An investigation by the Nursing and Midwifery Council (NMC) can be one of the most stressful experiences of a nurse or midwife's career. As part of wider reforms to its fitness to practise framework, new rules came into force on 1 October 2026 which govern how the NMC manages fitness to practise cases and how decisions are made. These new rules give the NMC the power to appoint Legally Qualified Chairs to preside over certain hearings, with the aim of improving efficiency, fairness and consistency in decision-making. For registrants, these reforms may mean more active case management and greater expectations to prepare their case at an earlier stage.
How NMC hearings worked previously
At a hearing before the NMC’s Fitness to Practise Committee, a Panel usually consists of three members: a registrant member, a lay member, and a Panel chair. In addition to the Panel, there was an independent Legal Assessor and their role was to advise the Panel on law, procedure and fairness, without making substantive decisions. When a legal issue arose, submissions were made by the parties, after which the Legal Assessor would provide independent legal advice to the Panel. Thereafter, the Panel would retire and reach its decision. This meant that matters such as witness availability, disclosure, amendments to charges, time estimates and admissibility arguments were often left to be resolved at the substantive hearing itself, which made NMC proceedings lengthy.
The NMC has been heavily criticised over the years for the time taken to conduct fitness to practise proceedings, which often span many years, and the impact this has on registrants, including emotionally, reputationally and physically. Ben Wesson, Chief of Staff at the NMC, has said: “Appointing Legally Qualified Chairs removes unnecessary duplication, supports more consistent chairing of hearings and will enable the NMC to conduct proceedings more efficiently while maintaining the required legal standards.”
What do these changes mean for nurses and midwives?
The NMC’s appointment of Legally Qualified Chairs (‘LQCs’), who are experienced solicitors, barristers or advocates, mirrors the approach already taken by other regulators such as the Medical Practitioners Tribunal Service (‘MPTS’). The LQC role combines the role of a Panel Chair and Legal Assessor.
Although the legal tests applied by Fitness to Practise panels remain unchanged, it is hoped that hearings are likely to become more actively managed and procedurally focused so that hearings can be listed and concluded more quickly. However, it is anticipated that case management directions, evidential issues and legal arguments may come under increased scrutiny at an earlier stage. The change also means that the NMC has enhanced powers to set timetables, and to give directions before hearings.
Going forward, these changes will mean that registrants will need to prepare their case at a much earlier stage. Witnesses will need to be identified at the earliest opportunity; disclosure issues will need to be identified and raised promptly; and any applications will have to be made in advance of the hearing. This could leave less opportunity for registrants to raise procedural issues later in the proceedings and mean that there will be a demand for stricter compliance with any deadlines set. As a result, it will be extremely important that nurses and midwives understand the NMC investigation and hearings process and seek early legal advice to ensure that they are properly prepared for each stage of proceedings.
Being referred to and investigated by the NMC can be an overwhelming and stressful experience. NMC fitness to practise proceedings can have significant implications for a nurse or midwife's professional registration, reputation and livelihood, particularly where an NMC investigation runs for a long time.
While the introduction of Legally Qualified Chairs represents a significant procedural change to the NMC's fitness to practise process, the long-term impact remains to be seen. However, what is clear is that registrants will be expected to engage earlier and comply with stricter procedural requirements.
Seeking specialist legal advice at the outset of an NMC investigation can help ensure that important evidential and procedural issues are identified early and that registrants are properly prepared to comply with the NMC's revised procedures. Our specialist NMC lawyers can assist in:
- Helping you understand the concerns raised;
- engaging effectively with the NMC investigation;
- Presenting evidence in a clear and organised manner;
- Responding to requests for information; and
- Navigating the hearing process with confidence.
How we assist nurses and midwives facing fitness to practise proceedings before the NMC
Our specialist NMC lawyers regularly advise healthcare professionals involved in professional disciplinary and regulatory investigations. We provide support throughout the fitness to practise process, from the initial investigation stage through to interim order hearings, substantive hearings and appeals where necessary.
Our services include:
- reviewing case papers and allegations;
- advising on regulatory procedure and strategy;
- preparing supporting documentation;
- liaising with the NMC on a registrant's behalf; and
- representation at hearings.
If you have been contacted by the NMC about a fitness to practise concern, obtaining specialist advice at an early stage can make a significant difference to the outcome and progression of your case.
To discuss your case with one of our NMC specialists in confidence, please contact our regulatory team on 0161 696 6250 or via our online form.
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