Joint communication from the NMC and CNOs for England, Wales and Northern Ireland

As we move into what is expected to be another demanding winter for health and social care services, we are writing to provide assurance that we will continue to take into account the context in which registrants work as part of our decision making processes.

We also wish to extend our sincere thanks for the work you do every day on behalf of patients, the public, and all who rely on health and social care services.

Winter traditionally places considerable strain on the health and social care system, and this year will be no exception. The flu season has begun early, demand across services remains high and is expected to rise further.

We also recognise that staff absence and caring responsibilities are likely to rise in the coming months, adding to the pressures you are already managing.

We recognise that the pressures you face may understandably raise concerns about the ability to deliver safe, effective care in challenging circumstances. Please be assured that we remain committed to ensuring you have the support and protection you need.

We have full confidence that clinicians will continue to act in accordance with the values and expectations embedded within our professional standards. We also know you will continue to balance the needs of the individuals you care for with the needs of people across the wider health and social care system.

In situations where established procedures cannot be followed exactly, and you need to adapt your practice to meet people’s needs, we recognise that this may cause concern about regulatory referral. We want to reassure you that when assessing any referrals we are always careful to understand the full context of care delivery.

As your regulator, the NMC takes full account of the context you are working in, including availability of staff, resources, and relevant guidance. Should any concerns be raised, these factors will be central to how your actions are considered.

It remains the responsibility of NHS-commissioned providers and health and social care leaders to ensure that staff are supported, and that avenues for raising concerns remain open and effective. We expect employers, supervisors, professional bodies, and national organisations to show flexibility and responsiveness in light of the pressures ahead.

We will continue to monitor developments and share updates through established quality and safety networks.

More than ever, it is vital that we support each other. Working under sustained strain can take a considerable toll, and relying on colleagues – both for practical help and emotional support – is good professional practice. We encourage you to seek assistance from your organisation whenever you need it.

Your impact is felt everywhere – whether you are providing direct care, supporting your peers, or steering teams and services through ongoing challenges. Your contribution continues to be essential to the wellbeing of the communities we serve.

Finally, we wish to once again reiterate our sincere appreciation for your continued commitment and the remarkable efforts you make to provide high-quality care to everyone who relies on you.

Yours sincerely

Duncan Burton
Chief Nursing Officer, England

Maria Mcllgorm
Chief Nursing Officer, Northern Ireland

Sue Tranka
Chief Nursing Officer, Wales

Paul Rees MBE
Chief Executive and Registrar
Nursing and Midwifery Council

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