Quality over quantity: preparing for the NMC's proposed practice learning changes
- Tess
- 22 minutes ago
- 15 min read
A summary of the MyKnowledgeMap / NMC / University of Roehampton webinar, 30 April 2026
A consultation that lands at a critical moment
On the 30 April 2026, just hours after the Nursing and Midwifery Council (NMC) opened its consultation on the practice learning review, more than 300 academics, practice partners and education leads gathered for a webinar hosted by MyKnowledgeMap. The session was led by Mariama Seray-Wurie, Co-Chair of the Pan London Practice Learning Group and Associate Professor and Head of Practice Learning at the University of Roehampton, and Julie Bliss, Senior Nursing Education Advisor at the NMC. It was a session that, as Mariama observed in closing, raised at least as many questions as it answered – which is precisely the point of a consultation.
The discussion ranged across the practical (placement capacity, tariff, validation timelines), the philosophical (what is practice learning actually for?), and the deeply pragmatic (how do we keep our students afloat financially, and our practice partners willing to host them?). For nursing educators, the core question is: how do we design a programme around the proposed standards that protects quality, supports our students, and our practice partners can sustain? This summary distils the key proposals, the strongest threads of debate, and the specific questions raised by attendees – with the answers given on the day.
The headline facts
The NMC consultation went live on 30 April 2026 and runs for 12 weeks, closing on 23 July 2026.
It covers pre-registration nursing, the nursing associate programme, pre-registration midwifery, the standards framework for nursing and midwifery education, and standards for student supervision and assessment.
Responses can be submitted as an individual or on behalf of an organisation. The survey allows respondents to answer all questions, or only the nursing or midwifery sections.
A free-text box at the end of the survey is the place to raise anything the questions miss – the NMC has actively encouraged its use.
A separate, midwifery-specific webinar is being planned.
What the NMC is proposing
Julie Bliss was clear that the consultation is about more than the headline figure on hours, but acknowledged that the hours are likely to dominate the conversation. The proposals are as follows.
Pre-registration nursing
Programme hours. A reduction of total programme hours from 4,600 to 3,600 – retaining the bachelor's degree, retaining the equivalent of three years, and retaining the requirement to meet all proficiencies and assessments. The 50/50 theory and practice split would be preserved, taking practice learning hours from 2,300 to 1,800. The proposed figure is a minimum, not a target: HEIs and practice partners could continue at higher hours if they wish.
Community practice learning. A proposal to mandate that all pre-registration nursing students must have a practice learning opportunity in the community. The NMC has deliberately resisted defining "community" too tightly, partly because lists become redundant and partly to encourage HEIs to think broadly: not solely district nursing, but also social care, the independent sector, charities, and roles outside hospital walls. As Julie put it, around 40% of those on the register work outside the NHS – the practice learning experience needs to reflect that.
Simulated practice learning. Rather than a fixed 600-hour ceiling, simulated practice learning would be capped at a proportionate maximum of 25% of practice learning hours. At 1,800 practice hours, that is 450 hours of permitted simulation. Use of simulated practice learning would remain optional.
Nursing associates
A proposed removal of the current standard which requires the nursing associate programme to be no less than 50% of the nursing degree programme. If nursing programme hours fall, applying the 50% rule would push the nursing associate programme below the level expected of a foundation degree.
Pre-registration midwifery
The midwifery proposals move in a different direction. Rather than reducing hours, the consultation asks whether the programme should be extended in length – not by adding content, but by stretching the existing requirements over a longer period. Other midwifery questions include strengthening the holistic assessment of labour and birth (retaining the 40 physiological births), strengthening continuity of supervision, and considering whether simulation could contribute to practice learning hours where it does not currently.
Standards framework and supervision
Two further areas are open for consultation: how reasonable adjustments are negotiated as a tripartite conversation between universities, practice learning partners and students; and whether the practice assessor role for pre-registration nursing students could be undertaken by Specialist Community Public Health Nurses who are registered midwives, where they are working in a SCPHN role.
