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New 'flexible' return to practice approach approved by NMC

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Nurses wanting to return to practice will soon be able to do so by taking a test of competence instead of a course, after changes were given the green light.

Council members of the Nursing and Midwifery Council approved the plans during a meeting at its London headquarters on Wednesday.

“We want to provide more flexibility in this area of regulation”


The test of competence mirrors the assessment that overseas applicants must undertake to join the NMC register and will serve as an additional option to the current return to practice programme route. 

Professor Geraldine Walters, director of education, standards and policy at the NMC, said the current system presented “barriers” to those wanting to return to practice.

There are currently 79 return to practice programmes approved across 86 locations. 

A report shown to the NMC council said: “We are aware of difficulties of access to these programmes due to factors such as location, programmes not running and restrictive entry criteria. 

Nursing and Midwifery Council

Geraldine Walters

Geraldine Walters

“We want to provide more flexibility in this area of regulation while ensuring safe and effective practice,” it added.

The document noted that the number of people who could complete a return to practice programme was currently “limited by the appetite and capacity” of education institutes.

As it stands, around 1,600 students finish a return to practice course per year.

Council registrant member Claire Johnston said the flexibility the changes would provide was “absolutely welcomed”.

She added that the move was timely because government arms’-length body Health Education England was about to launch a return to practice campaign.

However, Robert Parry, also a registrant member of the NMC council, warned that “with flexibility comes a little bit of risk” and he asked for the new approach to be kept under evaluation.

Return to practice is open to nurses and midwives who have not been able to complete enough clinical hours to revalidate; people whose registration has lapsed after a career break; professionals practising outside the UK; and individuals who have formerly been struck off but allowed to re-join after five years.

“With flexibility comes a little bit of risk”

Robert Parry

In a public consultation held by the NMC into the proposed changes, 63% of individuals and 77% of organisations opposed the idea of allowing those who have previously been struck off to return to practice by completing a test of competence.

However, the report that went before the council said there was “no available evidence” that these individuals posed a greater risk where they returned to practice.

The new approach is due to take force no later than November this year. 

At the meeting, council members also approved new return to practice standards that will give education providers greater freedom around the length and design of the programme.

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