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List of states and territories of the United States
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"States of America" redirects here. For the sovereign states of the Americas, see List of sovereign states and dependent territories in the Americas.
For a broader coverage related to this topic, see U.S. state and Territories of the United States.
A map of the United States showing its 50 states and District of Columbia
The United States of America is a federal republic[1] consisting of 50 states, a federal district (Washington, D.C., the capital city of the United States), five major territories, and various minor islands.[2][3] The 48 contiguous states and Washington, D.C., are in central North America between Canada and Mexico; the two other states, Alaska and Hawaii, are in the northwestern part of North America and an archipelago in the mid-Pacific, respectively, while the territories are scattered throughout the Pacific Ocean and the Caribbean Sea.
States are the primary subdivisions of the United States, and possess a number of powers and rights under the United States Constitution, such as regulating intrastate commerce, running elections, creating local governments, and ratifying constitutional amendments. Each state has its own constitution, grounded in republican principles, and government, consisting of three branches: executive, legislative, and judicial.[4] All states and their residents are represented in the federal Congress, a bicameral legislature consisting of the Senate and the House of Representatives. Each state is represented by two Senators, while Representatives are distributed among the states in proportion to the most recent constitutionally mandated decennial census.[5] Additionally, each state is entitled to select a number of electors to vote in the Electoral College, the body that elects the President of the United States, equal to the total of Representatives and Senators in Congress from that state.[6] Article IV, Section 3, Clause 1 of the Constitution grants to Congress the authority to admit new states into the Union. Since the establishment of the United States in 1776, the number of states has expanded from the original 13 to the current total of 50, and each new state is admitted on an equal footing with the existing states.[7]
As provided by Article I, Section 8 of the Constitution, Congress exercises "exclusive jurisdiction" over the federal district, which is not part of any state. Prior to passage of the 1973 District of Columbia Home Rule Act, which devolved certain Congressional powers to an elected mayor and council, the district did not have an elected local government. Even so, Congress retains the right to review and overturn laws created by the council and intervene in local affairs.[8] As it is not a state, the district does not have representation in the Senate. However, since 1971, its residents have been represented in the House of Representatives by a non-voting delegate.[9] Additionally, since 1961, following ratification of the 23rd Amendment, the district has been entitled to select three electors to vote in the Electoral College.
In addition to the 50 states and federal district, the United States has sovereignty over 14 territories. Five of them (American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands) have a permanent, nonmilitary population, while nine of them do not. With the exception of Navassa Island, Puerto Rico, and the U.S. Virgin Islands, which are located in the Caribbean, all territories are located in the Pacific Ocean. One territory, Palmyra Atoll, is considered to be incorporated, meaning the full body of the Constitution has been applied to it; the other territories are unincorporated, meaning the Constitution does not fully apply to them. Ten territories (the Minor Outlying Islands and American Samoa) are considered to be unorganized, meaning they have not had an Organic Act enacted by Congress; the four other territories are organized, meaning they have had an Organic Act that has been enacted by Congress. The five inhabited territories each have limited autonomy and a non-voting delegate in Congress, in addition to having territorial legislatures and governors, but residents cannot vote in federal elections.
California is the most populous state, with 38,332,521 residents (2013 estimate); Wyoming is the least populous, with an estimated 582,658 residents. The District of Columbia, with an estimated 646,449 residents as of 2012, has a higher population than the two least populous states (Wyoming and Vermont). The largest state by area is Alaska, encompassing 665,384 square miles (1,723,340 km2), while the smallest is Rhode Island, encompassing 1,545 square miles (4,000 km2). The first state to ratify the current Constitution was Delaware, which it did on December 7, 1787, while the newest state is Hawaii, which was admitted to the Union on August 21, 1959. The largest territory in terms of both population and size is Puerto Rico, with 3,725,789 residents as of the 2010 Census and a total area of 5,325 square miles (13,790 km2).
Contents
1 States
2 Federal district
3 Territories
3.1 Inhabited territories
3.2 Uninhabited territories
3.3 Disputed territories
4 See also
5 Notes
6 References
7 External links
States
The table below lists the 50 states, with their current capital, largest city,[A] the date they ratified the U.S. Constitution or were admitted to the Union, population and area data, and number of representative(s) in the U.S. House of Representatives.[B]
States of the United States of America
Name &
postal abbreviation[12]
Cities
Established[C]
Population
[D][14]
Total area[15]
Land area[15]
Water area[15]
Number
of Reps.
