Referred to the NMC? Your First 5 Steps

Quick answer

If you have been referred to the NMC, do not reply straight away. Read the letter carefully, note every deadline, contact your union or indemnity provider for advice, start a folder of evidence and look after your wellbeing. A referral is the start of a process, not a finding against you, and many concerns close at screening.

Key takeaways

A referral is an allegation to be assessed, not a verdict.
Get advice (union, indemnity provider or a regulatory solicitor) before you send a detailed response.
Start collecting training records, appraisals and testimonials now.
In 2024–25 the NMC received 6,539 referrals, so you are far from alone.

Opening a letter or email from your regulator is one of the most stressful moments in a healthcare career. It is natural to want to respond immediately and explain everything. The most useful thing you can do in the first few days is slow down: a referral is the start of a process, not a verdict, and a few calm, deliberate steps now will put you in a much stronger position.

What happens after an NMC referral?

After a referral, the NMC first screens the concern to decide whether it needs a full investigation. Many concerns are closed at this stage. If the case is investigated, it later goes to case examiners, who decide whether there is a case to answer. Only some cases reach a hearing or meeting.

You can read a stage-by-stage overview in our guide to the NMC Fitness to Practise process. For context on scale, the NMC received 6,539 referrals in 2024–25 and concluded 6,234 cases in the same year (NMC Annual Fitness to Practise Report 2024–2025).

1. Read it carefully, then put it down

Read the letter once to understand what is being alleged, who the NMC wants to hear from and what it is asking you to do. Then step away. Do not reply in the heat of the moment, and do not contact the person you think may have referred you. You will think far more clearly after a night's sleep and a conversation with someone you trust.

2. Note every deadline

Write down any date by which the NMC wants information or a response, and put it somewhere you will see it. If a deadline is unrealistic because you are unwell or waiting for advice, contact your case officer early and ask about an extension rather than missing it. Engaging with the process, even to say you need more time, matters.

3. Get advice before you respond in detail

Contact your union (for example the RCN or Unison) or your professional indemnity provider as early as possible. Many registrants have access to regulatory advice or representation through membership that they did not realise they had. A short conversation about what to say, and what not to say yet, can save a lot of worry later.

We explain when legal help matters most in Do I need a solicitor for an NMC investigation? If you are unsure whether you should have told the NMC something yourself, read Should I self-refer to the NMC?

4. Start gathering your evidence

Open a folder, paper or digital, and start keeping anything relevant: your training records, appraisals, supervision notes, compliments, and any reflective notes you have written. Ask yourself honestly what the concern is about and what learning would address it. The earlier you start, the more natural and complete your evidence of insight and strengthened practice will be.

A timeline of events, written while your memory is fresh (keep it factual and private until you have taken advice).
Certificates from relevant training, and notes on what you learned.
Contact details of managers and colleagues who could later provide a testimonial.
Copies of everything you send to and receive from the NMC.

Our first-steps action plan turns this into a printable checklist, and the Navigating Your FtP Journey course explains each stage in plain English.

5. Look after yourself

An NMC case can take many months. Protect your sleep, keep routines where you can, and tell at least one person you trust what is happening. The NMC offers a confidential emotional support service (Careline) for professionals involved in fitness to practise, and peer organisations such as NMCWatch support registrants who have been referred.

A referral is the start of a process, not a verdict.

If anxiety is building, read looking after your mental health during an investigation. If you would like someone who has been through the process alongside you, our 1:1 mentorship is confidential.

Frequently asked questions

The NMC screens the concern to decide whether it needs investigating. If it does, an investigation follows, then case examiners decide whether there is a case to answer. Many cases close before a hearing.

The deadline is set out in the NMC's letter and varies by stage. At the case examiner stage, the NMC's Fitness to Practise Rules give you 28 days to send written representations. If you need longer, ask your case officer before the deadline passes.

The NMC shares the details of the concern with you so that you can respond, and this usually makes clear where the concern came from. Do not contact the referrer about the case, as this could be seen as trying to influence the process.

It depends on your contract, local policy and whether your practice is restricted. If you have an interim order or conditions, the NMC Code requires you to tell employers. Read our guide to telling your employer and take union advice.