NMC takes next steps to tackle inequalities in regulation

Published on 25 April 2024

Our latest Ambitious for Change research found differences in nursing and midwifery professionals’ experiences and outcomes from our regulatory processes, depending on their diversity characteristics. Now we’re working to understand why, so that we can plan ways to make our work as fair as possible for everyone.

The research found, for example, that professionals who are men, Black, disabled, or whose sexual orientation we don’t know, are more likely to progress through the stages of our fitness to practise (FtP) process.

We’ve commissioned the University of Greenwich to review a sample of FtP cases that closed between September 2019 and September 2023. This will enable us to better understand why these differences exist and whether bias or discrimination contribute to the disparities we're seeing.

The review will also examine our current policies and guidance, and assess whether they effectively promote equality within our FtP processes. We’ll use these findings to improve our regulatory role and ensure our FtP practices are as fair as possible for everyone.

Understanding employer referrals

We’ve also seen disparities in the groups of professionals referred to us by employers. In particular, we found that some employers appear to refer a higher proportion of male and/or Black professionals compared to the proportion on the NMC register, and sometimes compared to the demographics of their own local workforces.

To identify the reasons behind this, our outreach team (the Employer Link Service) will work with employers to understand more about these findings and the measures they're implementing to reduce bias and ensure fairness in their referrals. We know there is good practice out there around how organisations are managing disciplinaries and referrals, and we want to share this with the employers we work with. We will analyse the outcomes of those discussions later this year. This will be key to influencing and supporting best practice in decision making.

Matthew McClelland, NMC Executive Director of Strategy and Insight, said:

“Every nurse, midwife and nursing associate needs to feel respected, valued and supported so they can deliver the best care possible for people. That includes every aspect of their working lives, including on those occasions when professionals are referred to our fitness to practise process.

“We’re speaking to employers to understand why there can be disparities in some groups of professionals who are referred to us as well as looking at why those groups experience our regulatory processes differently. This work will help us work towards being a fairer, more inclusive regulator. We’ll keep people informed as the work progresses.”


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