Capital
Largest[16]
mi2
km2
mi2
km2
mi2
km2
Alabama
AL Montgomery Birmingham Dec 14, 1819 4,874,747 52,420 135,767 50,645 131,171 1,775 4,597 7
Alaska
AK Juneau Anchorage Jan 3, 1959 739,795 665,384 1,723,337 570,641 1,477,953 94,743 245,384 1
Arizona
AZ Phoenix Feb 14, 1912 7,016,270 113,990 295,234 113,594 294,207 396 1,026 9
Arkansas
AR Little Rock Jun 15, 1836 3,004,279 53,179 137,732 52,035 134,771 1,143 2,961 4
California
CA Sacramento Los Angeles Sep 9, 1850 39,536,653 163,695 423,967 155,779 403,466 7,916 20,501 53
Colorado
CO Denver Aug 1, 1876 5,607,154 104,094 269,601 103,642 268,431 452 1,170 7
Connecticut
CT Hartford Bridgeport Jan 9, 1788 3,588,184 5,543 14,357 4,842 12,542 701 1,816 5
Delaware
DE Dover Wilmington Dec 7, 1787 961,939 2,489 6,446 1,949 5,047 540 1,399 1
Florida
FL Tallahassee Jacksonville Mar 3, 1845 20,984,400 65,758 170,312 53,625 138,887 12,133 31,424 27
Georgia
GA Atlanta Jan 2, 1788 10,429,379 59,425 153,910 57,513 148,959 1,912 4,951 14
Hawaii
HI Honolulu Aug 21, 1959 1,427,538 10,932 28,313 6,423 16,635 4,509 11,678 2
Idaho
ID Boise Jul 3, 1890 1,716,943 83,569 216,443 82,643 214,045 926 2,398 2
Illinois
IL Springfield Chicago Dec 3, 1818 12,802,023 57,914 149,995 55,519 143,793 2,395 6,202 18
Indiana
IN Indianapolis Dec 11, 1816 6,666,818 36,420 94,326 35,826 92,789 593 1,537 9
Iowa
IA Des Moines Dec 28, 1846 3,145,711 56,273 145,746 55,857 144,669 416 1,077 4
Kansas
KS Topeka Wichita Jan 29, 1861 2,913,123 82,278 213,100 81,759 211,754 520 1,346 4
Kentucky[E]
KY Frankfort Louisville Jun 1, 1792 4,454,189 40,408 104,656 39,486 102,269 921 2,387 6
Louisiana
LA Baton Rouge New Orleans Apr 30, 1812 4,684,333 52,378 135,659 43,204 111,898 9,174 23,761 6
Maine
ME Augusta Portland Mar 15, 1820 1,335,907 35,380 91,633 30,843 79,883 4,537 11,750 2
Maryland
MD Annapolis Baltimore Apr 28, 1788 6,052,177 12,406 32,131 9,707 25,142 2,699 6,990 8
Massachusetts[E]
MA Boston Feb 6, 1788 6,859,819 10,554 27,336 7,800 20,202 2,754 7,134 9
Michigan
MI Lansing Detroit Jan 26, 1837 9,962,311 96,714 250,487 56,539 146,435 40,175 104,052 14
Minnesota
MN St. Paul Minneapolis May 11, 1858 5,576,606 86,936 225,163 79,627 206,232 7,309 18,930 8
Mississippi
MS Jackson Dec 10, 1817 2,984,100 48,432 125,438 46,923 121,531 1,508 3,907 4
Missouri
MO Jefferson City Kansas City Aug 10, 1821 6,113,532 69,707 180,540 68,742 178,040 965 2,501 8
Montana
MT Helena Billings Nov 8, 1889 1,050,493 147,040 380,831 145,546 376,962 1,494 3,869 1
Nebraska
NE Lincoln Omaha Mar 1, 1867 1,920,076 77,348 200,330 76,824 198,974 524 1,356 3
Nevada
NV Carson City Las Vegas Oct 31, 1864 2,998,039 110,572 286,380 109,781 284,332 791 2,048 4
New Hampshire
NH Concord Manchester Jun 21, 1788 1,342,795 9,349 24,214 8,953 23,187 397 1,027 2
New Jersey
NJ Trenton Newark Dec 18, 1787 9,005,644 8,723 22,591 7,354 19,047 1,368 3,544 12
New Mexico
NM Santa Fe Albuquerque Jan 6, 1912 2,088,070 121,590 314,917 121,298 314,161 292 757 3
New York
NY Albany New York City Jul 26, 1788 19,849,399 54,555 141,297 47,126 122,057 7,429 19,240 27
North Carolina
NC Raleigh Charlotte Nov 21, 1789 10,273,419 53,819 139,391 48,618 125,920 5,201 13,471 13
North Dakota
ND Bismarck Fargo Nov 2, 1889 755,393 70,698 183,108 69,001 178,711 1,698 4,397 1
Ohio
OH Columbus Mar 1, 1803 11,658,609 44,826 116,098 40,861 105,829 3,965 10,269 16
Oklahoma
OK Oklahoma City Nov 16, 1907 3,930,864 69,899 181,037 68,595 177,660 1,304 3,377 5
Oregon
OR Salem Portland Feb 14, 1859 4,142,776 98,379 254,799 95,988 248,608 2,391 6,191 5
Pennsylvania[E]
PA Harrisburg Philadelphia Dec 12, 1787 12,805,537 46,054 119,280 44,743 115,883 1,312 3,397 18
Rhode Island[F]
RI Providence May 29, 1790 1,059,639 1,545 4,001 1,034 2,678 511 1,324 2
South Carolina
SC Columbia Charleston May 23, 1788 5,024,369 32,020 82,933 30,061 77,857 1,960 5,076 7
South Dakota
SD Pierre Sioux Falls Nov 2, 1889 869,666 77,116 199,729 75,811 196,350 1,305 3,379 1
Tennessee
TN Nashville Jun 1, 1796 6,715,984 42,144 109,153 41,235 106,798 909 2,355 9
Texas
TX Austin Houston Dec 29, 1845 28,304,596 268,596 695,662 261,232 676,587 7,365 19,075 36
Utah
UT Salt Lake City Jan 4, 1896 3,101,833 84,897 219,882 82,170 212,818 2,727 7,064 4
Vermont
VT Montpelier Burlington Mar 4, 1791 623,657 9,616 24,906 9,217 23,871 400 1,035 1
Virginia[E]
VA Richmond Virginia Beach Jun 25, 1788 8,470,020 42,775 110,787 39,490 102,279 3,285 8,508 11
Washington
WA Olympia Seattle Nov 11, 1889 7,405,743 71,298 184,661 66,456 172,119 4,842 12,542 10
West Virginia
WV Charleston Jun 20, 1863 1,815,857 24,230 62,756 24,038 62,259 192 497 3
Wisconsin
WI Madison Milwaukee May 29, 1848 5,795,483 65,496 169,635 54,158 140,268 11,339 29,367 8
Wyoming
WY Cheyenne Jul 10, 1890 579,315 97,813 253,335 97,093 251,470 720 1,864 1
Federal district
Federal district of the United States
Name &
postal abbreviation[12]
Established
Population
[G][14]
Total area[15]
Land area[15]
Water area[15]
Number
of Reps.
