NMC Referral by an Employer: What Happens Next

Hearing that your employer has referred you, or is thinking of it, is very frightening. It is common to feel shocked, ashamed, angry or numb. This guide explains in plain English how employers decide to refer, what the NMC does with a referral, how it can run alongside your employer's own process, and how to prepare. It is based on the NMC's published guidance for employers and its fitness to practise library. It does not replace advice from your union or a specialist adviser, and it covers nurses, midwives and nursing associates on the NMC register (other regulators such as the GMC or HCPC run their own processes; see our fitness to practise guide).

When employers refer

The NMC's guidance for employers sets out three types of concern, and the timing of a referral differs for each:

Source: NMC, "The three types of concerns you should raise with us", part of its Managing concerns resource for employers. The NMC says that referring someone is a significant step and encourages employers to speak to a Regulation Adviser before referring.

If you are told a referral is being considered, it is reasonable to ask which type of concern the employer believes it is, and whether the local investigation has been completed. Employers are expected to run fair local investigations with clear policies, a plan and terms of reference. Our guide to the disciplinary and misconduct process describes that side, and our capability procedure guide covers clinical competence concerns.

What the NMC does with a referral

Employers make referrals through an online form and are expected to send comprehensive documents from the start: the NMC lists unredacted care records, full investigation reports with appendices, decision letters and any action plans. The NMC may ask for more quickly if an interim order is being considered. Its process, in broad terms, is:

The case examiners do not make final findings of fact themselves. They assess the overall weight of the evidence, and look at responses from the people involved. A guiding principle in the NMC's guidance is that most people referred to it are normally safe. We have not found published timescales for each stage, so we do not quote any: ask your NMC case officer for updates.

Interim orders

An interim order restricts or suspends practice while the investigation continues. The NMC says there are two types:

• Interim conditions of practice order: you can continue to practise with specific restrictions, for example supervision or not working in certain areas.
• Interim suspension order: you cannot practise and your registration is suspended.

The test is whether patient safety would be put at risk, public confidence in the professions would be seriously damaged, or the professional themselves could be seriously harmed without restrictions. Orders are imposed by a panel of the Investigating Committee or Fitness to Practise Committee, and case examiners can direct a committee to consider one. The NMC says interim orders must be reviewed every six months. If you are told one is being sought, get advice straight away: the hearing may be at short notice. See the fitness to practise guide for more about interim orders across regulators.

Alongside your employer's process

The NMC says it does not automatically pause its investigation because an employer is investigating, and its investigators will always contact the other organisation to understand its view. It may wait where continuing would prejudice the other investigation, would be impractical, would be more efficient to wait, or where the other organisation's outcome would materially affect its decision, but it does not have to. It says the employer's outcome can influence its regulatory decisions, particularly on whether action is needed and on the context of the professional's conduct.

In practice, that means:

• What you say, and the records produced, in the local process can end up in front of the NMC. Take your union's advice before giving statements.
• A good result locally does not decide the NMC case, and the reverse is also true.
• If you are dismissed, the tribunal clock (6 months minus 1 day for most claims arising on or after 1 October 2026, per ACAS) and the NMC process run separately. See what happens after an NHS dismissal and how to appeal an NHS dismissal.
• Referral information may also be relevant to future employment checks. See DBS checks and reference checks.

How to prepare

• • Get advice first. Contact your union (for example the RCN or Unison), your indemnity provider or a solicitor who specialises in healthcare regulation, before you reply to the NMC. See NHS staff representation.
• • Note every deadline in every NMC and employer letter, and put them in a diary.
• • Ask your employer what has been sent. You can ask whether a referral has been made and for a copy of what was referred, through your representative.
• • Keep a private, dated timeline of events while your memory is fresh, for your adviser.
• • Build evidence of insight and strengthened practice. This includes reflective accounts, training completed, supervision records, feedback and changes you have made. The NMC's guidance to employers refers to considering evidence of insight and strengthened practice, and the earlier you start building this, the more credible it is. See insight and remediation.
• • Collect references and testimonials from colleagues and managers who know your practice, through your adviser.
• • Keep your registration and revalidation up to date.
• • Be honest with employers, forms and regulators. Do not guess. If unsure what to disclose, ask your adviser.
• • Do not discuss the case on social media or with potential witnesses.
• • Look after your health. See your GP if you are struggling. See also NHS practitioner health and mental health support.

Support

• NMC Careline. The NMC says it set up a Careline in October 2019 with the employee assistance provider CiC to give emotional and practical support. It also has an independent support line for witnesses and people who made referrals. Check the NMC website for current contact details.
• Your union or professional body. The NMC says unions and professional associations play a vital role in local support, representation and guidance, and expects employers to work with them.
• Your employer. The NMC expects employers to check in regularly on the wellbeing of staff who have been referred. Ask for a named contact, occupational health and employee assistance support.
• Your GP and trusted people. It is a long process, and it is normal to need support throughout.

Related guides

This page is general information about employer referrals to the Nursing and Midwifery Council, drawn from the NMC's published guidance, correct to the best of our knowledge as of October 2026. NMC processes and guidance change. It is not legal or regulatory advice and does not replace advice from your union, indemnity provider or a specialist solicitor. FrontlinePay is an independent site and is not affiliated with, or endorsed by, the NMC, any NHS trust, NHS England or any trade union.