Explore NMC leadership skills requirements for nurses and midwives. Learn how the Nursing and Midwifery Council defines leadership competencies and standards.
Written by Laura Bouttell • Fri 9th January 2026
Leadership skills within the NMC framework refer to the leadership competencies that the Nursing and Midwifery Council expects all registered nurses and midwives to demonstrate. The NMC's professional standards establish that leadership is not optional for nurses and midwives—it is a fundamental requirement of professional practice regardless of role or band. Every nurse and midwife is expected to lead within their sphere of practice, influencing care quality, patient safety, and professional standards.
What makes the NMC approach distinctive is its integration of leadership throughout professional practice rather than treating leadership as a separate specialty. The Code, the Standards of Proficiency, and the Standards for Education all embed leadership expectations. This integration reflects the reality that nursing and midwifery work involves constant leadership moments—from leading patient care to influencing colleagues to challenging poor practice.
The NMC sets clear leadership expectations for registrants.
The NMC states that all registered nurses and midwives must be able to demonstrate leadership as part of their professional practice. The Code requires nurses and midwives to: act as role models (leading by example), provide leadership to ensure people's wellbeing (taking responsibility for care quality), develop their own leadership capability (ongoing professional development), and support others' development (contributing to colleague growth). Leadership is framed as a professional responsibility, not an optional career path.
NMC leadership expectations:
| Source | Leadership Requirement | Application |
|---|---|---|
| The Code | Act as role model | All practice settings |
| Standards of Proficiency | Demonstrate leadership | Newly registered nurses |
| Education Standards | Develop leadership capability | Pre-registration education |
| Revalidation | Reflect on leadership | Ongoing registration |
Leadership is embedded in the NMC Code through: "prioritise people" (leading patient-centred care), "practise effectively" (leading safe, effective practice), "preserve safety" (leading on safety concerns), and "promote professionalism" (leading professional standards). Each section contains expectations that require leadership—from challenging poor practice to coordinating care to maintaining standards under pressure. The Code's leadership expectations apply to every registered nurse and midwife regardless of role.
Code leadership integration:
The Standards of Proficiency define specific competencies.
The NMC Standards of Proficiency for Registered Nurses include specific leadership competencies: providing leadership for care (coordinating nursing care), contributing to team effectiveness (supporting team functioning), contributing to supervision and learning (developing others), advocating for patients (speaking up for those in your care), challenging poor practice (addressing concerns), and managing resources effectively (optimising available resources). These competencies apply at the point of registration and develop throughout careers.
Proficiency leadership competencies:
| Competency | Description | Example Application |
|---|---|---|
| Care leadership | Coordinating nursing care | Managing patient episodes |
| Team contribution | Supporting effectiveness | Team communication |
| Supervision | Developing others | Supporting students |
| Advocacy | Speaking for patients | Representing patient needs |
| Challenge | Addressing poor practice | Raising concerns |
| Resource management | Optimising resources | Prioritising workload |
Whilst core leadership expectations are consistent, standards apply differently across nursing fields: adult nursing emphasises leading complex care coordination, children's nursing requires leading family-centred care, mental health nursing focuses on therapeutic relationship leadership, and learning disability nursing centres on person-centred advocacy. Midwifery standards emphasise woman-centred care leadership, normal birth advocacy, and multidisciplinary team leadership. Field-specific contexts shape leadership expression.
Field variations:
Specific skills underpin NMC leadership expectations.
Essential NMC leadership skills include: clinical decision-making (making sound judgments), care coordination (organising complex care), communication (clear, compassionate interaction), team working (contributing to effective teams), advocacy (speaking for patients and service users), supervision (supporting others' development), quality improvement (driving care enhancement), and professional courage (challenging poor practice). These skills apply across all nursing and midwifery roles, adapting to context and seniority.
Essential skills:
| Skill | Definition | NMC Expectation |
|---|---|---|
| Clinical decision-making | Sound judgment | Assess and intervene appropriately |
| Care coordination | Organising care | Manage patient pathways |
| Communication | Clear interaction | Inform, educate, support |
| Team working | Effective contribution | Collaborate across boundaries |
| Advocacy | Speaking for others | Represent patient interests |
| Supervision | Developing others | Support student and colleague learning |
| Improvement | Enhancing care | Contribute to quality improvement |
| Courage | Challenging practice | Raise and address concerns |
Advocacy relates to leadership because representing patient and service user interests requires: speaking up (voicing concerns on others' behalf), challenging systems (addressing barriers to good care), influencing decisions (ensuring patient perspectives inform choices), building alliances (working with others to effect change), and taking responsibility (not waiting for others to act). Advocacy is leadership on behalf of those who may struggle to advocate for themselves—a core nursing and midwifery responsibility.
Advocacy as leadership:
Leadership applies across different contexts.
Leadership applies at all bands, with scope and expectations varying: newly registered (Band 5) lead their own caseload and contribute to team effectiveness; senior staff (Band 6-7) lead shifts, teams, and improvement initiatives; ward/team leaders (Band 7-8a) lead services and people; senior managers (Band 8b+) lead departments, organisations, and systems. The fundamental leadership responsibility exists at every level—what changes is scale and complexity, not whether leadership applies.