mi2
km2
mi2
km2
mi2
km2
District of Columbia
DC Jul 16, 1790[17] 693,972 68 176 61 158 7 18 1[H]
Territories
Further information: Insular area
A map showing the location of each territory controlled by the United States. The United States is marked in blue, inhabited territories are marked in green, and uninhabited territories are marked in orange.
Inhabited territories
Inhabited territories of the United States
Name &
postal abbreviation[12]
Capital
Acquired
[19]
Territorial status[20]
Population
[I]
Total area[15]
Land area[15]
Water area[15]
Number
of Reps.
mi2
km2
mi2
km2
mi2
km2
American Samoa
AS Pago Pago[21] 1900 Unincorporated, unorganized[J] 57,400[22] 581 1,505 76 198 505 1,307 1[H]
Guam
GU Hagåtña[23] 1899 Unincorporated, organized 161,700[24] 571 1,478 210 543 361 935 1[H]
Northern Mariana Islands
MP Saipan[25] 1986 Unincorporated, organized[K] 52,300[24] 1,976 5,117 182 472 1,793 4,644 1[H]
Puerto Rico
PR San Juan[26] 1899 Unincorporated, organized[K] 3,337,177[14] 5,325 13,791 3,424 8,868 1,901 4,924 1[L]
U.S. Virgin Islands
VI Charlotte Amalie[27] 1917 Unincorporated, organized 103,700[28] 733 1,898 134 348 599 1,550 1[H]
Uninhabited territories
Territories of the United States with no indigenous population
Name
Acquired
[19]
Territorial status[20]
Land Area[M]
mi2
km2
Baker Island[29]
1856 Unincorporated; unorganized 0.9 2.2
Howland Island[29]
1858 Unincorporated, unorganized 0.6 1.6
Jarvis Island[30]
1856 Unincorporated, unorganized 2.2 5.7
Johnston Atoll[31]
1859 Unincorporated, unorganized 1 2.6
Kingman Reef[32]
1860 Unincorporated, unorganized 0.005 0.01
Midway Atoll[N][34]
1867 Unincorporated, unorganized 3 7.8
Navassa Island[35]
1858[O] Unincorporated, unorganized 3 7.8
Palmyra Atoll[P][37]
1898 Incorporated, unorganized 1.5 3.9
Wake Island[Q][38]
1899[R] Unincorporated, unorganized 2.5 6.5
Disputed territories
Main article: List of territorial disputes § Central America and the Caribbean
Territories (uninhabited) claimed but not administered by the United States
Name
Acquired
[19]
Territorial status[40]
Area
Administered by[40]
Also claimed by[40]
mi2
km2
Bajo Nuevo Bank (Petrel Island)[19]
1869 Unincorporated, unorganized
(disputed sovereignty) 56 145[S][41]
Colombia
Jamaica
Nicaragua
Serranilla Bank[19]
1880 Unincorporated, unorganized
(disputed sovereignty) 463 1,200[T][42]
Colombia
Honduras
Nicaragua
See also
Geography portal
North America portal
United States portal
List of regions of the United States
Lists of U.S. state topics
Political divisions of the United States
Notes
Jump up ^ The largest city is the city in a state with the largest population in the city proper (as opposed to metropolitan area).
Jump up ^ Each state is entitled to at least one representative. Current federal law sets the number of voting members of the House of Representatives at 435, which are apportioned among states every ten years according to their relative population.[10] Each state is also entitled to two senators.[11]
Jump up ^ The original 13 states became sovereign in July 1776 upon agreeing to the United States Declaration of Independence, and each joined the first Union of states between 1777 and 1781, upon ratifying the Articles of Confederation.[13] These states are presented in the order in which each ratified the 1787 Constitution, thus joining the present federal Union of states. Subsequent states are listed in the order of their admission to the Union, and the date given is the official establishment date set by Act of Congress. For further details, see List of U.S. states by date of admission to the Union
Jump up ^ 2017 estimate
^ Jump up to: a b c d Uses the term "commonwealth" rather than "state" in its full official name.
