The Nursing and Midwifery Council (NMC) has officially confirmed the commencement of a comprehensive public consultation regarding a newly drafted Code of Professional Standards and a significantly updated revalidation process. This move, described by regulatory leaders as a "landmark" moment for the professions, marks the first major overhaul of the foundational documents governing nursing and midwifery in nearly a decade. The consultation aims to ensure that the standards of practice, behavior, and continuous professional development remain fit for purpose in an increasingly complex and technologically advanced healthcare landscape.
A New Vision for Professional Standards
The decision to revise the Code comes at a time when the healthcare sector is facing unprecedented challenges, ranging from workforce shortages to the integration of artificial intelligence in clinical decision-making. The NMC, which oversees more than 800,000 nurses, midwives, and nursing associates across the United Kingdom, has stated that the proposed changes are designed to reflect the evolving roles of healthcare professionals.
The draft Code is expected to place a renewed emphasis on "cultural safety," psychological safety in the workplace, and the ethical use of digital technologies. While the core tenets of the Code—prioritizing people, practicing effectively, preserving safety, and promoting professionalism—remain the pillars of the document, the specific requirements under each header are being expanded to address modern clinical realities.
Chris Dzkiti, the Chief Executive and Registrar of the NMC, emphasized that the update is not merely a bureaucratic exercise but a fundamental realignment of professional expectations. "The world of health and social care has changed dramatically since the last major iteration of the Code," Dzkiti noted in a statement accompanying the announcement. "Our professionals are working with higher levels of autonomy and complexity than ever before. This consultation is an invitation to the professions and the public to help us define what excellent care looks like in the mid-21st century."
The Evolution of the Code: A Decade of Change
To understand the significance of this "landmark" consultation, it is necessary to examine the chronology of the NMC’s regulatory framework. The last substantial update to the Code occurred in 2015, which introduced a more streamlined and "user-friendly" version of the standards. This was followed by a minor revision in 2018 to incorporate the new role of nursing associates in England.
Since 2018, however, several high-profile inquiries into maternity services and general nursing care have highlighted the need for more robust professional accountability and a clearer focus on the "duty of candor." Reports such as the Ockenden Review and the East Kent investigation underscored how professional culture can impact patient safety. Consequently, the 2026 draft Code is expected to include more explicit language regarding the responsibility of professionals to speak up against poor practice and the duty of employers to support them in doing so.
Furthermore, the post-pandemic era has seen a shift in how healthcare is delivered, with a surge in remote monitoring and telehealth. The new Code will likely address the boundaries of digital practice, ensuring that the human element of nursing and midwifery is preserved even as digital tools become ubiquitous.
Modernizing Revalidation: Moving Beyond Compliance
Parallel to the revision of the Code is the "refresh" of the revalidation process. Revalidation was first introduced in April 2016 as a way for professionals to demonstrate that they continue to practice safely and effectively. It requires registrants to provide evidence of practice hours, continuing professional development (CPD), practice-related feedback, and reflective accounts every three years.
While revalidation has been generally well-received for promoting a culture of reflection, some critics have argued that it has become a "tick-box" exercise for many. The NMC’s data indicates that while over 90% of registrants successfully complete revalidation on time, the quality of reflection varies significantly.
The proposed 2026 refresh aims to make the process more meaningful and less burdensome. Key proposals include:
- Enhanced Reflective Practice: Moving away from static written accounts toward more interactive forms of professional reflection, possibly including peer-led discussions or digital portfolios.
- Tailored Requirements: Adjusting the requirements for those in non-clinical or highly specialized roles to ensure the process is relevant to their specific area of practice.
- Focus on Wellness: Integrating professional wellbeing into the revalidation framework, acknowledging that a professional’s health and resilience are intrinsically linked to patient safety.
