New employees

New employees should have:

  • a thorough induction into their area of work
  • training and supervision where necessary
  • preceptorship* and mentoring (especially for newly qualified staff)
  • ongoing access to professional development
  • clinical supervision.

*Preceptorship is a period of support for people who have joined the register to help their transition from student to qualified nurse or midwife.

Professional indemnity arrangements

From 17 July 2014, the Health Care and Associated Professions (Indemnity Arrangements) Act (2014) requires all nurses, midwives and nursing associates to have in place an appropriate professional indemnity arrangement.

This should reflect the risks associated with the scope of their practice and provide sufficient cover if a successful claim is made against them.

Read more information on professional indemnity arrangements

Vetting and barring

The sections in the Safeguarding Vulnerable Groups Act 2006 that prohibit individuals from working with children and vulnerable adults, has been in effect since October 2009. These sections cover a much wider range of workplaces.

The management of the different lists of barred individuals is centralised and run by the Disclosure and Barring Service in England, Wales and Northern Ireland, and by Disclosure Scotland.

You must check that anyone you employ is not on the barred lists. It is a criminal offence to knowingly let a barred individual work with vulnerable groups.


  • Always make sure that you receive at least two professional references from an applicant’s last place of work as a nurse or midwife.
  • Be sure to follow up on references too – contact referees yourself rather than relying on any written statements supplied to you by the job applicant.
  • Don’t let a person start work until you have verified their references – if you really cannot afford to wait for references to be confirmed in writing, at least obtain verbal assurances over the phone until the paperwork comes through.

Identity checks

As part of your background checks before employment, you should ask to see proofs of identity and address. Proof of identity should be photographic, for example a passport, photo driving license, or EU or EEA national identity card. Proof of address might include a recent bank statement, utility bill or council tax bill.

You should not employ someone if you are uncertain of their identity, and you should contact us immediately if you believe someone is fraudulently using a nurse, midwife or nursing associate's identity or registration details.

The Healthcare Professional Alert Notification (HPAN) scheme

HPANs are used to inform NHS bodies and others about health professionals who may pose a significant risk of harm to patients, staff or the public. HPANs are usually used while concerns are being considered and provide an additional safeguard during the pre-employment checking process.

If you're an employer within NHS organisations or another body providing services to the NHS you must check whether anyone you employ is subject to an active HPAN.

Please visit the NHS Resolution website for more information about signing up to the service.

Managing an employee’s fitness to practise

We recognise that many minor incidents are better dealt with by employers at a local level. You may need to discipline a nurse, midwife or nursing associate through your own employment procedures, or provide further training. Depending on the severity of the incident, our involvement is not always necessary.

If you manage a concern locally, you should monitor the situation and review the position if there is a change in circumstances.

If you manage a case of poor performance or ill health, and are not sure that the concerns can be adequately dealt with under your own procedures, you can seek advice from our Employer Link Service.

The service can provide employers with advice on individual referrals as well as NMC referral thresholds and the information we need for any investigation.