The Nursing and Midwifery Council has said it will monitor the impact of its decision to increase the annual registration fee from £100 to £120, which unions have warned could persuade tens of thousands of staff to leave the profession.
Speaking yesterday after the regulator approved the fee rise, NMC chief executive and registrar Jackie Smith said that the nursing regulator would keep track of its impact on the numbers of nursing staff “as best as we can”.
However, she added that the previous fee increase, which saw it rise from £76 to £100 in 2013, did not appear to have caused a reduction to the workforce.
Ms Smith said the NMC currently had around 680,000 registrants, more than it has ever had before.
“That would suggest that the 2012 increase didn’t result in a falling of numbers, but we cannot be complacent about this,” she said. “We need to monitor it [the impact of the fee increase to £120] and will do.”
However, Unison’s head of nursing Gail Adams warned that the new fees, which will be introduced from March 2015, could see tens of thousands of nurses choosing to leave the profession.
She said those aged 55 and over could potentially decide to retire, leaving a “massive shortfall” in nursing staff.
The NMC’s own consultation exercise on the fee rise, held earlier this year, appeared to support her concerns. Analysis of responses to consultation found 56% of nursing staff aged 55 and over said the increase would be likely to affect their decision to continue working.
The NMC currently has 132,000 registered nurses in this age group. Ms Adams warned that the majority of this group could decide to stop working.
Ms Adams told Nursing Times: “Registrants will be absolutely horrified by the NMC’s decision. I have a genuine concern about the impact this will have but in particular nurses and midwives who are 55 and over who could vote with their feet.”
“It does little to protect the public if you lose the nurse and midwives and health visitors who are looking after some of the most vulnerable in our society”
Speaking during the NMC council meeting yesterday, she urged the regulator to monitor the impact of the fee increase on a more regular basis than its current annual review.
She added: “It does little to protect the public if you lose the nurse and midwives and health visitors who are looking after some of the most vulnerable in our society.”
Howard Catton, head of policy at the Royal College of Nursing, said the registration fee increase – against the backdrop of pay freezes, the introduction of revalidation next year and work pressures – presented a “significant” and “potentially quite immediate” risk to the size of the nursing workforce.
He said: “This isn’t an issue solely about the NMC and regulation – the implications and consequences are wider than that and potentially quite immediate.”
Mr Catton also warned that if nurses decided to quit or retire earlier than planned, this would add to the pressure for those remaining at time when there is already a shortage of workers.
Asked by Nursing Times if the NMC had a contingency plan for the potential loss of nurses and midwives from the workforce, Ms Smith said: “If we had a 10 or 20% fall off the register then we would have to understand the financial implications and where it leads us, so that is the contingency. That is why it’s really important to monitor this closely.”
Ms Smith added that the regulator had committed to looking at the possibility of reducing the annual registration fees in the future, if it met its financial targets.
“Something we need to come back to at a later date is whether we can bring the fee down. But it is predicated on the essential changes that we need in fitness to practise legislation,” she said.
NMC chair Mark Addison confirmed that the council had also committed to looking at setting the annual registration fee in future years according to a nurse or midwife’s pay band.
He said: “We have said we will look sympathetically – but don’t want to make any commitments – about the fee in relation to different salary levels.”
Recent history of the NMC fee
March 2015 – fee increases from £100 to £120
February 2013 – fee increases from £76 to £100
August 2007 – fee increases from £43 to £76