The nursing regulator is strongly expected to rubber-stamp plans to increase the annual registration fee from £100 to £120 at its latest council meeting this week.
The Nursing and Midwifery Council seems determined to introduce the fee rise, despite an angry response to the plans from registrants. It argues that the 20% rise in the fee is necessary for its long-term financial stability and, therefore, its ability to protect patients.
A three-month consultation on the unpopular plans to up the fee closed on 31 July. The NMC’s council will consider the outcome of the consultation at its meeting on 1 October and, if agreed, could seek to introduce the fee rise from March 2015.
However, unions have condemned the potential fee rise, coming as it does against the background of a pay dispute with the government.
They have claimed that increasing the registration fee could damage efforts to retain highly skilled nursing staff to the NHS at a time when the service is facing a major staffing shortage.
The regulator first attempted to increase the annual registration fee to £120 in 2012. But following a one-off £20m government grant, the NMC instead upped the fee to £100 for two years in February 2013.
However, the NMC’s long-term financial strategy allowed for it to revisit an increase to £120 from March 2015, which it is currently doing less than two years after the last increase.
In February, the NMC warned that its financial situation would be “unsustainable” in future without a further rise in the annual registration fee.
Its financial strategy requires it to maintain available free reserves of between £10m and £25m to cope with changes in fitness to practice trends. In August, its reserves were £9.7m, meaning it was already in breach of its policy.
During the current 2014-15 financial year, the NMC expects £68m of its total £71m income to come from registration fee payments.
In their responses to the consultation, submitted in August, Unison and the Royal College of Nursing urged the NMC to find other ways to balance its books rather than passing on its funding problems to registrants. Unison called for it to review costly fitness to practise referrals to ensure they were appropriate, noting that only 0.6% of registrants ever had their fitness to practise questioned.
Meanwhile, a nurse-led petition calling on the government to review the process the NMC uses to decide its annual registration fee has so far been signed by over 105,000 people.
The Nursing and Midwifery Council
The regulator does however appear to be making moves to try and soften the potential blow of a fee increase.
Last month it launched a consultation on rule changes which would enable nurses and midwives to pay the annual registration fee in instalments.
Depending on the result of the consultation, which closes on 3 October, the NMC said it expects to have fully functioning system of paying registration fees in instalments in place from 2016.
Meanwhile, the regulator has also highlighted that most registered nursing staff are still failing to claim back the tax relief they are due on the annual fee.
The NMC said last week that 70% of nurses and midwives were not claiming tax relief on their annual registration fee.
Nurses and midwives are eligible to claim tax relief on the NMC annual registration fee, which is worth £20 per year at the current fee level of £100.