You do not need to tell the NMC about a health condition, including a mental health condition, that is being managed and does not affect your ability to practise safely. The NMC's own self-referral examples say you should consider self-referring where your condition is likely to affect your fitness to practise, for example if workplace adjustments are not enough. Where the NMC does look at health, it is heard in private.
Key takeaways
- A well-managed health condition with no concerns about your practice does not need a self-referral.
- Consider self-referring if your health is likely to affect safe practice despite support.
- Health matters are heard in private and health undertakings are not published if they could identify the condition.
- Confidential support is available, including the NMC Careline and NHS Practitioner Health.
Many nurses, midwives and nursing associates live with long-term conditions, mental health problems or periods of ill health, and practise safely throughout. If you are worried about what your health means for your registration, or you have been referred because of it, this article explains what the NMC says. It is general information, not legal advice.
Do I need to tell the NMC about a health condition?
Not always. The NMC's guidance on deciding whether to self-refer includes two health examples that show where the line is.
- A nurse whose condition affects their memory and ability to perform routine tasks, despite medication, and whose employer has not been able to make adjustments that adequately support them, should consider self-referring, because their condition is likely to affect their fitness to practise.
- A nurse whose condition makes them more prone to tiredness, but who is on medication and whose employer has made adjustments such as longer breaks, slightly reduced hours and a monitored shift pattern, does not need to self-refer, because the condition is managed effectively and there is no concern about their practice.
The question in both is not the diagnosis. It is whether your health is likely to affect your ability to practise safely, given the support around you.
What about mental health?
The same principle applies. Having depression, anxiety or another mental health condition, or getting treatment for it, does not by itself mean the NMC needs to know. If your mental health is affecting your ability to practise safely and adjustments are not enough, that is when to take advice about self-referral. Talking to your GP or occupational health first can help you see the picture clearly.
How does the NMC approach health concerns?
Serious ill-health is one of the types of concern the NMC can consider. But the NMC says its role is not to punish people, and several parts of its process treat health differently:
- Fitness to practise hearings are generally public, but health matters are heard in private.
- Undertakings can be used in health cases. Where a concern is about health, the NMC does not publish details of the concern, or the undertakings if they could identify a health condition.
- A striking-off order cannot be used where fitness to practise is impaired because of health alone, unless the person has been on a suspension or conditions of practice order for a continuous period of two years.
- The NMC says its Professionals Support and Engagement team is working to progress cases in a more compassionate, person-centred way, including a bespoke approach to cases involving health concerns such as dementia or substance misuse.
To be honest about the other side: the NMC lists serious illness among the kinds of case where an interim order may be considered, and an order can only be made where a panel finds it necessary to protect the public or in your own interests. If that applies to you, representation matters.
Should I self-refer for a health condition?
If you think your health may be affecting safe practice, take advice first. The NMC suggests that union or professional body members discuss it with them before deciding whether to self-refer. If you do self-refer, the NMC screens it to decide whether there is a good reason to take any further action.
Our article should I self-refer to the NMC? walks through the decision in more detail.
Where can I get health support during an NMC case?
The NMC's Careline offers free, confidential and independent support to anyone involved in the fitness to practise process. It is run by CiC, an independent wellbeing provider, and is available 24 hours a day, every day of the year, on 0800 587 7396 or by email at assist@cicwellbeing.com. CiC will not tell the NMC you have used it, and using it will not affect your case. Support can include emotional support, practical advice, counselling and signposting, and you do not need to be in crisis to call.
NHS Practitioner Health is a mental health treatment service for healthcare staff in England and Scotland. The NMC describes it as having expertise in the needs of healthcare professionals with mental illness or addiction, including where staff are under investigation and mental illness may have played a part.
If you are struggling right now, Samaritans are available all day, every day, free on 116 123.
Our guide to looking after your mental health during an NMC investigation lists more urgent and everyday support.
What should I do now?
- Prioritise your health: speak to your GP, occupational health or a confidential service.
- Contact your union or professional indemnity provider before making or responding to any referral.
- Keep a note of the adjustments and support you have had at work, and how they have worked.
- Gather medical evidence with your adviser's help, only sharing what is relevant.
When should I get legal advice?
As soon as you think a referral is possible, or as soon as you hear from the NMC. Contact the RCN, RCM, Unison or Unite if you are a member, or your professional indemnity provider. If you are not in a union, the NMC encourages you to seek advice from a regulated legal professional with experience in regulation, such as a regulatory solicitor. Our mentorship offers confidential support from people who have been through the process.
Frequently asked questions
Getting treatment is not something you need to report in itself. The NMC's examples focus on whether a condition affects safe practice. Careline is confidential, and CiC will not tell the NMC you have used it.
Not straight away. The NMC's guidance says a striking-off order cannot be used where impairment is due to health unless the person has been on a suspension or conditions of practice order for a continuous two years.
Hearings are generally held in public, but the NMC says private matters such as health concerns are heard in private, and health-related undertakings are not published if they could identify a condition.
The NMC describes NHS Practitioner Health as a mental health treatment service for healthcare staff covering England and Scotland. It assesses referrals and registrations to decide whether it can offer treatment or signpost elsewhere.
