NMC breaks another screening record in fitness to practise

In March 2025, 806 cases were either progressed or closed at screening, surpassing the previous record of 797 in January.

Reducing the caseload at screening was a key recommendation from the Independent Culture Review of the NMC. It means people are seeing faster decisions, either resolving their concern at this early stage of the process, or moving it forward to a full investigation.

Decision rates up across the FtP process 

We have delivered 10,405 outcomes (case closures or progressions) across all stages of the FtP process since April 2024. That is an average of 867 decisions on cases per month – a significant rise from the previous 12-month average of 780.  

Further signs of progress include: 

• A reduction in the FtP caseload since December 2024, falling to 6,357 by the end of March 2025 
• The proportion of cases resolved within our 15-month-target reaching 68.4 percent – up from 67.1 percent in January 2025 
• The number of people waiting longer than 18 months for their case to conclude falling by 39 percent between March 2024 (3,308 cases) and March 2025 (2,010 cases). 

Challenges remain 

As previously reported, we have seen a rise in the number of new concerns being raised with us. Between April 2024 and March 2025, we received an average of 546 referrals per month, compared to 493 per month during the same period last year (April 2023 to March 2024). 

A higher referral rate into the FtP process reduces the positive impact of the progress we are making on decision rates. 

To ensure we achieve a faster and fairer experience of the FtP process for people, we are continuing to work hard to deliver on our FtP improvement plan. 

• We have now updated our screening guidance. Our new risk-based approach distinguishes concerns that require regulatory action from those better handled by employers or agencies. This means genuine regulatory cases are progressed swiftly, allowing our teams to deliver faster, more consistent decisions for everyone involved.  
• We are now scheduling hearings further in advance, cutting red tape around admin, and reducing turnover among hearing coordinators to keep panels running smoothly. We are also increasing in‑person hearings, which finish more often when first listed, and take fewer days than virtual hearings. However, we continue to offer hybrid meetings so people can join from somewhere they feel more comfortable. 
• We are expanding our Professional Support and Engagement Team, and as part of this the professionals involved in FtP will have clearer guidance around the process and better wellbeing support.  
• Whilst the overall caseload is gradually reducing, we are seeing increases in caseload at the Investigations stage, and we are proactively looking at plans to reverse that trend.   

Lesley Maslen, Executive Director of Professional Regulation, said: 

“Our fitness to practise improvement plan is having a positive impact, from record screening decisions to a reduction in the number of older cases in our caseload. These improvements reflect the dedication of our colleagues and the focused changes we’re making to how we work." 

"At the same time, we know many people are still spending too long in our processes, especially in the later stages. We’re prioritising measures to speed up case progression through investigations and adjudications, to minimise the impact unnecessary delays can have on people. We’re also strengthening the wellbeing support available for everyone involved." 

"We remain determined that every case, no matter how complex, reaches an appropriate outcome at the earliest possible opportunity, reducing the anxiety and frustrations people can feel.” 

Further information

• Careline: we offer an independent service run by specially trained counsellors, providing confidential emotional and practical support to professionals 24 hours a day, 365 days a year. 
• Referral: This is what we call a new concern submitted to us about a nursing or midwifery professional on our register  
• Screening: This is the initial assessment stage when we receive a new concern about a professional on our register and decide whether it should go to a full investigation  
• Investigations: If we've decided that a concern needs further investigation, the screening team will pass it onto the investigation team. The investigation team will then gather evidence and continually assess all the information they receive to decide what the next steps in the investigation should be. At the end of the investigation, the team will put together a report for our case examiners to look at  
• Case examiners: If a referral has been made about a professional and we have investigated the case, our case examiners will decide whether there is a ‘case to answer’  
• Adjudications: cases are prepared for a final decision, which could be made in a meeting, hearing or by other means. 
   

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