The Nursing and Midwifery Council (NMC) has launched its most significant consultation on pre-registration nursing and midwifery education in years. The outcome of this consultation could completely reshape the training of nurses and midwives in the UK.
The NMC has been reviewing pre-registration nursing practice learning since January 2024. Since leaving the EU, the regulator no longer has to follow the EU Directive that fixed the UK at 4,600 minimum programme hours, of which 2,300 must be practice learning. That flexibility is the technical reason the review is possible.
The substantive reason is the body of evidence the NMC has gathered. Research and 25 engagement events in 2025, attended by 1,250 students and professionals across the UK, found that while many students benefit from positive placements, the quality of those experiences varies considerably.
The consultation document was approved by the NMC's governing Council in November 2025, and responses — analysed independently by Thinks Insight & Strategy — will inform any final changes to the standards from September 2026.
A proposed reduction from 4,600 to 3,600. Practice learning hours would fall to 1,800.
Midwifery courses would change from 3 years to 4 years.
These become explicit standards rather than expectations.
Every nursing student must have at least one community placement.
Nursing associate programmes set at a minimum of 2,300 hours.
This is the headline change, and the most contested. The 50/50 theory-to-practice split would be retained, meaning practice learning hours fall from 2,300 to 1,800. The NMC's argument is that the 4,600-hour requirement is a legacy of EU legislation that no longer applies, and that the UK's hours sit well above international comparators — the consultation cites approximately 700 practice hours in the USA, 800 in Australia, and 1,100 in New Zealand. The intent is to shift emphasis from quantity of hours to quality of experience, and to give Approved Education Institutions (AEIs) more space to design innovative programmes.
This proposal moves in the opposite direction. Against the backdrop of high-profile maternity inquiries across all four UK nations, and stark MBRRACE-UK data showing Black women are three times more likely and Asian women 1.3 times more likely to die during or after pregnancy than White women, the NMC has heard sustained feedback that three years is not enough time for students to develop the breadth of competence required. Stakeholders describe current programmes as producing task-oriented learning rather than the holistic, culturally responsive care today's maternity services need.
The proposals make these explicit standards across nursing and midwifery education, moving them from implicit expectations to defined requirements.
Every pre-registration nursing student would have at least one community practice learning experience in health or social care — a direct response to the shifting balance of care delivery away from acute settings.
If nursing programme hours are reduced, the consultation proposes that nursing associate programmes should be set at a minimum of 2,300 hours, decoupling them from the current rule that ties them to 50% of the nursing programme.
Supporters point to several strands of evidence. The 2,300-hour floor is a regulatory legacy, not an evidence-based threshold — there is no published study demonstrating that 2,300 hours produces a safer or more competent nurse than 1,800. International comparators with lower hours produce nurses who pass equivalent registration standards.
The NHS Long Term Workforce Plan (2023) explicitly supported a reduction from 2,300 to 1,800 hours, arguing it would expand placement capacity and reduce pressure on learners.
Reducing programme hours also frees curriculum time for emerging priorities — digital health, social care contexts, advanced clinical reasoning — that are difficult to embed in already-saturated programmes.
The strongest pushback has come from the Royal College of Nursing. RCN Chief Nursing Officer Lynn Woolsey has stated that the evidence base must be thoroughly examined during the consultation, and emphasised the need to uphold nursing as a safety-critical profession.
RCN Professional Lead for Students Will Malcher has previously voiced concern that the UK's nursing education frameworks are already shorter than those in many European and Asian countries, where four-year programmes are common — pointing out that the NMC's chosen comparators are not the only international benchmark available.
A core concern is preparedness. Newly registered nurses already report struggling with the transition to qualified practice, and removing 500 practice hours risks compounding that problem unless the quality improvements the NMC is promising actually materialise — and quality is harder to mandate than quantity.
Critics also note that the NHS workforce-planning rationale of expanding training capacity is a system benefit, not a learner benefit, and risks driving the change for the wrong reasons.
If practice placement hours fall in undergraduate nursing programmes, the burden of proof shifts onto the experience itself — supervision, assessment, environment, supernumerary status, simulated practice integration, and the consistency of what students encounter across placements.
The infrastructure that supports high-quality learning becomes more important, not less. The NMC has been clear that responses will shape the final proposals, and practice learning partners and universities sit at the centre of the system the consultation is rewriting.
