Remediation in NMC cases
The NMC rarely uses the word remediation in its current guidance. It talks about strengthened practice: the steps you take to address the concern so that you can practise safely, kindly and professionally. Its guidance on insight and strengthened practice says this evidence will usually be central to deciding whether your fitness to practise is currently impaired.
The NMC asks three questions. Can the concern be addressed? Has it been addressed? Is it highly unlikely that the conduct will be repeated? It also asks decision makers to consider the context in which the incident happened, because concerns that look like poor individual practice are sometimes caused by system pressures or other factors, before deciding what steps you needed to take.
Online courses can be part of strengthened practice. The NMC’s own guidance says training is more useful when it is relevant to the concerns, sufficiently comprehensive, and ideally includes a practical element and some form of assessment. Our courses include an assessment. The practical element comes from showing how you have used the learning at work.
Before you start
We are an independent CPD provider, not part of the NMC. No regulator approves remediation courses, and no course can guarantee an outcome. Take advice from your defence organisation, union or solicitor, and agree with them which learning is relevant to your case.
Which course fits your NMC concern
Match your learning to the allegation and to the part of the Code it engages. Concerns the NMC sees as easier to address need focused clinical learning and evidence of safe practice. Attitudinal concerns need deeper reflection and evidence of sustained change.
Medication errors and clinical practice
The NMC treats medication administration errors and failings in a discrete area of practice as generally easier to address. That makes strong, focused evidence especially valuable. Show what went wrong, the checks you now use, and supervised practice or competency sign-off in medicines management. A course supports this but should sit alongside workplace assessment.
Record keeping
Poor record keeping is one of the examples the NMC gives of a concern that can usually be addressed. Show you understand why accurate, timely records protect people receiving care and colleagues, and provide audits or manager feedback on your recent documentation. Explain the specific habits you have changed. Keep copies of positive audits.
Dishonesty
The NMC’s sanctions guidance says honesty is of central importance to a professional’s practice, and that serious, sustained dishonesty is much harder to address. Its guidance on the highest risk cases notes that conditions of practice cannot address attitudinal concerns of this kind. Your reflection must show you understand why it was dishonest, the effect on trust, and how you now act with integrity.
Boundaries and relationships with people receiving care
Inappropriate personal or sexual relationships with people receiving care are among the concerns the NMC says may be very hard to address. For less serious boundary concerns, such as over-familiarity or contact on social media, learning about power, trust and boundary drift, combined with honest reflection, can help show that you understand the risks.
Discrimination, bullying and harassment
The NMC’s guidance on the highest risk cases says discriminatory conduct is higher risk because it is harder for the professional to put right. Remediation needs to show genuine understanding of the harm caused to colleagues or people receiving care, and evidence from your workplace that your behaviour has changed over time.
Communication and complaints
Many referrals follow complaints from people receiving care or their families about how they were spoken to or kept informed. Show that you understand how the interaction felt to them, how you now communicate with compassion, and how you respond when someone raises a concern with you directly. Ask colleagues to confirm it.
Candour and raising concerns
Being open and honest when things go wrong is a professional duty under the Code. The NMC lists breaches of the professional duty of candour alongside higher risk conduct. Show that you understand why openness matters to people receiving care and how you now report and explain incidents. Reflect honestly on what made openness difficult at the time.
Confidentiality
Accessing records without a care reason, or sharing information inappropriately, including online, breaches the Code. Show that you understand the duty of confidentiality, when information can be shared, and the safeguards you now follow. Evidence of completed local information governance training adds weight. Explain how you now check that access to records is justified.
How the NMC fitness to practise process works
The NMC’s view is that local investigation and resolution by employers is usually the right first response, unless there is a risk the employer cannot manage. Concerns that do come to the NMC move through the stages below. Contact your union or a regulatory solicitor early.
- 1
Screening
The NMC first checks whether there is a written concern about someone on its register and whether there is evidence of an ongoing risk to public safety, public confidence or professional standards that could require regulatory action. Its screening guidance says it will consider evidence of strengthened practice provided at this stage. Screening can end with no action, no action but a notification to your employer, or referral for a full investigation.
- 2
Investigation
If the case is referred, the NMC gathers evidence from employers, witnesses and records, and asks for your response. This is where a calm, well-supported account matters. You can send evidence of insight and strengthened practice, such as relevant training, a reflective account and references from a manager who knows about the concern. Ask your representative to check everything before it is sent.
- 3
Case examiners
At the end of the investigation, two case examiners review the evidence. One is a nurse, midwife or nursing associate and one is not. They decide whether there is a real possibility that a Fitness to Practise Committee would find the facts proved and your fitness to practise currently impaired. Your insight and strengthened practice evidence can affect that decision.
