The immediate steps every nurse and midwife should take when a patient complaint reaches the NMC — what to do, what to avoid, how to protect your NMC registration from day one, and how to start building your response
Finding out that a patient has made a complaint to the NMC is one of the most stressful professional experiences any nurse or midwife can face. What you do in the first hours and days matters enormously. This guide tells you exactly what to do — and what not to do — from the moment you find out.
An NMC complaint is the beginning of a process — not the end of one. The NMC applies a threshold test to every concern received: would the concern,
if proved, raise a real question about the nurse or midwife's fitness to practise? Many complaints do not meet this threshold and are closed at initial assessment without formal investigation. Where a formal investigation is opened, the outcome depends heavily on how you respond.
The full NMC fitness to practise process — including what happens after investigation at the case examiner and panel stages — is set out in the guide to NMC investigation process. This guide focuses on the immediate steps that protect your registration from day one.
Before any other action — before responding to the NMC, before speaking to your employer, before contacting anyone connected to the complaint — contact your trade union representative, the Royal College of Nursing (RCN), or the Royal College of Midwives (RCM). Today. Not tomorrow.
CPD Certified — Online — Immediate Access
The RCN and RCM provide regulatory support and representation for members facing NMC investigations as a standard membership benefit. Trade unions including Unison and Unite also provide regulatory support.
Contact your relevant body immediately. Every statement you make about the complaint — to the NMC, to your employer, to colleagues — can become part of the evidence in the case. Professional advice before making any statement protects you from inadvertently creating additional problems.
However natural the impulse to explain, apologise, or resolve the situation directly — do not contact the patient without specific legal advice.
Direct contact with a complainant can be treated as an attempt to influence them and can create additional conduct concerns. Maintain complete professional distance until your legal representative advises otherwise.
Gather all relevant clinical records from the period in question. Do not alter, annotate, or amend any record — in any way.
Altering records after a complaint is one of the most serious additional conduct concerns and can turn a manageable case into a career-ending one. Preserve everything exactly as it is and secure copies where you are entitled to do so.
This is the step that most nurses and midwives delay — and it is one of the most consequential early decisions in any NMC case. CPD directly addressing the area of concern — NMC-specific nursing ethics and professionalism,
the relevant aspect of the NMC Code — started from day one carries far more evidential weight than the same courses completed in the weeks before a hearing.
NMC case examiners assess the timing of CPD as a signal of genuine engagement. Early CPD signals that you took the concern seriously from the outset.
Late CPD signals regulatory compliance. The guide to demonstrating remediation to your regulator explains exactly how CPD evidence is assessed in NMC proceedings.
When the NMC sends a formal allegation letter — inviting your written response, typically within 28 days — do not draft or submit the response without professional advice and review. The response is the first formal document in your case file. Its quality has lasting consequences for the trajectory of the case.
The response should address each specific allegation honestly and specifically, provide relevant clinical context, submit documentation in support, and outline any remediation already undertaken.
The NMC case examiner guide shows how this response will be assessed — and why quality and specificity matter so much more than length.
Whether you must tell your employer about an NMC complaint depends on your employment contract. Many NHS and other healthcare employer contracts include provisions requiring disclosure of regulatory proceedings.
Your trade union representative can advise on your specific contractual obligations. Do not make any disclosure without taking advice first — but do not deliberately conceal something you are contractually required to disclose.
Absent an NMC interim order, you can continue working. An NMC complaint does not restrict your registration. Continue your clinical work, maintain the highest professional standards, document your practice carefully, and
build your remediation evidence progressively throughout the investigation period. The guide to NMC suspension covers the specific position when restrictions do arise.
UK-registered nurses and midwives can access professional ethics training through Healthcare Ethics Courses.
Professionals with connections to Ireland can consult ethics training in Ireland.
Those with connections to Canada can review professional development in Canada.
10 CPD-certified courses for £500. CPD started immediately after an NMC complaint — with specific reflective notes — is the strongest signal of genuine professional engagement and the most persuasive early evidence you can build.
Bulk Buy 10 Courses →Contact your trade union, the RCN, or the RCM immediately — before responding to the NMC, before speaking to your employer, before contacting anyone connected to the complaint.
No — without specific legal advice. Direct contact with a complainant can be treated as an attempt to influence them and can create additional conduct concerns.
Absolutely not. Altering records is a serious additional conduct concern. Preserve all records exactly as they are.
Yes — from day one. Early CPD signals genuine engagement and carries far more evidential weight than the same courses completed just before a hearing.
Typically 28 days. Never draft or submit the response without professional advice and review.
Check your employment contract. Many NHS contracts require disclosure. Your trade union can advise on specific contractual obligations.
Yes — absent an interim order. An NMC complaint does not restrict registration.
No — many complaints do not meet the investigation threshold and are closed at initial assessment without formal investigation.
The RCN, RCM, Unison, and Unite all provide regulatory support to members as a standard membership benefit.
The formal notification that an NMC investigation has been opened — setting out the specific concern and inviting your written response within 28 days.
Responding without professional advice. The initial response is the most consequential document in the case.
Yes — many NMC cases are resolved at the case examiner stage through a no case to answer decision or agreed outcome.
Variable — from several months to over a year for complex cases. Every week of genuine professional development during this period builds evidence that cannot be replicated at the last minute.
This guide is for educational purposes only and does not constitute legal advice. Seek independent legal advice from a solicitor experienced in NMC regulatory proceedings.