Jump up ^ Officially the "State of Rhode Island and Providence Plantations".
Jump up ^ 2017 estimate
^ Jump up to: a b c d e Represented by a non-voting delegate in the House of Representatives.[18]
Jump up ^ 2015 population estimate for: American Samoa, Guam, Northern Mariana Islands, and Virgin Islands; 2017 population estimate for Puerto Rico.
Jump up ^ Although not organized through a federal organic act or other explicit Congressional directive on governance, the people of American Samoa adopted a constitution in 1967, and then in 1977, elected territorial officials for the first time.[22]
^ Jump up to: a b Organized as a commonwealth.
Jump up ^ Represented by a non-voting resident commissioner in the House of Representatives.[18]
Jump up ^ Excluding lagoon
Jump up ^ Although there are no indigenous inhabitants, around 40 United States Fish and Wildlife Service staff and service contractors live on the island at any given time.[33]
Jump up ^ U.S. sovereignty is disputed by Haiti.[36]
Jump up ^ Although there are no indigenous inhabitants, between four and 20 Nature Conservancy, employees, United States Fish and Wildlife Service staff, and researchers live on the island at any given time.[33]
Jump up ^ Although there are no indigenous inhabitants, as of 2009, around 150 U.S. 150 U.S. military personnel and civilian contractors were living on the island, staffing the Wake Island Airfield and communications facilities.[38]
Jump up ^ U.S. sovereignty is disputed by the Republic of Marshall Islands.[39]
Jump up ^ This is the approximate figure for the land area of the bank, and does not include the surrounding territorial waters.
Jump up ^ This figure includes the total land area of the Serranilla Bank and the water area of its lagoon, but not the surrounding territorial waters.
References
Jump up ^ Onuf, Peter S. (1983). The Origins of the Federal Republic: Jurisdictional Controversies in the United States, 1775–1787. Philadelphia: University of Pennsylvania Press. ISBN 978-0-8122-1167-2. (Subscription required (help)).
Jump up ^ "Common Core Document of the United States of America: Submitted With the Fourth Periodic Report of the United States of America to the United Nations Committee on Human Rights concerning the International Covenant on Civil and Political Rights". U.S. Department of State, via The Office of Website Management, Bureau of Public Affairs.
Jump up ^ "U.S. Insular Areas: application of the U.S. Constitution" (PDF). Government Accountability Office. November 1997.
Jump up ^ "Frequently Asked Questions About the Minnesota Legislature". Minnesota State Legislature.
Jump up ^ Burnett, Kristin D. "Congressional Apportionment (2010 Census Briefs C2010BR-08)" (PDF). U.S. Department of Commerce, Economics and Statistics Administration. Archived from the original (PDF) on 2011-11-19.
Jump up ^ Elhauge, Einer R. "Essays on Article II: Presidential Electors". The Heritage Foundation.
Jump up ^ "Doctrine of the Equality of States". Justia Law. Retrieved June 16, 2017.
Jump up ^ "DC Home Rule". Council of the District of Columbia. Archived from the original on November 17, 2011.
Jump up ^ Tarr, David R.; Benenson, Bob, eds. (2012). Elections A to Z (4th ed.). Sage Publications. p. 165. ISBN 9780872897694.
Jump up ^ "The Permanent Apportionment Act of 1929: June 11, 1929". Washington, D.C.: Office of the Historian, United States House of Representatives. Retrieved February 28, 2018.
Jump up ^ "The Senate and the United States Constitution". www.senate.gov. Washington, D.C.: Secretary of the Senate. Retrieved February 28, 2018.
^ Jump up to: a b c "Appendix B: Two–Letter State and possession Abbreviations". Postal Addressing Standards. Washington, D.C.: United States Postal Service. May 2015. Retrieved March 3, 2018.
Jump up ^ Jensen, Merrill (1959). The Articles of Confederation: An Interpretation of the Social-Constitutional History of the American Revolution, 1774–1781. University of Wisconsin Press. pp. xi, 184. ISBN 978-0-299-00204-6.
^ Jump up to: a b c "Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2017". Washington, D.C.: U.S. Census Bureau, Population Division. December 2017. Retrieved March 3, 2018.
^ Jump up to: a b c d e f g h i "State Area Measurements and Internal Point Coordinates". Washington, D.C.: U.S. Census Bureau. Retrieved March 3, 2018. ... provides land, water and total area measurements for the 50 states, the District of Columbia, Puerto Rico and the Island Areas. The area measurements were derived from the Census Bureau's Master Address File/Topologically Integrated Geographic Encoding and Referencing (MAF/TIGER®) database. The land and water areas, ... reflect base feature updates made in the MAF/TIGER® database through August, 2010.
