NMC proposes to consult on first fee increase in 10 years

The governing body of the Nursing and Midwifery Council (NMC) is next week (21 October) to be asked to approve proposals to launch a public consultation on increasing its registration fee – with the proposed rise in the fee to be set out in the autumn, if the consultation goes ahead.

The regulator has frozen its registration fee since 2015, helping registrants during the cost-of-living crisis and a period of high inflation. However, the decade-long freeze in the fee has led to a 28% real terms reduction in income for the NMC, in comparison to where it would have been if the fee had kept pace with inflation – equating to about £180m in lost income up to the end of the current financial year.

If an increase in the fee takes place it would be the first rise for a decade – with any increase in the fee being used to invest in critical change and improvement programmes, as part of the ongoing transformation of the NMC – as it becomes a strong and independent regulator.

The consultation on increasing the fee would follow the publication last week (9 October) of the NMC’s decision to propose an internal restructure and reduce 145 roles – equating to 10% of its headcount – as part of a cost-saving programme.

During the course of the 10-year freeze in the registration fee, there has been a 24% increase in the number of professionals the NMC regulates – from 686,811 in 2015 to 853,707 today.

At the same time, Fitness to Practise referrals, new concerns raised about professionals on the register, have increased by 21% during the same period, from 5,415 (new concerns received in 2015-2016) to 6,539 (new concerns received in 2024-2025).

As a result of freezing its fee, while investing in regulatory improvements, and responding to the growing demand, the NMC has started to have to use reserves to fund day-to-day activities for the last three financial years – including this year – meaning the freeze in fee is no longer sustainable.

The NMC sets the standards of proficiency for nursing and midwifery professionals, as well as maintaining the register of those who can practise and overseeing education for nursing and midwifery students.

It has been delivering wide-ranging improvements to ensure it regulates effectively and compassionately. This includes:

• A marked increase in the timeliness of its Fitness to Practise process, with the average number of cases being resolved within 15 months end-to-end – up from 60.8% in July 2023 to 71.6% in August 2025
• The publication of a roadmap to improve education and standards and make sure they are fit for the modern era, with a plan to publish a practice learning review in autumn 2026; a new Code and revalidation process in autumn 2027; and standards for Advanced Practice by March 2028
• A Culture Transformation Plan, to respond to the issues that were highlighted in the Independent Culture Review, published in summer 2024
• The embedding of equity, diversity and inclusion across regulatory processes, including a commitment to be an anti-racist organisation.

The regulator has also been strengthening its approach to safeguarding – launching a Safeguarding Hub which screens new referrals into Fitness to Practise. Over the past year, this has identified more than 1,200 safeguarding risks or wellbeing concerns, and taken steps to keep people safe from harm.

Paul Rees MBE, Chief Executive and Registrar, said:

“For the first time in a decade, we are proposing to increase the registration fee.

“The intention of the freeze was to help nursing and midwifery professionals at a time of a cost-of-living crisis and high inflation. At the same time, it has seen our income contract by 28% in real terms – and will equate to £180m in lost income up to the end of the current financial year.

“We are now using up our reserves to pay for day-to-day running costs, and our Executive Board no longer believes the freeze in the fee is sustainable.

“We are currently reducing our costs – and have taken the difficult decision to propose reducing our headcount by 145 roles, which is 10% of posts.”

He added: “If there is an increase in the registration fee, we will use the increased funding to pay for the ongoing transformation of the NMC – as we gradually improve Fitness to Practise; work to improve education and standards; fix our culture and embed equity, diversity and inclusion, including becoming an anti-racist organisation.

“The changes we are making will enable us to meet our core priorities of protecting the public, maintaining confidence in the nursing and midwifery professions and upholding the standards of proficiency.

“Through building a new NMC, we are ensuring that we become the strong and independent regulator that everyone wants to see.

“If the consultation goes ahead, we will encourage everyone to share their thoughts on the fee changes. Whether you are a nurse, midwife or nursing associate on our register, a student, a member of the public or someone involved in the wider health and social care sector, we would be keen to hear your thoughts.”

Details about the Council meeting can be found on our website.

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