Julie's slides can be found here:
Five themes that dominated the debate
1. Quality versus quantity – the central question
The strongest current running through the discussion was a near-consensus that hours alone do not equal competence. Multiple participants pointed out that AHP colleagues qualify as Band 5 practitioners on roughly 1,000 to 1,200 placement hours, and that focusing on hours can encourage a tick-box culture in which students are "signed off" rather than demonstrably proficient. Julie Bliss reinforced this:
"It's the practice learning that you need to be thinking about. It's not hours that you need to make up." — Julie Bliss, NMC
However, several practice partners voiced concern that reduced hours, combined with an unchanged set of 91 proficiencies plus episodes of care and medication management, could intensify exactly the tick-box pressure the review is meant to relieve. The reassurance from the NMC – that the proficiencies review is on the agenda but not in scope of this consultation – did not fully satisfy participants who felt the standards should logically be reviewed before the hours.
2. The 50/50 split is becoming a fault line
If practice hours fall to 1,800, the 50/50 split forces theory hours down to 1,800 too – a 500-hour reduction. Several attendees raised the implications for QAA bachelor's requirements (360 credits), for the pedagogical depth of theory teaching, and for the inclusion of fast-evolving areas such as digital, public health and genomics. There was repeated, audible appetite for the consultation to revisit the 50/50 rule itself, perhaps replacing it with language closer to "equal balance" rather than a precise split. Julie noted that some programmes already use non-credit-bearing modules to navigate this, but acknowledged the difficulty.
3. Tariff, capacity and the de facto floor
A reduction billed as a "minimum" was widely expected by participants to function as a de facto standard. In a buyer's market for student applications, HEIs that retain higher hours risk losing applicants to competitors offering lower-debt, shorter routes. Tariff was raised repeatedly: in England, a reduction in placement hours means a reduction in the income that funds practice education infrastructure (PEFs, clinical educators, civic engagement placements with charities and the third sector). Julie noted this is an England-only issue but confirmed that the NMC is doing parallel work with chief nursing and midwifery officers to model the financial implications.
4. The practice assessor / practice supervisor role needs urgent attention
Several speakers – from both academic and practice settings – argued that reducing hours places more, not less, weight on the quality of practice supervision and assessment. The removal of mandated mentorship updates was cited as a real loss. Trusts struggle to release staff, and PAs/PSs feel under-prepared and under-recognised compared with AHP colleagues, where social work and physiotherapy assessor roles often attract additional pay or formal kudos. The NMC standards require preparation and regular updates but do not specify what these look like, which several participants felt was too loose. Julie confirmed that the parallel revalidation review is exploring whether CPD and reflections could be tied to specific roles – such as practice assessor – going forward.
5. Field-specific and dual-field considerations
The discussionexplored the differential impact of a flat 1,800-hour rule across fields. Mental health, learning disability and child nursing programmes already struggle to attain physically-oriented proficiencies in the time available. Annex B was singled out by multiple participants as needing review, particularly from a mental health perspective. Dual-registration programmes (child/adult, adult/mental health) face an even sharper version of the same problem: meeting the proficiencies of two fields within proportionally less practice time. The NMC's response: that programmes will need to demonstrate how they meet the proficiencies, as they do today.
Practical guidance for HEIs working through modifications now
For programme leads currently mid-modification, the most actionable point of the day was Julie's clear advice: do not delay. Continue the work in line with the current standards. The consultation closes on 23 July, with the original September outcome timetable likely to slip; recommendations will go to council, will need to be approved, and will then move into an implementation period. A transition period of around two years (possibly longer) is anticipated. Whether changes will require a minor or major modification will depend on the final recommendations and the scope of each HEI's response, and the NMC is doing its own scenario planning on this in parallel with the EdQA review.
Julie also issued a direct invitation: the NMC is collecting case studies of innovative practice learning. HEIs and practice partners with examples that work - whether in community placement design, simulated practice learning, supervision models or assessment – are encouraged to make contact directly so the case studies can be developed and shared.
Watch the recording of the presentation part of the webinar discussion here.