Band-level leadership:
| Band | Leadership Scope | Typical Responsibilities |
|---|---|---|
| 5 | Own practice | Caseload management, team contribution |
| 6 | Extended practice | Specialty expertise, supervision |
| 7 | Team/unit | Team leadership, service development |
| 8a | Service | Service management, improvement |
| 8b+ | Department/system | Strategic leadership |
Clinical leaders need skills including: clinical credibility (excellence in practice that earns respect), improvement capability (driving quality enhancement), team development (building capable teams), change management (implementing improvements), resource management (optimising limited resources), stakeholder engagement (influencing across boundaries), and strategic thinking (longer-term perspective). Clinical leadership combines professional expertise with organisational capability—neither alone is sufficient.
Clinical leadership skills:
Multiple pathways support leadership development.
Develop NMC leadership skills through: pre-registration education (foundation leadership learning), preceptorship (supported transition to practice), experiential learning (progressive responsibility), formal development programmes (leadership courses and qualifications), mentoring and coaching (relationship-based development), reflective practice (learning from experience), and revalidation (ongoing professional development). The NMC expects continuous leadership development throughout nursing and midwifery careers.
Development pathways:
| Stage | Development Focus | Methods |
|---|---|---|
| Pre-registration | Foundation competency | Education, placement |
| Newly registered | Transition support | Preceptorship |
| Developing | Growing capability | Experience, courses |
| Experienced | Advanced practice | Formal programmes |
| Senior | Strategic leadership | Executive development |
Programmes supporting NMC-registered leadership development include: Mary Seacole Programme (foundation clinical leadership), Elizabeth Garrett Anderson Programme (senior nursing leadership), Florence Nightingale Foundation scholarships (leadership and improvement), RCN leadership programmes (professional body offerings), university programmes (academic qualifications), and employer programmes (NHS trust and organisation-specific development). Selection depends on career stage, role, and development priorities.
Available programmes:
Revalidation includes leadership reflection.
Revalidation addresses leadership by requiring nurses and midwives to: reflect on practice (including leadership moments), demonstrate CPD (continuing professional development including leadership learning), obtain practice confirmation (which includes leadership competence), gather feedback (including on leadership effectiveness), and maintain standards (including Code leadership requirements). Revalidation conversations provide opportunities to discuss leadership development and demonstrate ongoing capability.
Revalidation leadership elements:
| Requirement | Leadership Connection |
|---|---|
| Practice hours | Leadership demonstrated in practice |
| CPD | Leadership learning activities |
| Reflective accounts | Leadership incidents and learning |
| Feedback | Including leadership effectiveness |
| Confirmation | Leadership competence confirmed |
| Declaration | Commitment to standards including leadership |
Document leadership for revalidation by: recording leadership learning (courses, reading, events), writing reflective accounts (leadership incidents and what you learned), gathering relevant feedback (including on leadership), linking to the Code (connecting leadership to specific standards), demonstrating impact (showing how leadership improved care), and planning development (identifying leadership growth areas). Quality documentation demonstrates both competence and commitment to ongoing leadership development.
Documentation guidance:
The NMC states that all registered nurses and midwives must demonstrate leadership as part of professional practice. The Code requires acting as role models, providing leadership for people's wellbeing, developing leadership capability, and supporting others' development. Leadership is a professional responsibility, not an optional career path.
NMC Standards of Proficiency require leadership competencies including providing leadership for care coordination, contributing to team effectiveness, supervision and learning, patient advocacy, challenging poor practice, and managing resources effectively. These apply at registration and develop throughout careers.
Leadership applies at all bands with varying scope: newly registered nurses lead their caseload and contribute to teams; senior staff lead shifts and initiatives; ward leaders lead services and people; senior managers lead departments and systems. The fundamental responsibility exists at every level—scale and complexity change, not whether leadership applies.
Essential skills include clinical decision-making, care coordination, communication, team working, advocacy, supervision of others, quality improvement, and professional courage to challenge poor practice. These apply across all nursing and midwifery roles, adapting to context and seniority.
Advocacy is leadership on behalf of patients and service users. It requires speaking up for others, challenging systems that create barriers, influencing decisions, building alliances for change, and taking responsibility rather than waiting for others. Advocacy is a core nursing and midwifery leadership responsibility.
Develop through pre-registration education, preceptorship, experiential learning with progressive responsibility, formal development programmes, mentoring and coaching, reflective practice, and revalidation requirements. The NMC expects continuous leadership development throughout nursing and midwifery careers.
Revalidation addresses leadership through practice reflection (including leadership moments), CPD requirements (leadership learning), practice confirmation (including leadership competence), feedback gathering (leadership effectiveness), and maintaining Code standards that include leadership requirements. Revalidation provides opportunity to demonstrate ongoing capability.
Leadership skills within the NMC framework are not optional extras for ambitious nurses and midwives—they are fundamental professional requirements applying from registration throughout careers. The NMC's integration of leadership throughout the Code, Standards of Proficiency, and revalidation requirements reflects the reality that nursing and midwifery practice involves constant leadership moments.
For nurses and midwives at any career stage, recognise that you are already a leader through your professional practice. The question is not whether you will lead but how effectively you will do so. Invest in developing leadership capability through formal learning, experiential opportunities, reflective practice, and relationship-based development with mentors and coaches.
For those seeking to enhance their leadership impact, look beyond your immediate clinical role to consider how you influence colleagues, contribute to improvement, develop others, and advocate for patients and the profession. Leadership in nursing and midwifery extends far beyond formal management positions—every registrant is a leader whose practice shapes care quality, patient safety, and professional standards.