- 4
Case examiner outcomes
If there is no case to answer, case examiners can take no action, give private advice, or give a warning that is published on the register for 12 months. If there is a case to answer, they can recommend undertakings, which usually means the case does not go to a hearing, or send the case to a Fitness to Practise Committee panel at a meeting or a hearing.
- 5
Interim orders (at any point)
If there may be a risk while the case is investigated, an Investigating Committee panel or the Fitness to Practise Committee can impose an interim conditions of practice order or an interim suspension order. An interim order lasts a maximum of 18 months at any one time and should be reviewed by a panel every six months. Interim orders are not findings that the allegations are true.
- 6
Fitness to Practise Committee
The panel decides the facts, then whether your fitness to practise is currently impaired, then what sanction, if any, is needed. In a consensual panel determination, you and the NMC agree on impairment and sanction, but you must admit the facts and the panel still makes its own decision. Evidence of insight and strengthened practice is central at the impairment stage.
- 7
Sanctions and reviews
The panel starts with the least restrictive option: taking no further action, a caution order of one to five years, a conditions of practice order of up to three years, a suspension order of up to twelve months, or a striking-off order. Conditions and suspension orders can be reviewed before they end, when the panel will ask what you have done since the order was made.
What NMC decision makers look for
The NMC’s fitness to practise library sets out how case examiners and panels weigh your evidence. These are the points its guidance on insight and strengthened practice returns to most often.
Insight
The NMC describes insight as being able to step back from the situation and look at it objectively, recognise what went wrong, accept your role and responsibilities, and appreciate what could and should have been done differently. Decision makers look at the quality of insight, not just whether it is claimed. The guidance also notes that disputing the facts does not automatically mean you cannot show insight into the professional issues raised.
Whether the concern can be addressed
The NMC says some concerns are generally easier to address, such as medication administration errors, poor record keeping, or failings in a discrete and easily identifiable area of clinical practice. Others are much harder, such as dishonesty that was serious and sustained, discrimination, harassment, sexual misconduct, or violence towards or neglect of people receiving care. Decision makers focus on the conduct that led to the outcome, not only the outcome itself.
Relevant, assessed training
When looking at courses, the NMC considers whether the training was relevant to the concerns in the case and sufficiently comprehensive, ideally with a practical element and some form of assessment. A certificate in an unrelated subject adds little. Choose learning that maps to the exact part of the Code engaged, and then show how you have put it into practice in a real clinical or care setting. Keep a note of where and when you did so.
Reflection that shows learning applied
The NMC says reflective accounts carry more weight when you give examples not only of what you have learned since the concerns were raised, but also how you have applied that learning in your practice. Write about specific situations at work where you acted differently because of what you learned. Link your reflection back to the Code and to the people receiving care who were affected. Be specific about dates and settings.
References and safe practice
References from a manager or supervisor usually carry more weight than those from friends or colleagues. The NMC says they should be signed, dated, on headed paper with contact details, and show that the author knows about the concerns. A period of safe practice in the relevant area, with your employer aware of the concern and assessing your work, is strong evidence that the risk has reduced. Ask early, so they have time to observe you.
Recommended NMC remediation courses
All 19Each course is self-paced and online. You get scenario-based questions with an 80% pass mark, a structured reflective account and a CPD certificate showing your name, the course title and the CPD hours.
Fitness to Practise for Healthcare Professionals
A Core Course on Regulation, Current Impairment and Professional Response in the United Kingdom
Professionalism and Professional Standards for Nurses and Midwives
The NMC Code, Revalidation and Professional Conduct in Practice
Ethics and Ethical Standards for Nurses and Midwives
Principles, the NMC Code and Professional Conduct in Nursing and Midwifery
Probity for Healthcare Professionals
Honesty, Integrity, and Trust in Professional Practice
Ensuring Clinical Competence and Patient Safety for Healthcare Professionals
Competence, Safety, and Continuous Development in Practice
Professionalism in Documentation for Healthcare Professionals
Accuracy, Integrity and Accountability in Clinical and Non-Clinical Records
Ethical Boundaries with Patients and Colleagues
Recognising, Maintaining and Restoring Professional Limits
Duty of Candour in Healthcare Practice
Being Open and Honest When Things Go Wrong
Ensuring Effective Communication as Healthcare Professionals
Clear, Respectful and Patient-Centred Communication in Practice
Building your NMC strengthened practice bundle
Your bundle should answer the NMC’s three questions: can it be addressed, has it been addressed, and is repetition highly unlikely? Agree the contents with your union or representative.
What to put in your bundle
- Certificates for training that matches the concern, ideally with an assessment, showing date and CPD hours.
- A reflective account that gives examples of how you have applied the learning in practice.
- A reference from your manager or supervisor, signed, dated, on headed paper, confirming they know about the concern.
