Committee publication · Correspondence · 20 May 2026

Correspondence from the NMC- Increase in registration fees and change to fitness to practice rules

From: Health and Social Care Committee

Summary

The NMC writes to inform the Health and Social Care Committee of two decisions requiring Parliamentary approval: increasing the annual nursing registration fee from £120 to £143 (first rise in 11 years) due to inflation eroding real fee value by 28.8% and depleting reserves from £101m to £49.6m; and streamlining Fitness to Practise rules to accelerate case resolution and improve fairness through legally qualified chairs, enhanced case management, and digital information sharing.

Key findings

  • NMC registration fees have remained at £120 since 2015, causing inflation to reduce real fee value by 28.8%, approximately £186 million in lost income over the decade.
  • NMC reserves have fallen from £101m in March 2024 to £49.6m and are projected to reach £15.9m by March 2027 without a fee increase, necessitating the £23 annual increase (£1.92 monthly).
  • Fitness to Practise referrals have increased by around 21% since 2015; NMC now regulates 867,935 professionals (one in 50 of working-age population), driving demand for regulatory services.
  • Proposed Fitness to Practise rule changes include appointing Legally Qualified Chairs, strengthening case management powers, enabling digital information sharing, and providing enhanced witness support to reduce delays and timelines.
  • NMC has implemented cost controls: 10% workforce reduction (137 roles), £3.1 million annual non-staff spending cuts, and strengthened financial controls; consultation feedback showed support for proposed changes despite opposing the fee increase.

Tone

Factual

Topics

healthcare-regulationprofessional-standardspublic-financeprocedural-reform

Key actors

NMC (Nursing and Midwifery Council), Paul Rees MBE (Chief Executive and Registrar, NMC), Layla Moran MP (Chair, Health and Social Care Committee), NMC Council, Privy Council

Notable line

The NMC is now regulating many more professionals, in a more demanding environment, while operating with fees that have steadily reduced in value for 11 years.

Key Quotes

… inflation has reduced the real value of the registration fees by around Restricted: For Committee use only 28.8% …
Paul Rees MBE, Chief Executive and Registrar, NMC · Explaining financial impact of frozen fees since 2015
Our reserves have fallen from £101m in March 2024 to around £49.6m now and are projected to fall to £15.9m in March 2027 if there is no increase in the fee.
Paul Rees MBE, Chief Executive and Registrar, NMC · Demonstrating urgency of fee increase
Council agrees that an increase in the main fee by the equivalent of £1.92 per month is fair and proportionate.
Paul Rees MBE, Chief Executive and Registrar, NMC · Presenting the fee increase decision
Fitness to Practise referrals have increased by around 21% – and rising – since 2015, reflecting both workforce growth and the increasing complexity of modern healthcare.
Paul Rees MBE, Chief Executive and Registrar, NMC · Supporting need for regulatory investment
Having a strong, independent regulator – one that can act quickly, fairly and effectively to protect the public and support confidence in the professions – matters.
Paul Rees MBE, Chief Executive and Registrar, NMC · Justifying both fee increase and rule changes
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Source · parliament.uk record ↗

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