Jump up ^ "State and Local Government Finances and Employment" (PDF). United States Census Bureau. 2012. p. 284. Archived from the original (PDF) on October 17, 2011. Retrieved July 8, 2013.
Jump up ^ "The History of Washington, DC". Destination DC. 2016-03-15. Retrieved March 3, 2018.
^ Jump up to: a b "Directory of Representatives". Washington, D.C.: U.S. House of Representatives. Retrieved March 5, 2018.
^ Jump up to: a b c d e "Acquisition Process of Insular Areas". Office of Insular Affairs. Archived from the original on April 14, 2012. Retrieved July 9, 2013. CS1 maint: Unfit url (link)
^ Jump up to: a b "Definitions of Insular Area Political Organizations". Washington, D.C.: U.S. Department of the Interior. 2015-06-12. Retrieved March 1, 2018.
Jump up ^ "American Samoa". The World Factbook. Central Intelligence Agency. Retrieved July 9, 2013.
^ Jump up to: a b "Islands We Serve: American Samoa". Washington, D.C.: U.S. Department of the Interior. 2015-06-11. Retrieved March 1, 2018.
Jump up ^ "Guam". The World Factbook. Central Intelligence Agency. Retrieved July 9, 2013.
^ Jump up to: a b "Islands We Serve: Guam". Washington, D.C.: U.S. Department of the Interior. 2015-06-11. Retrieved March 1, 2018.
Jump up ^ "Northern Mariana Islands". The World Factbook. Central Intelligence Agency. Retrieved July 9, 2013.
Jump up ^ "Puerto Rico". The World Factbook. Central Intelligence Agency. Retrieved July 9, 2013.
Jump up ^ "Virgin Islands". The World Factbook. Retrieved July 9, 2013.
Jump up ^ "Islands We Serve: Virgin Islands". Washington, D.C.: U.S. Department of the Interior. 2015-06-11. Retrieved March 1, 2018.
^ Jump up to: a b "Baker Island". Office of Insular Affairs. Archived from the original on April 19, 2012. Retrieved July 9, 2013.
Jump up ^ "Jarvis Island". Office of Insular Affairs. Archived from the original on February 7, 2012. Retrieved July 9, 2013.
Jump up ^ "Johnston Island". Office of Insular Affairs. Archived from the original on March 14, 2012. Retrieved July 9, 2013.
Jump up ^ "Kingman Reef National Wildlife Refuge". United States Fish and Wildlife Service. Retrieved July 9, 2013.
^ Jump up to: a b "United States Pacific Islands Wildlife Refuges". The World Factbook. Central Intelligence Agency. Retrieved October 10, 2014.
Jump up ^ "Midway Atoll". Office of Insular Affairs. Archived from the original on February 4, 2012. Retrieved July 9, 2013.
Jump up ^ "Navassa Island". Washington, D.C.: U.S. Department of the Interior. 2015-06-12. Retrieved March 3, 2018.
Jump up ^ Colon, Yves (September 25, 1998). "U.S., Haiti Squabble Over Control of Tiny Island". Miami Herald. Webster University.
Jump up ^ "Palmyra Atoll". Office of Insular Affairs. Archived from the original on January 11, 2012. Retrieved July 9, 2013.
^ Jump up to: a b "Wake Island". The World Factbook. Central Intelligence Agency. Retrieved October 10, 2014.
Jump up ^ Earnshaw, Karen (December 17, 2016). "Enen Kio (a.k.a. Wake Island): Island of the kio flower". Marshall Islands Guide. Majuro, Republic of the Marshall Islands. Retrieved March 4, 2018.
^ Jump up to: a b c Lewis, Martin W. (March 21, 2011). "When Is an Island Not An Island? Caribbean Maritime Disputes". GeoCurrents. Retrieved June 16, 2017.
Jump up ^ "US Minor Outlying Islands - Bajo Nuevo Bank". Geocaching. June 6, 2017.
Jump up ^ "Cayo Serranilla" (in Spanish). Eco Fiwi. Retrieved June 16, 2017.
External links
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Nursing and Midwifery Council
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Nursing and Midwifery Council
NMC Logo
Key people
Jackie Smith, CEO
Office location
London, WC2
Country
United Kingdom
Website
nmc.org.uk
The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses eligible to practise within the UK. It sets and reviews standards for their education, training, conduct and performance. The NMC also investigates allegations of impaired fitness to practise (i.e. where these standards are not met).
It has been a statutory body since 2002, with a stated aim to protect the health and well-being of the public. The NMC is also a charity registered with the Charity Commission, charity number 1091434 and in Scotland with the Office of the Scottish Charity Regulator, charity number SC038362. All Council members are trustees of the charity.
