2025-26 in review: reflecting on a year of significant transition

Throughout the year, the NMC focused on transforming its culture, strengthening regulatory performance and uncovering and addressing legacy issues.

In March 2025, the regulator published its three-year Culture Transformation Plan designed to ensure improvements in both organisational culture and operational performance. This was followed by the launch of the organisation's new I-FREE values – Integrity, Fairness, Respect, Equity and Effectiveness.

Meanwhile, the NMC transitioned to new leadership. Ron Barclay-Smith took up his role as Chair in April 2025, and Paul Rees MBE became the substantive Chief Executive and Registrar (CER) in July 2025, having previously served as Interim CER. A virtually new Executive team was assembled, bringing renewed focus and direction at a critical time for the organisation.

A key priority during 2025-26 was the ambition to become an anti-racist organisation. The NMC agreed a set of 84 concrete actions to eliminate bias based on ethnicity and gender from its Fitness to Practise (FtP) process, co-designed anti-racism principles for nursing and midwifery education and practice, and signed the UNISON Anti-Racism Charter.

The regulator also continued to strengthen its core regulatory functions, developing a clear roadmap for the continuing improvement of its standards to ensure they remain fit for the future and responsive to the needs of the public and the professions it regulates. Key milestones during the year included:

• In response to serious and persistent failures in maternity and neonatal services across the four countries of the UK, publishing a Midwifery Action Plan that has strengthened assurance and improvement, with a clearer emphasis on anti-racism, bias awareness and cultural curiosity, safety and respect
• Introducing new principles for advanced practice, laying the groundwork for the development of future standards, due to be published by March 2028
• Launching reviews of the Code and Revalidation to ensure these key regulatory tools reflect today's health and social care landscape
• Launching a landmark consultation about nursing and midwifery practice learning to prompt a national conversation on how best to ensure high-quality student learning experiences in a changing care environment.

Elsewhere, the NMC continued to support important inquiries and reviews across health and care in all four countries of the UK, including the Independent Review of Maternity Services at Nottingham University Hospitals NHS Trust, led by Donna Ockenden. As well as the Maternity and Neonatal National Assurance Assessment by Professor Sally Holland in Wales and the National Maternity and Neonatal Investigation led by Baroness Amos.

In addition, there have been signs of progress across other regulatory work. By the end of the financial year, FtP cases were being resolved at the fastest rate since late 2020 – despite increasing numbers of referrals (new concerns about a registrant). The NMC recognises the impact that delays in FtP can have on everyone involved and says there is more to do to deliver a timely, fair and compassionate service.

During 2025-26, the NMC uncovered a historical failure in its registration process, where health and character declarations had not been consistently managed in line with the right process over a 12-year period. The regulator has apologised unreservedly for this failing.

Alongside this, the Annual Report reflects the significant financial challenges facing the organisation. As a result of the serious risk to the sustainability of its reserves, the NMC’s governing Council approved the first registration fee increase in 11 years, subject to Parliamentary approval.

Ron Barclay-Smith, Chair, said:

"Transforming an organisation that has been subject to critical reports since 2008 takes time, and there is still a long journey ahead. However, during the past year we have strengthened our leadership, governance and culture, providing the foundations for lasting change.

"We have been open about where we have fallen short, taken responsibility where things have gone wrong, and made difficult decisions to put the organisation on a stronger footing for the future.

"While challenges remain, I am confident that we are building a fairer, stronger and more independent NMC – one that earns the trust and confidence of the public and the professionals we regulate.”

Paul Rees MBE, Chief Executive and Registrar, said:

“This year was one of significant transition, as we continued the important task of building a new NMC. We laid the foundations for transforming our culture, began strengthening regulatory performance and tackled legacy issues that had built up over many years.

“Alongside this, we’ve made progress across our core regulatory functions. By the end of the financial year, Fitness to Practise cases were being resolved at their fastest rate since late 2020. We’ve also improved our approach to safeguarding, and we’ve taken forward an ambitious programme of work to ensure our standards remain fit for the future and responsive to the changing health and social care landscape.

“We know there’s still a long road ahead, and there is more to do. But we're determined to turn this organisation around once-and-for-all, and become the strong and independent regulator that everyone wants to see."

Read the Annual Reports and Accounts for 2025-26.

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