of another person.
There is no need for the Investigating Committee to see evidence that the person who made the application has been convicted of a criminal offence in order to find the allegation proved.
Person H completes a nursing course but decides not to enter the NMC register. They separate from their partner, Person I, who becomes involved with Person J. Person J would like a career in nursing but does not wish to complete a nursing degree. Person J decides that they will apply for registration in Person H’s name and rely on Person H's nursing degree to join the register. If Person J succeeds in joining the register using Person H's name and nursing qualification, we would have grounds to investigate whether their entry on the register has been fraudulently procured.
Practising without registration
Nurses and midwives in the UK, and nursing associates in England, are only entitled to practise if they're registered with us. If a nurse, midwife or nursing associate leaves the register, they'll have to apply for readmission if they want to practise again. In order to be readmitted to the register, applicants must demonstrate that they meet our character requirements. As part of meeting these requirements, we ask them to declare if they've worked without registration. If they made a mistake when completing their declaration, this could mean that their entry on the register is incorrect. If they made a false declaration to deliberately conceal the fact that they've worked without registration, it's likely that their entry would have been fraudulently procured.
Nurse K forgets to revalidate on time and so her registration lapses. She doesn’t tell her employer and continues to complete sixteen shifts as a nurse at the hospital where she is employed. She applies for re-admission to the register and on her application she states that she has not worked as a nurse since her registration lapsed. This appears to be deliberately misleading, so could result in us investigating her for a fraudulent entry.
Dual registration
Nurses, midwives or nursing associates can apply to be on more than one part of the register as long as they meet the relevant entry requirements for each part. For example, they may be on the nursing part and the midwifery part of the register.
Someone who entered one part of the register by fraud and was removed can still practise if they are on another part of the register.
Where someone has acted fraudulently there is likely to be public interest in making a fitness to practise referral. For example, if the Investigating Committee decides that a nurse, midwife or nursing associate fraudulently gained entry to one part of the register this is likely to call into question their fitness to practise on the other part of the register even where this entry was not fraudulently gained.
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What happens when we receive an IEFE allegation?
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