Contents
[hide]
1 History
1.1 UKCC
1.2 Establishment of NMC
2 Council
3 Role
4 Activities
4.1 Education
4.2 Registering nurses and midwives
4.3 Setting standards
4.4 Revalidation
4.5 Managing complaints about nurses and midwives
5 Legislation
5.1 Changes to healthcare regulation
5.2 Affecting regulation of professionals within the EU
6 Criticism
6.1 Accusations of bullying and racism
6.2 Panorama controversy
6.3 Regulatory criticism
6.4 Data loss
6.5 Increase in membership cost
6.6 Morecambe Bay
7 Regulator
8 See also
9 References
10 External links
History[edit]
UKCC[edit]
In 1983, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) was set up, replacing the General Nursing Council for England and Wales established by the Nurses Registration Act 1919, the Central Midwives Board in London and seven other bodies.[1][2] The UKCC was expected to maintain a register of UK nurses, midwives and health visitors, provide guidance to registrants, and handle professional misconduct complaints. At the same time, National Boards were created for each of the UK countries. Their main functions were to monitor the quality of nursing and midwifery education courses, and to maintain the training records of students on these courses.
Establishment of NMC[edit]
This structure of the UKCC survived with minor modifications up to April 2002, when the UKCC ceased to exist and its functions were taken over by a new Nursing and Midwifery Council (NMC). This was legislated for in the Parliament of the United Kingdom, through the Nursing and Midwifery Order 2001.[3] The English National Board was also abolished and its quality assurance function was taken on board by the NMC. The other National Boards were also abolished, but new bodies were created in each country to take over their functions.
Council[edit]
The NMC Council has two key roles: setting the strategic direction for the NMC and overseeing the work of senior NMC staff.
The Council ensures that the NMC complies with all relevant legislation, including the Nursing and Midwifery Order 2001 and the Charities Act 1993.
The Council is made up of 12 lay and registrant members, including one member from each of the four UK countries. They are appointed by the Privy Council. Registrant members are from a nursing or midwifery background; lay members are selected for their expertise in various fields and strategic experience.
The current Council took office on 1 May 2013.[4]
Role[edit]
The NMC's role is to:
protect the health and wellbeing of the public
set standards of education, training, conduct and performance so that nurses and midwives can deliver high quality healthcare consistently throughout their careers
ensure that nurses and midwives keep their skills and knowledge up to date and uphold the NMC’s professional standards, and
have clear and transparent processes to investigate nurses and midwives who fall short of the NMC’s standards.[5]
Activities[edit]
The NMC has an annual income in excess of £52 million and employs over 400 staff.[6] To fulfill the activities of the NMC it charges a registration fee to its members.
Education[edit]
The NMC set standards, guidance and requirements for nursing and midwifery education across the UK. These standards help to shape the content and design of programmes and state what a registered nurse or midwife needs to know and be able to do.
The NMC approves higher education institutions to deliver programmes. They currently accredit 1000 programmes in 79 education institutions across the UK.
When students successfully complete their programme, their education institution will let the NMC know that they have met the education and practice standards and are of good health and good character. If they are deemed fit to practise they will then be eligible to apply to join the register. Each year the NMC receives over 22,000 newly qualified nurses and midwives from education institutions.
Registering nurses and midwives[edit]
As of October 2015[update] there are 685,000 nurses and midwives on the NMC register,[7] meaning the NMC is the body responsible for regulating the largest number of healthcare professionals in the UK.[6] Nurses and midwives must be on the NMC register to practise in the UK. Anyone is able to search the NMC register.[8]
Setting standards[edit]
The NMC's revised code became effective on 31 March 2015. The code contains professional standards of practice and behaviour that all nurses and midwives must keep to. Four key sections describe what nurses and midwives are expected to do: • prioritise people • practise effectively • preserve safety, and • promote professionalism and trust.
The Code was updated to reflect changes in healthcare and society since its last publication in 2008. The updates include new requirements on the fundamentals of care, the duty of candour, raising concerns and social media use.
The introduction to the code states: “When joining our register, and then renewing their registration, nurses and midwives commit to upholding these standards. This commitment to professional standards is fundamental to being part of a profession. We can take action if registered nurses or midwives fail to uphold the Code. In serious cases, this can include removing them from the register. The Code should be useful for everyone who cares about good nursing and midwifery.”[9]
Revalidation[edit]
The NMC has committed to developing and implementing a system of revalidation.[10] In October 2015, the NMC introduced the new system which all nurses and midwives in the UK must go through to remain on the NMC register.[7] Nurses and midwives will need to renew their registration every three years and confirm that they continue to remain fit to practise by meeting the principles of the revised Code. They must demonstrate that they have completed the required hours of practice and learning activity through continuing professional development, have used feedback to review and improve the way they work, and have received confirmation from someone well placed to comment on their continuing fitness to practise.[11]
The NMC ran a public consultation from January to March 2014 on how revalidation can be applied in practice.[12] Pilots involving over 2,000 nurses and midwives across the UK would inform the final plans.[13] Revalidation for nurses and midwives will start on 1 April 2016, with approximately 16,000 nurses and midwives going through the process initially. All nurses on the NMC register will eventually go through revalidation when their registration is up for renewal.[14] In January 2016, the NMC launched a microsite to assist nurses and midwives through the revalidation process.[citation needed]
Managing complaints about nurses and midwives[edit]
The NMC handles complaints made about nurses and midwives, and investigates allegations where appropriate. The NMC has the power to restrict a nurse or midwife's practice or strike them off their register.
