NMC proposes changes to its structure to ensure it is a strong and independent regulator

The Nursing and Midwifery Council (NMC) has today (9 October) launched a proposed workforce restructuring programme to ensure a sustainable financial position and focus resources on the effective delivery of core regulatory work.

The regulator has started an internal consultation around the difficult decision to propose the removal of 145 posts from a total of around 1,400, and to restructure parts of the organisation. Around a third of the posts proposed to be removed are vacant.

The restructuring proposals are essential to build the new NMC – a strong and independent regulator that is financially secure and has the right structures to deliver on the priority areas under the new organisational strategy for 2025-2027.

The NMC has frozen its registration fees over the last 10 years. This has protected registrants – hard working nurses, midwives and nursing associates – during the cost-of-living crisis and a period of high inflation.

However, freezing the fees has reduced income in real terms by 28% over the last decade compared to what it would have been if we had increased the fee in line with inflation.

By the end of this financial year, this will equate to £180m of lost revenue. 

During that time, expenditure has increased – the NMC workforce has doubled from 681 in 2016-2017 to around 1,400 today. The regulator has also committed additional expenditure to critical improvement programmes. These include the transformation of its culture, the improvement of Fitness to Practice (FtP), and a roadmap for reviewing education and standards.

The fees freeze and increased expenditure has resulted in a financial gap – the difference between what the NMC receives in income from fees and what it spends. This financial gap was £22m last year and is projected to be £24m this year. Whilst this has been managed through prudent use of our reserves it is not sustainable moving forward.

The proposed reduction in roles and action taken to cut some non-staff costs by around £3.1m a year, would help the regulator to realise savings of £9.7m per annum into future years.

The NMC is also proposing to improve its structure. More than half the staff team is currently in one directorate – Professional Regulation. There are proposals to better group the NMC’s core regulatory teams.

This includes moving the Registration and Revalidation team into the Professional Practice directorate, bringing it closer to the Education and Standards teams. This would consolidate all non-FtP regulatory functions in one directorate.

Crucial to the NMC’s strategy is continuing the steady progress being made under the FtP Plan, including:

• An increase in the rolling average of cases being resolved within the regulator’s target of 15 months – up from 60.8% in July 2023 to 71.6% in August 2025
• A record number of decisions being made at screening, bringing the caseload at the initial assessment stage of the process below 2,000 for the first time in five years (1,983 in July 2025).

Therefore, a proposed new Transformation and Technology Services Directorate will lead on all operational transformation. This includes building on the ongoing work to make FtP more efficient, ensure quality assurance across the whole process, reduce disparities and cut costs over time.

This new directorate will also drive forward the modernisation of the NMC to ensure it is fit for the future. This includes updating the regulator’s technology and systems – and the careful consideration of artificial intelligence (AI) to enable more effective processes.

The NMC has launched a 60-day consultation period on the proposals, with an initial 30-day consultation with its recognised trade union, UNISON.

The regulator is supporting staff through this difficult process and is committed to redeploying staff wherever possible.

Paul Rees MBE, Chief Executive and Registrar, said:

“The nursing and midwifery professions need a strong and independent regulator to uphold high professional standards and protect the public. To achieve this, we must ensure our financial stability and modernise the NMC.

“Along with this comes the need for changes to our organisational structure, and the difficult but necessary decision to propose a reduction in our headcount. This will enable us to make the savings we need heading into next year and beyond, as we continue to build the new NMC.

“Importantly, all of our proposals are subject to consultation with our recognised trade union and staff. We want to deliver on change in the best way we can. This means minimising the impact on our hard-working, dedicated people as far as possible, while meeting the clear need to secure our finances and ensure we are fit for the future.”

Notes to editors

The proposed changes also include the creation of a new Finance directorate, which will align the Finance, Procurement and Estates teams. There are further proposed changes in back office teams.

Other recent news…