1.1 Nurses and Midwives Act & SNB Regulatory Powers

1.1 Nurses and Midwives Act & SNB Regulatory Powers

The practice of nursing and midwifery in Singapore is governed by a rigorous statutory framework established to protect public health, safety, and welfare. At the core of this legal structure is the Nurses and Midwives Act (Cap. 209), enacted by the Parliament of Singapore. This primary legislation establishes the legal boundaries of nursing practice, regulates professional titles, and creates the Singapore Nursing Board (SNB) as the sole statutory regulatory body for nurses and midwives across all healthcare sectors in Singapore.

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Statutory Authority and Role of the Singapore Nursing Board (SNB)

The Singapore Nursing Board (SNB) operates as a statutory board under the Ministry of Health (MOH). SNB publishes its current Board membership.

Under Section 8 of the Nurses and Midwives Act, the primary statutory functions of the SNB include:

1. Registration and Enrollment: Approving or rejecting applications for registration and enrollment, and maintaining official Registers and Rolls.
2. Accreditation of Education: Regulating nursing education standards, approving pre-registration and post-registration curricula, and accrediting nursing schools (e.g., NUS Alice Lee Centre, Nanyang Polytechnic, Ngee Ann Polytechnic, SIT).
3. Standards of Practice and Conduct: Issuing the SNB Code for Nurses and Midwives (April 2018), read alongside the current Scope of Professional Nursing and Midwifery Practice (2023) and RN core competencies, to guide safe and accountable practice.
4. Issuance of Practising Certificates: Administering the annual licensing cycle and ensuring practitioners meet ongoing competency standards.
5. Professional Discipline: Investigating complaints regarding professional misconduct, negligence, or fitness to practise, and enforcing disciplinary sanctions.

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Registration, Enrolment and APN Certification

SNB distinguishes RN and midwife registration, EN enrolment and Advanced Practice Nurse certification. A practitioner must satisfy the applicable pathway and hold the relevant current Practising Certificate before practising; registration or enrolment alone is insufficient.

APN status alone does not grant unrestricted prescribing or diagnostic-ordering privileges. MOH’s collaborative-prescribing guidance requires appropriately qualified and trained APNs, the relevant programme, a collaborative practice agreement and institutional approval.

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Practising Certificate (PC) Renewal and CPE Framework

Registration or enrolment alone does not confer a right to practise. Nurses must hold a valid Practising Certificate (PC) and apply for renewal before their current PC expires.

Annual Renewal Cycle

• Current cycle: Renewal for PC Year 2027 opened on 1 September 2026. The current PC expires on 31 December 2026.
• Payment-specific dates: Employer-Pay-On-Behalf (EPOB) and existing GIRO applicants were required to submit by 30 September 2026. For this renewal cycle, a late application/renewal fee applies to applications submitted after 3 December 2026. Follow the published notice for each year and payment method rather than treating these dates as a permanent annual timetable.
• Special groups: The current notice excludes provisional registration/enrolment and nurses undertaking competency assessments; SNB sends separate instructions to them and their employers.

Continuing Professional Education (CPE) Framework

SNB is moving towards mandatory CPE. The point targets per qualifying period are 15 for RNs and 10 for ENs and single-register midwives. The qualifying period runs from 1 September to 31 August. SNB’s notice updated 21 July 2026 asks nurses and midwives to continue earning points for 1 September 2026 to 31 August 2027, while expressly allowing those with insufficient points for the current period to renew their PC for 2027. This transition exception is specific to that renewal year; it does not remove the professional duty to maintain competence or establish a permanent exemption from CPE.

APNs have separate requirements: 30 CPE points per qualifying period, including at least 15 related to advanced practice nursing or the relevant clinical specialty. No more than 15 points may come from Category I in-service programmes.

The currently linked August 2024 CPE Award Criteria lists Categories I–VI: in-service programmes; local/structured and local/overseas events; research, evidence-based practice and nursing quality improvement projects; publications; self-directed learning/reading; and formal courses/clinical attachments. Award points according to the actual activity, role and cap in that table. Keep the required claim evidence and monitor awarded points through SNB’s Professional Registration System (PRS).

Sources: SNB nurse/midwife CPE notice, PC renewal for Year 2027, and APN PC renewal.

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SNB Complaints and Board Decisions

SNB’s current public complaints guidance describes this process:

1. A written complaint identifies the practitioner, allegations and supporting evidence.
2. The Board may appoint a Complaints Committee to investigate relevant convictions, misconduct/negligence or physical/mental fitness. The committee may conduct a formal inquiry and submits a report and recommendations to the Board.
3. Under section 19(2), the Board may cancel registration/enrolment, suspend it for not more than two years, impose conditions, impose a financial penalty of not more than S$2,000, censure the practitioner or issue a written warning.

The Board considers the applicable powers in each case; a complaint does not automatically determine a particular sanction. Consult current SNB guidance for the decision and review procedures.

Source: SNB complaints guidance, updated 24 June 2025.

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Raising Patient-Safety Concerns

The April 2018 SNB Code requires accountable practice and action when patient safety is compromised. Raise concerns about unsafe practice, impaired fitness or inadequate care arrangements through the appropriate clinical, institutional and regulatory channels. Use objective observations, document relevant facts and protect confidential information. Choose the appropriate reporting channel for the concern and follow the applicable procedure.

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Clinical Scenario: Managing PC Expiry in Ward Practice

Scenario: Nurse Tan, an RN in an acute general ward, did not complete renewal before her PC expired on 31 December 2026. On 5 January 2027, during a routine audit, the Nurse Manager discovers Nurse Tan's PC expired on 31 December. Nurse Tan has already completed two shift duties in January.

Analysis & Required Action:

1. Immediate Cease of Practice: Nurse Tan must be relieved of clinical duties immediately. Practising clinical nursing without a valid PC constitutes an illegal act under the Nurses and Midwives Act.
2. Duty Roster Adjustment: The Nurse Manager cannot allow Nurse Tan to perform patient assessments, administer medications, or document nursing entries as an RN.
3. Urgent Late Renewal Application: Nurse Tan must contact SNB, complete the applicable renewal process and pay any required fees. She must not resume practice until she has a valid PC. SNB’s current transition notice permits PC2027 renewal despite insufficient current-period CPE points; it does not permit practice with an expired PC.
4. Institutional Reporting: The hospital nursing administration must document the administrative lapse and report the incident to MOH/SNB if required by institutional policy.