Most regulators screen complaints and reports as they arrive to assess the degree of risk presented and to prioritize matters appropriately. The UK regulator for nurses and midwives (NMC) has particular challenges because they receive thousands of complaints a year and have a long backlog of matters. Concerns have been raised that risks were not always prioritized appropriately.
To address this concern, the NMC has established a “Safeguarding Hub”. Upon receipt of a matter, it is screened for risk. Matters identified as warranting initial intervention are taken to a “hub” consisting of multiple professionals. The hub considers risk to the registrant (e.g., incapacity or self-harm), risks to complainants and witnesses (e.g., need for support), and risks to the general public (e.g., future misconduct by the registrant). Appropriate measures are then taken to address the risks including involving external agencies that may be able to assist in addressing the risk. The measures can include an interim order limiting the practice of the registrant. Staff within the regulator can also request assistance with any risks they have identified in the files on which they are working.
The regulator describes the initiative as follows:
How the Safeguarding Hub works
All new referrals are reviewed by the safeguarding team. Those with identified risks are escalated into the hub for collective discussion by a multi-professional group with expertise in safeguarding and wellbeing.
This group agrees any actions to reduce risks, such as supporting professionals or witnesses, or liaising with statutory safeguarding agencies. Each case is allocated to a safeguarding adviser, who supports the case team and ensures actions are delivered.
Key to this work is supporting timely, proportionate interim order applications in high-risk cases where professionals’ practice may need to be restricted to protect vulnerable adults, children and the wider public.
The hub also shares safeguarding concerns externally with statutory authorities, ensuring the right agencies are involved at the earliest stage to investigate and manage concerns.
Colleagues across the NMC can request advice any time they have a safeguarding concern, whether in [complaints and discipline] or other areas of our regulatory work. Between April 2024 and March 2025, colleagues made 644 advice requests – a clear sign of growing awareness and confidence in recognising and escalating concerns within our work.
Adapting features of this model may result in public protection benefits for some Canadian regulators.