Questions raised by attendees – and the answers given
The questions below are drawn from those put verbally during the webinar and from the live chat. They have been paraphrased and anonymised, and the responses summarised.
On the reduction in hours and the 50/50 split
Q: We have just finished a major modification process. If all 100+ AEIs need to modify again, this cannot be a minor mod for most of us. Has the NMC thought through the QA implications, and will there be any support?
A: Yes, scenario planning is already under way. The NMC is working through what would constitute a minor versus a major modification under different consultation outcomes, and whatever is recommended will need council approval followed by an implementation period. A transition window of around two years (possibly longer) is anticipated. The parallel work on education quality assurance is intended to strengthen those processes alongside any standards changes.
Q: If practice hours drop to 1,800 and the 50/50 split holds, theory drops by 500 hours too. How do we maintain BSc (Hons) credit volume and depth of theory – particularly when content like digital, public health and genomics keeps growing?
A: The NMC standards are outcome-focused, and programme design sits with universities and practice partners working in partnership. Some programmes use non-credit-bearing modules to navigate the relationship between hours and academic credit. Julie acknowledged the financial and pedagogical challenges, and encouraged the use of the consultation's free-text box to raise the 50/50 rule itself if respondents felt that was the issue.
Q: Will the 1,800-hour figure simply become a de facto standard? In a competitive market for applicants, why would any HEI retain higher hours?
A: The NMC accepts this is a real risk, which is why the consultation explicitly tests whether 1,800 should be a minimum that HEIs can choose to exceed. The NMC is also doing parallel financial modelling work with chief nursing and midwifery officers across the four countries to understand what reduced hours would mean for placement tariff and provider sustainability. This is acknowledged as an England-only tariff issue, but the financial modelling is broader.
Q: Is the proposal to reduce nursing hours, and to extend midwifery, grounded in evidence about scope, risk and accountability – or in capacity pressures? How will it affect parity of esteem, professional identity, recruitment and retention?
A: Julie was candid that the NMC cannot promise these changes will improve recruitment or retention, but that student wellbeing, cost of living and the demands of placement were significant themes raised in the stakeholder engagement that informed the proposals. The NMC will not market or recruit, but is committed to retention through a better practice learning experience for students, supervisors and assessors. The consultation is the route to test whether respondents agree.
On proficiencies, fields and dual programmes
Q: Where is the appetite to review the number and range of proficiencies students must meet? Many regional cohorts – particularly in mental health and learning disability – already struggle to complete physically oriented skills. Compressing this into fewer hours risks deepening the tick-box problem.
A: The proficiencies are not in scope for the practice learning review. However, the suite of standards is due to be reviewed under the NMC's standards methodology, and that work is on the agenda – with timing influenced by the parallel code, revalidation, and advanced practice reviews. Julie acknowledged that this does not solve the problem now, but confirmed the proficiencies review is recognised as needed.
Q: For dual-registration programmes (e.g. child and adult, or adult and mental health), are the same hours and competencies still required if 1,800 becomes the floor? How are students expected to meet two fields' proficiencies in proportionally less time?
A: Students completing programmes leading to two annotations still hold one nursing registration. As is the case now, programmes will need to demonstrate how they meet all proficiencies and assessments. Julie acknowledged the legitimate difficulty and noted that some current dual programmes already run beyond 2,300 hours; HEIs will need to consider how they design these programmes within any new framework.
Q: Annex B is widely seen as not fit for purpose, particularly from a mental health perspective. Will field-specific standards and proficiencies be considered?
A: Not under this consultation, which is focused on practice learning standards and not the proficiencies. The point was acknowledged and Julie reflected that splitting interpersonal communication (Annex A) from physical "doing" (Annex B) had, in her personal view, disaggregated skills that should sit together. The proficiencies review is on the future agenda.
On simulated practice learning
Q: Should simulation operate within a minimum and maximum range, rather than just a maximum? If 25% becomes a target rather than a ceiling, simulation hours come out of clinical placement.
