Biggest investment in fitness to practise in a decade

Published on 20 March 2024

We’ve published a draft new plan to make the biggest investment in fitness to practise in a decade, ensuring we can continue making decisions that keep people safe, but in a more timely and considerate way.

At its meeting on 27 March, our Council approved the fitness to practise plan. 

We’ve been transparent about our timeliness challenges in fitness to practise. Despite the best and sustained efforts of our NMC colleagues, people are waiting longer than they should for cases to be resolved. That has a personal impact on members of the public and professionals, and impedes our ability to regulate well.   

Now there is a changing context, including an increase in the number of new concerns being raised with us. We have received an average of 493 referrals per month since April 2023, compared to 417 in the same period last year – an increase of 18 percent. In February 2024 alone, 596 new concerns were raised. Therefore we are asking our Council to approve a substantially increased investment in fitness to practise. 

The areas we will prioritise 

We’ve identified seven key areas for improvement. 

Referral quality, safety and supporting stakeholders through our processes  

We will help employers and the public to understand when a referral to the NMC is appropriate, enabling us to focus on safe and swift progression of cases that are appropriate for us as the regulator. For those referrals we do receive and progress, we will ensure everyone involved is properly supported, and our decision makers have access to the right clinical and safeguarding advice. 

Safe and swift progression of cases at screening and investigations  

We will expand our screening team, which provides an initial assessment of new concerns. We will make sure more referrals are being actively progressed, and we will swiftly progress the most serious cases which may require an interim order to restrict someone’s practice. 

Releasing capacity in case preparation and presentation, and investigations  

Outsourcing work, where appropriate, has long been part of our operating model in fitness to practise. We will expand this to ensure more cases are being actively progressed, and to release our internal legal capacity to prepare and present more cases at hearings or meetings. 

Delivering sustainable change in case preparation and presentation  

We will introduce new approaches to allocating and risk assessing cases, with a focus on cases with interim orders that restrict a professional’s practice. We will introduce additional management capacity to support case progression.  

Improving the quality and timeliness of decisions at the adjudication stage 

We will review the skills, experience, training and support our hearing coordinators need to manage hearings effectively. We will increase our panel capacity and run more hearings. 

People, culture and organisational design  

We will recruit and retain skilled and engaged colleagues, and make sure that resourcing and oversight remain appropriate to the number of cases we are progressing. 

Improving our systems. 

We will introduce a new case management system in 2025. This will better equip our teams to progress cases safely and swiftly in a person-centred way, and ensure the public is protected. 

Lesley Maslen, NMC Executive Director of Professional Regulation, said: 

“Thanks to the hard work of our colleagues, we’ve improved our fitness to practise processes over the last few years and increased the number of decisions we make. But we’re still not resolving enough cases swiftly, and feedback from our colleagues tells us they’re feeling overwhelmed. 

“We need a fitness to practise service that is truly person-centred, collaborative, and straightforward for everyone involved. That’s why our new plan commits £30 million to fitness to practise over the next three years, with a particular focus on investment and improvement over the next 18 months. It will ensure we can continue making decisions that keep people safe, but in a more timely and considerate way that will be sustainable into the future.   

“We are building on strong foundations. We have a new senior team in place, and better data from process reviews and modelling about the impact of our caseload. That insight has enabled us to shape this plan, which will realise our determination to resolve cases as safely and swiftly as possible, for the benefit of the public and the professionals on our register." 

The full plan is subject to approval by our governing Council at its next public meeting in London on 27 March. The draft plan can be found in the Council papers on our website. 


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