- Evidence of a period of safe practice in the relevant area, with your employer aware of the concern.
- Competency assessments or supervised practice records, for example in medicines management.
- Audits of your recent records or practice in the area that was criticised.
- Evidence of how you have kept up to date if you are not currently working.
Writing your reflection
- Structure your thinking around the Code’s four themes: prioritise people, practise effectively, preserve safety, and promote professionalism and trust. The NMC plans to consult on a new draft Code, but the current Code applies until any replacement takes effect.
- Describe the context honestly, but do not use it to shift responsibility away from yourself.
- Show you understand the impact on the person receiving care, their family and colleagues.
- Give real examples from your practice where you now act differently, with dates where you can.
- Keep it in your own voice; a short, honest account is better than a long, polished one.
When to start strengthening your practice
As early as possible. The NMC considers evidence of strengthened practice from the screening stage onwards, and case examiners make their decision on the evidence they have. Evidence that arrives only at a hearing has had less time to show real change, and the panel will want to know whether it has lasted.
Start by understanding exactly what is alleged and which parts of the Code it engages. Then choose relevant training, reflect in writing, and ask your manager how you can show the change at work. Under an interim order, plan your learning so each six-monthly review shows progress.
Undertakings and consensual panel determination
Not every case with a case to answer goes to a contested hearing. Case examiners can recommend undertakings: measures that address the areas of practice that cause a current risk to people receiving care. Undertakings are published on your register entry with a summary of the concern, except where the concern relates to your health. Your insight and strengthened practice evidence helps case examiners decide what undertakings are needed.
Later, a consensual panel determination may be possible, where you and the NMC agree that your fitness to practise is impaired and what sanction is appropriate. You must admit the factual allegations, and the panel still makes its own decision. Both routes depend on honest acceptance of the concern, which is why insight matters so much.
Common mistakes nurses and midwives make
- Choosing training that is not relevant to the concern.
- Writing a reflection that describes learning without examples of changed practice.
- Sending references from people who do not know about the concern.
- Blaming the workplace instead of explaining context while still accepting your part.
- Waiting for a hearing date, when evidence can be considered from screening onwards.
- Responding to the NMC without advice from your union, defence body or a solicitor.
Core course
Fitness to Practise for Healthcare Professionals
Our most complete remediation course: 4 CPD hours and 40 scenario questions on impairment, insight, remediation and reflection, with a certificate when you pass.
NMC remediation: common questions
Are these courses approved by the NMC?
No. The NMC does not approve, accredit or endorse remediation courses. Case examiners and Fitness to Practise Committee panels judge the evidence you provide. The NMC’s guidance says they will consider whether training was relevant, comprehensive and ideally assessed. Our courses include an assessment and a structured reflective account, but the weight given depends on how relevant they are and how you apply the learning.
Will a course guarantee a good outcome at my NMC hearing?
No. Nothing can guarantee an outcome. Panels consider the seriousness of the concern, the context, your insight and the evidence of strengthened practice. For some concerns, such as serious dishonesty or sexual misconduct, the NMC’s guidance on the highest risk cases shows that a serious sanction may still be needed to maintain public confidence, even where remorse is shown.
What does strengthened practice mean?
Strengthened practice is the NMC’s term for the steps you take to address the concern so that it is highly unlikely to happen again. It can include relevant training, supervised practice, reflection, and a period of safe practice in the area concerned. It goes hand in hand with insight, which is your understanding of what went wrong and why.
Can I show insight if I deny the allegations?
The NMC’s guidance says that disputing the facts does not necessarily stop you showing insight into the professional issues raised. You can still reflect on the standards involved and how you would act in similar situations. This is a delicate area, so take advice from your union or a solicitor before writing anything.
Should I send evidence before the case examiners decide?
Usually yes, after taking advice. Case examiners decide whether there is a case to answer on the evidence in front of them, and strong evidence of insight and strengthened practice can affect what they decide, including whether undertakings are enough. Evidence sent only at a hearing has had less time to show lasting change.
What do I get when I buy a course?
Immediate access to a self-paced online course. Each course carries 2 CPD hours and 15 multiple choice questions, except the Fitness to Practise course, which carries 4 CPD hours and 40 questions. You need 80% to pass. You then complete a structured reflective account and receive a CPD certificate PDF with your name, the course title and CPD hours.
Do I need a union rep or solicitor as well?
We strongly recommend it. A union representative, defence organisation or regulatory solicitor can advise on what to send the NMC, when, and how it will be read. Our courses support your learning and reflection. They are not legal advice and do not replace representation. Your representative can also help you decide which courses are most relevant.
Official sources
This page was checked against Nursing and Midwifery Council guidance in October 2026. Processes and guidance change, so always confirm the current position with the regulator and your adviser. This page is general information, not legal advice.