Workforce Statistics and Regulatory Pressure
The context of this consultation is framed by stark data regarding the UK nursing and midwifery workforce. As of early 2026, the NMC register has reached record numbers, yet the "leaky bucket" phenomenon persists. Data from the 2025 NMC permanent register report showed that while recruitment remains high—particularly from international sources—the number of UK-trained professionals leaving the register prematurely remains a concern.
Analysis suggests that "burnout" and "moral distress" are primary drivers for professionals leaving the sector. By updating the Code and revalidation process, the NMC hopes to provide a framework that supports professionals rather than just policing them. The goal is to foster a regulatory environment that promotes retention by valuing professional growth and providing clear guidance on managing ethical dilemmas in under-resourced environments.
Addressing the ‘Culture of Care’
One of the most anticipated aspects of the new consultation is how it will address systemic issues within healthcare cultures. The NMC has signaled that the new Code will have a stronger focus on "inclusive leadership" and "anti-discriminatory practice."
This follows years of data showing that professionals from Global Majority backgrounds are disproportionately likely to be referred to the NMC for fitness-to-practise investigations. By embedding principles of fairness and cultural competence directly into the Code, the regulator aims to set a standard that mitigates bias and promotes equity within the workplace.
The consultation will also seek views on how the Code can better support "multi-disciplinary team" (MDT) working. In the modern NHS, nurses and midwives rarely work in isolation; the new standards will likely emphasize the importance of collaborative practice and shared accountability across different professional groups.
Stakeholder Perspectives and Public Input
The launch of the consultation has already drawn reactions from major healthcare organizations. The Royal College of Nursing (RCN) welcomed the move, stating that any update to the Code must reflect the reality of the "staffing crisis" and ensure that nurses are not unfairly penalized for systemic failures beyond their control.
Similarly, the Royal College of Midwives (RCM) highlighted the need for the Code to protect the unique, autonomous nature of midwifery practice. "Midwives face distinct challenges, particularly in the current climate of maternity service reform," a spokesperson for the RCM stated. "We look forward to ensuring that the new Code supports midwives in delivering the high-quality, woman-centered care that is the hallmark of the profession."
Patient advocacy groups have also expressed a keen interest in the consultation. Organizations such as National Voices have emphasized that the Code is a "social contract" between the profession and the public. They are calling for the new standards to place a greater emphasis on "co-production" and the involvement of patients in their own care planning.
A Roadmap for Implementation
The consultation is set to run for a period of 12 weeks, during which the NMC will host a series of town hall meetings, webinars, and focus groups across the four nations of the UK. This inclusive approach is intended to gather a diverse range of perspectives from frontline clinicians, educators, students, and the public.
Following the consultation period, the timeline for implementation is as follows:
- Late 2026: Analysis of consultation responses and publication of the final report.
- Early 2027: Formal approval of the new Code and revalidation requirements by the NMC Council.
- Mid-2027: Launch of an extensive educational campaign to familiarize registrants with the new standards.
- January 2028: The new Code and revalidation process officially go live.
Implications for the Future of Nursing and Midwifery
The long-term implications of this "landmark" consultation are profound. By redefining the standards of the profession, the NMC is effectively shaping the future identity of nursing and midwifery in the UK.
The emphasis on digital literacy and AI ethics suggests a future where nurses and midwives are seen as "knowledge workers" who navigate complex data to provide personalized care. The focus on cultural safety and anti-discrimination points toward a more inclusive profession that reflects the diversity of the population it serves.
Furthermore, the refresh of the revalidation process could transform the way professionals view their own development. If the NMC succeeds in making revalidation a tool for genuine growth rather than a hurdle for registration, it could significantly enhance professional morale and contribute to a more resilient workforce.
As the consultation begins, the eyes of the healthcare world are on the NMC. The outcome will determine whether these new standards can bridge the gap between the traditional values of nursing and midwifery and the demands of a rapidly changing, high-pressure modern healthcare system. For the hundreds of thousands of professionals on the register, the "green light" for this consultation represents a critical opportunity to influence the rules that will govern their professional lives for the next decade.