A: Simulated practice learning is not compulsory. The proposed 25% is a maximum, not a target, and HEIs and practice partners can use it or not at all (Northern Ireland's nursing programmes currently do not, in line with their links to the Republic of Ireland). The NMC sees value in simulation for safeguarding, difficult conversations, bereavement support and rehearsing high-risk skills, but recognises it is resource-intensive and is not a replacement for clinical placement.
Q: What is the NMC's view on a meaningful proportion of proficiencies being achieved in simulation, given that 450 of 1,800 practice hours could be simulated?
A: The NMC pointed to the published evaluation of simulated practice learning in nursing programmes, which gives examples of where it works well. There is no proposal to require any specific proficiency to be achieved in simulation; programme design remains with universities and practice partners.
On community placements
Q: How feasible is it to mandate a community placement for every pre-registration nursing student given the size and capacity of community teams, vacancies and sickness?
A: The NMC sees this as part of the case for redefining what counts as community. A list approach was rejected because lists become redundant; instead, the focus is on practice learning that is not bedside or hospital-based, including the independent sector, social care, charity and third-sector providers, GP and primary care, prisons, and other settings outside acute hospitals. The NMC plans a position statement to give people "permission" to think broadly about practice learning settings.
On midwifery
Q: On what evidence is the 40-births standard being retained? Networks across midwifery education have reported significant appetite to reconsider it, given that the assessment depends on an unpredictable outcome and that competence in antenatal and postnatal care is already evidenced through the 100 records.
A: The NMC team led by Julie's colleague reported that the stakeholder engagement work did not show a desire to move away from the 40 births. This response was directly contested by attendees, who reported the opposite from their own networks.
Q: If the midwifery programme is extended to four years, will the qualification remain a BSc (Hons) – effectively becoming part-time with implications for paid work – or will it become an MSci? And how will the additional year of student costs be addressed?
A: The NMC cannot mandate funding decisions, but is doing financial modelling work in parallel and recognises that an extra year of expenses is a major issue. Julie noted that some four-year midwifery programmes and a master's in midwifery and leadership already exist; the consultation is a route to test what model respondents support. No decision on the level of qualification has been made.
On practice assessors, supervisors and capacity
Q: If hours reduce, will Trusts be required to revisit their PEF provision and time allocations for PA/PS roles? Practice quality will be more critical and experiences potentially more intense.
A: PEF and tariff arrangements sit outside the NMC's remit. However, the parallel revalidation review is exploring whether CPD and reflections could be linked to specific registrant roles – including practice assessor – which could begin to formalise expectations. The NMC standards require preparation and regular updates for PAs/PSs but do not specify what these look like; the consultation is an opportunity to argue for greater specificity.
Q: With less time available, will we see an increase in failure to fail – or, conversely, more students failed because PAs/PSs cannot give them the time to flourish, particularly in rural and dispersed placement networks?
A: The NMC's hypothesis runs in the opposite direction: with fewer hours competing for attention, PAs/PSs may have more capacity for focused assessment, support and reflection. As is the case now, struggling students can have placements extended or supplemented. The concern is acknowledged, and education quality assurance processes will need to monitor it.
Q: Should the practice assessor role remain with a registered nurse, on the basis that this is a clear and important QA boundary?
A: The consultation specifically asks about widening this role to include Specialist Community Public Health Nurses who are registered midwives but working in a SCPHN role. Respondents who feel the boundary should remain with registered nurses can use the consultation to make that case.
On reasonable adjustments and student support
Q: Should reasonable adjustments be limited to OH-recommended health-related conditions, or should they extend to social factors such as childcare or undiagnosed conditions like anxiety?
A: The chat included a strong consensus to keep reasonable adjustments grounded in the legal framework of the Equality Act 2010 – distinct from flexible working arrangements, which are the more appropriate mechanism for childcare and similar needs. The NMC's consultation focuses on strengthening the partnership conversation between universities, practice partners and students about what is reasonable in a practice setting, given that a learning plan in a university does not always translate directly into practice. Practice partners attending the session reported significant cumulative pressure from RAPs, and asked for guidance that reflects the operational realities of placement settings.
