NMC Reflection Course: Writing a Reflection After a Concern

Written and reviewed by Dr Shehzad Iqbal, MBBS, MRCS, MRCGP, Postgraduate Certificate in Healthcare Law and Ethics · Updated 10 November 2026

When a nurse or midwife writes a reflection after a concern

• the NMC has written to say a concern has been raised;
• the investigation has ended and you are invited to respond before the case examiners decide;
• a patient has complained, or an incident review has named you, and your employer wants a written reflection;
• a colleague has raised a concern about your conduct or teamwork.

Our NMC courses guide matches each kind of referral to a course.

What the NMC Code says about reflecting when things go wrong

Three standards of the Code, under the themes Practise effectively, Preserve safety and Promote professionalism and trust, speak to a reflection after a concern:

• 9.2: “gather and reflect on feedback from a variety of sources, using it to improve your practice and performance”;
• 24.2: “use all complaints as a form of feedback and an opportunity for reflection and learning to improve practice”;
• section 14: be open and candid “including when any mistakes or harm have taken place”, explaining what happened and apologising (14.2) and documenting it formally (14.3).

Name the standard you fell short of by its number, not only the theme.

Revalidation account or case reflection: how to write the one the NMC reads

The NMC’s reflective accounts form asks four questions: what the activity, feedback or event was; what you learned; how you changed or improved your practice; and how it is relevant to the Code. It must not record a name, the date of the event or the ward or place, and you keep it rather than send it to the NMC.

A reflection for a fitness to practise case answers the concern the NMC has set out, so it has to be specific, and the NMC will read it. Its guidance FTP-16b gives weight to examples of “what they have learned” and to taking responsibility “without seeking to blame others or excuse their actions”. Built on the four questions, a case reflection adds:

1. the concern in two or three factual sentences;
2. your own part in it, apart from what others did;
3. the effect on the patient, on colleagues and on public confidence in nursing and midwifery;
4. what you do now, with examples a manager could confirm;
5. any facts you dispute, said plainly: FTP-16b says a denial is “not necessarily a bar to demonstrating insight”.

Where your reflection counts in the NMC process

The NMC’s guidance on insight and strengthened practice (FTP-16) asks whether the concern can be addressed, has been addressed and is highly unlikely to be repeated. Your reflection counts at three points:

• After the NMC’s first letter: you have 14 days to respond, and the NMC asks for “any reflections you’ve undertaken so far” and steps such as completing courses.
• At the end of the investigation: you have 28 days to respond to the evidence (INV-7).
• At the case examiners: they weigh “the quality of the nurse, midwife or nursing associate’s reflection” in deciding whether there is a case to answer (CAS-1).

If the case ends there, each outcome is explained in our guide to a case closed without a hearing.

What the Module on Reflection covers

Nine sections and 18 lessons: what is worth reflecting on; self-awareness; Gibbs’ Reflective Cycle and Schön’s reflection-in-action and reflection-on-action; what gets in the way; reflection in fitness to practise and the evidence a regulator can rely on; and an assessment with your certificate.

When a different course fits better

• you cannot yet say what the event shows about your practice: Module on Insight;
• you need the whole response to an NMC case: How to Deal with a Complaint or Investigation.

To write it with a tutor, see our reflective statement workshop.

Counting the reflection course as NMC CPD

Revalidation asks for 35 hours of CPD in three years, with a record of the method, topic, dates, hours, relevant part of the Code and evidence. The module gives 1.5 hours with a dated certificate; log 9.2 or 24.2.

Our NMC reflection course, for a concern and for CPD

Courses that sit beside it

Bulk Buy covers the £79 courses: 3 for £200, 5 for £300, 10 for £500. Not sure what to take? Book a free 15-minute call or see which course do I need.

This guide is part of our Professional Misconduct hub, which brings together every Probity & Ethics guide and course on the subject.

The CPD courses linked from this guide, Module on Reflection, Module on Insight, How to Deal with a Complaint or Investigation and Module on Remediation, are by Probity & Ethics, written by Dr Shehzad Iqbal, CPD certified and accredited by The CPD Certification Service (provider no. 13197) and offered since 2020.

Questions and answers