NMC Confirmation: The Final Sign-Off

Confirmation is the eighth and final revalidation requirement. A third party reviews the evidence you’ve gathered, checks each of the previous seven requirements is in order, and signs a form to that effect. The signature goes into your submission and is what completes the cycle.

The confirmation requirement is the one most often missed by nurses working outside conventional employment: agency, bank, locum, self-employed. This chapter covers who can confirm, what they’re actually doing when they confirm, and how to find a confirmer when the default path doesn’t work for you.

What the confirmer does

The confirmer reviews evidence for all eight revalidation requirements:

1. 450 practice hours (or 900/1,350).
2. 35 CPD hours, 20 of them participatory.
3. 5 pieces of practice-related feedback.
4. 5 written reflective accounts on Form 6.
5. Reflective discussion completed and form signed.
6. Health and character declaration.
7. Professional indemnity arrangement.
8. Themselves, the confirmer’s involvement.

For each one, the confirmer needs to see enough evidence to be satisfied that the requirement has been met. They sign a form stating they have reviewed the evidence and that, to the best of their knowledge, the requirements are satisfied.

What the confirmer does not do:

• Audit the truthfulness of the evidence (that’s the NMC’s audit).
• Read every word of every reflective account (a representative sample is normal).
• Verify the underlying facts of your CPD certificates or feedback sources.
• Take responsibility for the accuracy of the submission (you remain accountable).

The confirmer’s role is closer to “witness” than to “auditor”. They confirm that the paperwork exists and appears to meet the criteria.

The hierarchy of confirmers

The NMC publishes a hierarchy. You follow it in order, choosing the highest-priority option available to you.

Priority 1: Your line manager. Doesn’t have to be NMC-registered. The default for any nurse with a clear line manager.

Priority 2: A senior NMC registrant who has worked with you for at least 12 months. Used when you don’t have a line manager (agency, locum, self-employed) or when your line manager isn’t appropriate (recently appointed, doesn’t know your practice).

Priority 3: Another regulated healthcare professional in a similar position. Used when neither of the above is available. Examples: a consultant doctor you work alongside, a senior allied health professional, a registered pharmacist if you work in pharmacy-adjacent roles.

Priority 4: An overseas equivalent. For nurses working in countries with regulated healthcare professionals, an equivalent senior figure can confirm. Rarely used.

The NMC doesn’t expect you to find the highest-priority option at all costs. If your line manager is unavailable but a senior registered colleague is, the registered colleague is fine.

The 12-month rule

The confirmer should have worked with you for at least 12 months. This is the NMC’s published expectation, not a hard legal rule.

What “worked with you” means in practice:

• They’ve observed your nursing practice directly, or
• They’ve had professional oversight of your work, or
• They’ve worked alongside you regularly enough to have a view of your competence.

A brand-new line manager you’ve worked with for two months doesn’t meet the test. A trusted colleague at the same level who you’ve worked alongside for two years does.

If you can’t meet the 12-month rule with anyone, document why and choose the strongest available option. The NMC accepts that some nurses (newly qualified, recent role changes, agency at multiple sites) can’t always hit it. Be ready to explain at audit if asked.

Finding a confirmer when you don’t have a line manager

Three common situations and the workable solutions.

Agency nurse with no consistent placement. Approach a senior registered nurse at your most frequent placement. If you’ve worked at the same trust regularly for 12+ months, the ward manager or clinical lead is usually willing. If not, ask your agency — many agencies have clinical leads who are NMC-registered and routinely confirm for their nurses.

Self-employed independent nurse. Look for senior registered nurses you’ve collaborated with — consultants who refer to you, GPs you work alongside, other independent nurses in your network. Failing that, a non-nurse healthcare professional who knows your work qualifies under priority 3.

Nurse returning from a long break. Your Return to Practice supervisor is the standard confirmer for returning nurses. If you’ve completed the course and started a role, your new line manager is the natural next confirmer in subsequent cycles.

What to give your confirmer

Send the evidence in advance. The confirmer reviews on their own time before the meeting, then you meet briefly to discuss and sign.

The evidence package:

• A short cover note summarising what’s enclosed.
• Practice hours summary with payslip dates or employer letter.
• CPD list with certificates or attendance confirmations.
• Five pieces of feedback with sources noted.
• Five Form 6 reflective accounts.
• Signed reflective discussion form.
• Health and character declaration (just the text; they’re confirming you signed, not auditing your disclosure).
• Indemnity arrangement (employer confirmation or union letter).

You don’t need to share the underlying source material for every item, just enough that the confirmer can verify each requirement has been met.

The confirmer meeting

Brief. 30–60 minutes is typical:

1. Quick walk-through of each requirement (for example, “here’s how I’ve met the 450 hours, here’s the CPD evidence”).
2. Q&A from the confirmer on anything that needs clarification.
3. Confirmer signs the form.

Some confirmers prefer to review on their own and just sign at the end. Some prefer a substantive discussion. Both approaches are valid.

The next chapter walks through exactly what the confirmer is verifying for each requirement, useful both for you (to prepare the evidence pack) and for any confirmer who hasn’t done this before.