The NMC produced guidance for nurses and midwives on raising concerns which aims to help them take action in the public interest when needed. It includes information on legislation that offers protection to whistleblowers and information on organisations nurses and midwives can go to for further advice.[15]
Helene Donnelly, ambassador for cultural change at Staffordshire and Stoke-on-Trent Partnership NHS Trust, spoke to NMC Council about raising concerns and gave her support to the guidance.[16]
Legislation[edit]
Changes to healthcare regulation[edit]
On 2 April 2014, the Law Commission published its draft bill, Regulation of Health and Social Care Professionals. The bill aims "to aim to sweep away the out-dated and inflexible decision-making processes associated with the current legislation."[17] The bill would give healthcare regulators in the UK more autonomy.
The NMC's Chief Executive and Registrar Jackie Smith welcomed the publication of the draft bill, but stated how the NMC needs the bill to become law quickly if it is able to modernise and become an efficient regulator. In its current legislative framework, the NMC spends nearly 80% of its income of fitness to practise hearings.[18]
Affecting regulation of professionals within the EU[edit]
The revised Mutual Recognition of Professional Qualifications (MRPQ) Directive, which came into effect 19 January 2016, will bring in a number of changes that aim to further facilitate the free movement of professionals within the EU, including amendments to language controls.[19] The changes will enable the NMC to ensure, on a case-by-case basis, that a nurse or midwife from the EU has sufficient knowledge and command of English to practise safely and effectively.[20]
Criticism[edit]
Accusations of bullying and racism[edit]
On 11 March 2008 two Members of Parliament Jim Devine and John Smith made accusations in the House of Commons of bullying and racism within the NMC. The accusations have been denied by the NMC.[21] The government set up an independent inquiry asking the Council for Healthcare Regulatory Excellence and the Charity Commission to investigate.[22]
Panorama controversy[edit]
On 16 April 2009, nurse Margaret Haywood was barred from practising as a Nurse in the UK following a ruling by the NMC Conduct and Competence committee panel.[23] This followed Haywood's contribution to a BBC Panorama television programme, exposing significant deficiencies in care at the Royal Sussex County Hospital, an acute teaching hospital in Brighton, England.[24] The public and media response was generally antagonistic towards the NMC, the response being described by the Royal College of Nursing as 'unduly harsh'.[25] On 12 October 2009, the striking off order was dropped, and replaced with a one-year caution.[26]
Regulatory criticism[edit]
In an early July 2012 report, the Council for Healthcare Regulatory Excellence (CHRE), now known as the Professional Standards Authority for Health and Social Care (PSA),[27] critically examined the leadership of the Nursing and Midwifery Council.[28] In late July 2012, a new chair for the NMC, Mark Addison, was appointed by the privy council, an appointment which was subject to criticism by the NMC Council, who described their "grave concern" with regard to what they claimed was a "lack of an open, transparent and equal opportunities process" in regards to the appointment.[29][30] In contrast, the CHRE stated that they were pleased with the appointment of a new Chair, and that they would "look forward to working with Mark Addison".[31] On 26 June 2015, the PSA reported in their performance review 2014–2015 report that the NMC had made overall improvements in their performance.[32]
Data loss[edit]
In March 2013 the NMC was fined £150,000 by the Information Commissioner's Office after it admitted that personal data, including "highly sensitive" information about nurses and about vulnerable children, had been placed on DVD without being encrypted, sent by courier and then lost. The ICO said that "it should have been obvious ... that such a contravention would be of a kind likely to cause substantial distress to the data subjects due to the nature of the data involved".[33]
Increase in membership cost[edit]
The cost charged to remain registered on the NMC has increased from £76 per year in 2013, to £100 in 2014. Since 2015 the registration fee is £120.[34] The annual registration fee to the NMC is an allowable expense for UK income tax, however a survey by the NMC discovered that more than 75 percent of NMC registrants do not claim tax relief on their registration.[35]
Morecambe Bay[edit]
The council was criticised by Bill Kirkup for the way it handled the investigation resulting from events at University Hospitals of Morecambe Bay NHS Foundation Trust relating to misconduct by two midwives involved in the Furness General Hospital scandal. He said their response to his report had "fallen far short of expectations". The Professional Standards Authority said the regulator's investigation was "deficient" because evidence was not presented to the panel by the council, even though it had it in its possession.[36]
Regulator[edit]
The Professional Standards Authority for Health and Social Care (PSA), is an independent body accountable to the UK Parliament, which promotes the health and wellbeing of the public and oversees the nine UK healthcare regulators, including the Nursing and Midwifery Council.[37]
In 2015 it was suggested that the costs of regulating the Nursing and Midwifery Council would be paid for by the membership of the NMC i.e. nurses and midwives.[38]
In 2015 the PSA published the 2014 audit it had undertaken of the NMC which found that whilst it had improved, it was still failing in areas.[39]
See also[edit]
Nursing portal
Nursing in the United Kingdom
Royal College of Nursing
References[edit]
Jump up ^ Administrative background notes in National Archives entry for the Records of the General Nursing Council for England and Wales
Jump up ^ Hannah Cooke, Susan Philpin, Sociology in Nursing and Healthcare, Elsevier Health Sciences, 2008 p131
Jump up ^ Nursing and Midwifery Order 2001
Jump up ^ Calkin, Sarah (17 May 2013). "NMC council members swept away in overhaul". Nursing Times. Retrieved 14 March 2016.
