Future standards

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In 2023 we launched a review to consider the additional regulation of advanced nursing and midwifery practice – the complex, autonomous and expert roles that many experienced nurses and midwives carry out.

On 27 March 2024, our Council agreed the following approaches:

  • Developing a set of principles for advanced practice. These principles form the foundation of a wider set of regulatory measures that will support the best possible advanced practice care in the future.
  • Throughout 2025/26 we’ll work to ensure that advanced practice considerations are taken into account through the reviews of revalidation and the Code.
  • We’ll continue the transition work to recognise nurses and midwives already practising at an advanced level, exploring potential options and exploring operational implications in preparation for the development of standards.
  • In Spring 2027, we’ll begin work to develop standards of proficiency and associated advanced practice programme standards. This will include a public consultation before finalising the new standards. We’ll also ensure that our quality assurance processes are in place and ready to support approval of programmes that meet our standards.
  • We’ll then move to Phase 3, implementation of standards and transition.

Developing a set of principles for advanced practice

The principles for advanced practice set out our expectations of best practice for nurses and midwives working at an advanced level, as well as for employer organisations.

These principles aim to bring clarity and consistency to advanced level nursing and midwifery practice across the UK. They enable the public to understand the role of a nurse or midwife working at an advanced level, support professionals by setting clear expectations for their practice and help employers develop and sustain systems in which advanced practice can thrive.

The principles have been developed through extensive UK-wide engagement with professionals and the public. They distinguish between experienced practice and advanced practice – emphasising that advanced practice is not about a title but a level of expertise achieved through additional, often specialised, education and experience after initial registration.

The principles recognise the well-established four pillars of advanced practice (clinical practice, education, research, and leaderships and management). They are relevant to all workplace settings and complement the advanced practice frameworks of each of the four nations of the UK.

Council approved the principles at its meeting on 26 March 2025 and we published them on 10 June 2025. You can read the principles here

Developing standards

Setting standards of proficiency for advanced practice programmes will create a consistent threshold of what nurses and midwives working at an advanced level should know and be able to do. It will also set clear regulatory standards for education programmes enabling education institutions to develop curricula to meet these standards. Standards will provide us with regulatory oversight and assurance of how nurses and midwives become qualified to work at an advanced level.

We will develop our advanced practice standards of proficiency and associated programme standards in the 2027–2028 financial year (April to March). This will include public consultation.

Enhancing The Code and revalidation

We will consider requirements for nurses and midwives working at an advanced level as part of the Code and revalidation reviews scheduled for 2025/26. As part of both reviews we’ll consider whether there needs to be additional requirements in both the revalidation process and the Code.

Developing transitional arrangements for existing nurses and midwives working at an advanced level

Through developing a transitional approach, we’ll ensure that nurses and midwives who are currently working at an advanced level (and those studying) can demonstrate that they meet our standards of proficiency. This work will include:

  • exploring a number of potential options which ensure a proportionate approach is developed.
  • enabling NMC operational systems to support the delivery of the newly developed process.

This work will continue throughout 2025/26 and continue as we progress towards standards development and launch.

How we developed our approach

Our options are founded on independent research by The Nuffield Trust, followed by NMC-led key lines of enquiry involving extensive engagement with professionals and the public. Both stakeholder groups found great variation in how professionals across the UK undertake advanced practice roles.

We heard clearly from both the public and professionals about the important role advanced level practitioners play in delivering care for people. They also said a lack of consistency in education and training, qualifications, responsibilities, and governance processes can create a risk to the public, and that additional regulation will help reduce the risk. We heard that no single option would be able to mitigate the risk and a phased approach to a number of options was recommended to Council.

You can read more about how we developed our approach on the next two pages.

At its meeting on 27 March 2024 following the recommendation of the advanced practice independent stakeholder steering group, the Council agreed that there was a risk to public protection with the current regulatory arrangements and a need to proceed to the development of additional regulation for nurses and midwives working at an advanced level. Council agreed to a phased approach to the work, recognising that no single regulatory option would be sufficient to mitigate the risk.

As we progress the development of additional regulation our approach will focus on collaboration and co-production, ensuring we utilise expertise and experience across the four nations and diverse settings in an open and transparent way and through extensive stakeholder engagement.

Further information

You can read more about how we developed these proposals in: