NMC approves first increase in registration fees for 11 years

Due to inflation since the NMC last increased the fees, there has been a 28.8% loss in the real value of the fees, with a resultant loss of £186m of income up to the end of March.

As a result of freezing the fees, the regulator has had to start funding its vital and expanding workload by drawing down on its reserves – and posting substantial deficits.

Its reserves have fallen from £101m in March 2024 to around £49.6m now. They are projected to fall to £15.9m in March 2027, if the fees do not increase.

The Council considers that the proposed increase to the main fee of £1.92 per month (before tax relief) is fair and proportionate – and necessary to ensure the NMC is financially sustainable, and able to carry on delivering its work to protect the public.

As a result of the decision by the Council, the main fee will increase by £23 per year, rising from £120 to £143 from 1 October, subject to Parliamentary approval. 

At a meeting of the Council today (28 April), members agreed that the 11-year freeze in the fees was well intentioned, to help nursing and midwifery professionals with the cost of living – however, over that period, the safety-critical work of the regulator has grown substantially, and the freeze has become unsustainable. 

Council recognised that many of the respondents who took part in the NMC’s consultation on its plans were clear about the ongoing financial pressures facing nurses, midwives and nursing associates today. However, it also could not ignore that the regulator is now posting substantial deficits on an annual basis.

The NMC now regulates 867,935 professionals – around one in 50 working-age people in the UK.

This has increased demand on all the NMC’s regulatory services, including Fitness to Practise, which now handles 21% more referrals per year – and rising – compared to 2015. Over this period, the real terms value of the frozen fees has steadily reduced due to inflation.

Council acknowledged these growing demands on the NMC’s services and endorsed the regulator’s commitment to achieving operational excellence in all areas – from education and standards to registration and revalidation, employer outreach, safeguarding and Fitness to Practise. 

Council also noted that, while most respondents to the NMC’s consultation opposed an increase in the fees, they also agreed that the regulator should continue to invest in improvements:  

• Better education quality assurance, ensuring new professionals are well prepared  
• Stronger and clearer professional standards, reflecting modern practice  
• Faster, fairer Fitness to Practise processes, reducing stress and delay  
• Regulatory fairness, embedding equity, diversity and inclusion to eliminate bias  
• Modern digital services, making it easier to interact with the NMC. 

If the fee had increased in line with inflation since 2015, it would now be around £168. 

Ron Barclay-Smith, Chair, said: 

“The Council has considered at length the impact that these proposed increases will have on those whom it regulates. Today’s full and robust debate recognised the financial pressures facing many nursing and midwifery professionals. 

“At the same time, Council was clear in its view that the professions and the public need, and deserve, a high-performing regulator. After 11 years of flat fees, it’s now time to ensure a sustainable financial future for the organisation. 

“We’ve not taken this decision lightly. Registrants who responded to our consultation were clear that the cost-of-living remains a real issue, more than a decade on since we froze the registration fees to try and ease those financial pressures.

“While the freeze was well intentioned, this has had a profound impact on our finances, which many registrants also told us that they understand.

“Having a strong, independent regulator – one that can act quickly, fairly and effectively to protect the public and support confidence in the professions – matters. 

“That is what this decision is ultimately about. 

“Council’s commitment is that it will hold the Executive to account for delivering better value to registrants – with a higher standard of regulation which better supports professionals on the register to uphold high standards and protect the public.”

Paul Rees MBE, Chief Executive and Registrar, said: 

“We’re building a new NMC – the strong and independent regulator that everyone wants to see. 

“But we can only achieve this for the professions and the public from a sustainable financial position. That’s why we’re taking the step of increasing the registration fees for the first time in 11 years. 

“We recognise the responsibility that comes with this decision and will be accountable for demonstrating the impact of every pound we spend.

“We are fully committed to spending every registrant’s fee wisely to protect the public and inspire confidence in the nursing and midwifery professions. That means delivering better education quality assurance, stronger and clearer professional standards, faster and fairer Fitness to Practise processes, regulatory fairness and modern digital services. 

“Every year, nursing and midwifery professionals care for millions of people across the UK. Behind that care must sit a regulator that is strong, fair and trusted. This change ensures we can continue to play that role – not just today, but for the future.”

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