On timeline, validation and existing students
Q: When can we expect the consultation outcome, and what is the advice for HEIs in the middle of programme modifications now?
A: The original September timeline is likely to slip given the consultation's slightly delayed launch; the NMC will receive weekly updates from the independent research company analysing responses, and will go to council with recommendations once the analysis is complete. The advice for HEIs working on modifications now is unambiguous: do not delay. Continue work in line with the current standards. Whether further changes are required after the consultation will depend on the recommendations and may be minor or major depending on the scope.
Q: Is there a pathway to support validation and rewriting of programmes once changes are confirmed?
A: The NMC is doing scenario planning alongside the EdQA review. No specific pathway was confirmed on the day; respondents requesting one were encouraged to make that point in the consultation.
On evidence, international comparators and recruitment
Q: On what evidence is 1,800 hours based, and what data exists on what proportion of students currently meet their proficiencies before completing the 2,300 hours?
A: The NMC's engagement work last summer included around 25 events and over 1,250 participants, alongside an independent research company's work and the council paper of November 2025. The 2024 mandatory exceptional reporting indicated that around 50% of programmes were including breaks as practice learning hours – a finding that has shaped the question about whether quantity is acting as a proxy for quality. The NMC has consciously not been prescriptive in justifying a specific number, instead opening the question to consultation. International comparators (Australia at around 800-1,000 hours; the Republic of Ireland at 2,925 hours; Japan with two years of post-registration supervision) were acknowledged as informative but not directly transferable, given very different educational, supervision and clinical contexts.
Q: If a student trained on 1,800 hours in the UK wants to register in the Republic of Ireland, where the requirement is 2,925 hours, will there be implications for them?
A: UK pre-registration nursing programmes are not within the EU directive, so a UK-trained nurse moving to the Republic of Ireland (or anywhere else internationally) will need to meet the host country's requirements – as is already the case with international nurses joining the UK register following CBT and OSCE. The Northern Ireland universities currently offering pre-registration nursing do not include simulated practice learning because of their links with Ireland.
Q: What will the NMC do to help with the recruitment crisis facing nursing programmes?
A: As a regulator, the NMC cannot recruit or advertise. However, it can showcase the breadth of opportunities in nursing and midwifery, and is engaging with NHS England, the Scottish task force and others. Improving the practice learning experience – for students, supervisors and assessors – was offered as the NMC's most direct contribution to retention.
What this means for educators – a closing reflection
Mariama Seray-Wurie closed the session with a question worth keeping on the desk for the next twelve weeks:
"If we were designing pre-registration nurse education from scratch today, with our current knowledge of students, services and society, should we design it around a fixed number of hours or around clearly evidenced outcomes and learning quality?" — Mariama Seray-Wurie, University of Roehampton / Pan London Practice Learning Group
For nursing educators, the consultation is the most consequential opportunity to shape pre-registration nursing and midwifery education in the UK in a generation. Three things are worth doing now. First, encourage students, practice partners, alumni, members of the public and – critically – newly qualified registrants to respond, individually or collectively. Second, use the free-text response. Many of the most pointed concerns raised in the webinar (the 50/50 split, the 91 proficiencies, Annex B, dual-registration programmes, the practice assessor role, RAP guidance, tariff and PEF infrastructure) sit outside the formal questions. Third, gather and share innovative practice. The NMC is actively collecting case studies and a strong body of examples will support better implementation, whatever the outcome.
The consultation closes on 23 July 2026. We encourage everyone in nursing and midwifery education to have their say using the consultation link: https://www.nmc.org.uk/about-us/consultations/practice-learning-consultation/
This summary is drawn from the recording, transcript and chat of the webinar held on 30 April 2026, hosted by MyKnowledgeMap. If you have further questions, the NMC has an FAQ for the consultation here: https://www.nmc.org.uk/about-us/consultations/practice-learning-consultation/practice-learning-consultation-faqs/