Jump up ^ "Our Role". Nursing and Midwifery Council. 9 June 2014. Retrieved 4 July 2014.
^ Jump up to: a b "Strategic review of the Nursing and Midwifery Council: Final report" (PDF). Council for Healthcare Regulatory Excellence. 3 July 2012. p. 7. Retrieved 2 August 2014.
^ Jump up to: a b Merrifield, Nicola; Ford, Steve (8 October 2015). "Plans for new system of nurse competency checks approved by regulator". Nursing Times. Retrieved 17 November 2015.
Jump up ^ "NMC Register". Nursing and Midwifery Council. Retrieved 4 April 2014.
Jump up ^ "Standards: The Code for nurses and midwives". Nursing and Midwifery Council. Retrieved 9 January 2016.
Jump up ^ "Revalidation: your step-by-step guide through the process". Revalidation NMC.
Jump up ^ "The Code for nurses and midwives". NMC.
Jump up ^ "Revalidating nurses:what's the score?". Nursing in Practice. Retrieved 3 July 2014.
Jump up ^ "Reflection and engagement key to revalidation". National Health Executive. Retrieved 1 April 2015.
Jump up ^ "NMC introduces revalidation for all nurses and midwives" (Press release). NHS Employers. 13 October 2015. Retrieved 18 January 2016.
Jump up ^ "Raising concerns". Nursing and Midwifery Council. Retrieved 4 April 2014.
Jump up ^ "Helene Donnelly addresses NMC Council". Retrieved 4 April 2014.
Jump up ^ "Regulation of Health and Social Care Professionals". Law Commission. 2 April 2014. Retrieved 14 April 2014.
Jump up ^ Smith, Jackie (7 April 2014). "Bill needs push to sweep away 'inflexible' healthcare regulation framework". The Guardian. Retrieved 19 January 2016.
Jump up ^ "Mutual recognition of professional qualifications in healthcare". Government of the United Kingdom. Retrieved 10 December 2015.
Jump up ^ "English Language Requirements – EEA". NMC Nursing and Midwifery Council. 20 January 2016. Retrieved 14 March 2016.
Jump up ^ "Statement in response to allegations by Jim Devine MP". Nursing and Midwifery Council. Archived from the original on 18 March 2008. Retrieved 12 March 2008.
Jump up ^ Carvel, John (12 March 2008). "Bullying and racism claims at nursing council". The Guardian. London. Retrieved 12 March 2008.
Jump up ^ "Nurse struck off register for confidentiality breach". Nursing and Midwifery Council. Archived from the original on 25 April 2009. Retrieved 28 April 2009.
Jump up ^ "Calls for whistle-blower review". BBC News. 16 April 2009. Retrieved 28 April 2009.
Jump up ^ "Over 15,000 sign petition to support struck off RCN member". Royal College of Nursing. Archived from the original on 2009-04-30. Retrieved 28 April 2009.
Jump up ^ "Panorama nurse can return to work". BBC News. 12 October 2009. Retrieved 12 October 2009.
Jump up ^ "Our Work – The Professional Standards Authority for Health and Social Care". The Professional Standards Authority for Health and Social Care.
Jump up ^ "Strategic review of the Nursing and Midwifery Council Final report 3 July 2012" (PDF). Retrieved 11 September 2012.
Jump up ^ "Appointment of Mark Addison as Chair of the NMC" (Press release). 31 July 2012. Retrieved 14 March 2016.
Jump up ^ Ford, Steve (31 July 2012). "'Grave concerns' over appointment of new NMC chair". Nursing Times. Retrieved 11 September 2012.
Jump up ^ "NMC Chair appointment". Council for Healthcare Regulatory Excellence. Archived from the original on 7 November 2012. Retrieved 11 September 2012.
Jump up ^ "The Authority publishes Annual Performance Review of regulators". The Professional Standards Authority. Retrieved 18 January 2016.
Jump up ^ "Nursing watchdog fined £150k for confidential unencrypted DVD loss". The Register. 19 February 2013. Retrieved 22 March 2013.
Jump up ^ "NMC wants 'shockingly unfair' fee rise to £120 a year". nationalhealthexecutive.com. Retrieved 8 February 2016.
Jump up ^ "NMC tax relief". nmc-taxrebate.co.uk. Retrieved 21 June 2014.
Jump up ^ Lintern, Shaun (13 May 2016). "Kirkup outlines 'lamentable' NMC failures to health secretary". Health Service Journal. Retrieved 31 July 2016.
Jump up ^ "Statutory Regulators Directory: Organisation Profile: Nursing and Midwifery Council (NMC)". Professional Standards Authority for Health and Social Care. Retrieved 19 January 2016.
Jump up ^ "Government pushes ahead with plans that may see NMC fee rise". Nursing Times. Retrieved 8 February 2016.
Jump up ^ "NMC performance improves but some targets still missed". Nursing Times. Retrieved 8 February 2016.
External links[edit]
Nursing and Midwifery Council
NMC YouTube channel
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