The Four Principles of the NMC Code
The NMC Code is built around four principles, also called the four themes or the four Ps. They are:
- Prioritise people
- Practise effectively
- Preserve safety
- Promote professionalism and trust
The Code is published by the Nursing and Midwifery Council and sets out the professional standards that every registered nurse, midwife and nursing associate in the United Kingdom must uphold. Each of the four principles contains a set of statements that, taken together, describe what good practice looks like.
This page gives you a short, direct explanation of each principle. If you want a fuller walkthrough of how the Code is tested in the CBT, with worked scenario types, read our companion guide, the NMC Code explained.
The Four Ps at a Glance
| Principle | In one line |
|---|---|
| Prioritise people | Put the people in your care first, treating them with dignity and respecting their choices. |
| Practise effectively | Work within your competence, communicate clearly, and keep accurate records. |
| Preserve safety | Recognise risk, act on it without delay, and raise concerns when practice is unsafe. |
| Promote professionalism and trust | Behave in a way that upholds the reputation of the profession and maintains public confidence. |
1. Prioritise People
The first principle puts the people in your care at the centre of your practice. It asks you to treat people as individuals, to uphold their dignity, and to avoid discrimination on any grounds.
In practice this covers consent, confidentiality, and acting as an advocate for people who cannot speak up for themselves. For example, if a patient who has the capacity to decide refuses a treatment, you respect that decision even when you disagree with it. Their right to choose comes first.
2. Practise Effectively
The second principle is about the quality of your work. It asks you to keep your knowledge and skills up to date, to work within the limits of your competence, to communicate clearly, and to keep clear and accurate records.
A common example is being asked to carry out a task you have not been trained for. Under this principle the correct response is to decline and escalate to someone competent, rather than attempt it. Accurate, timely record keeping also sits under this theme, because good documentation is part of safe and effective care.
3. Preserve Safety
The third principle is about protecting people from harm. It asks you to recognise and respond to risks, to act immediately when someone is at risk, and to raise concerns when you believe practice is unsafe.
This theme includes the duty of candour, which is the duty to be open and honest with patients and their families when something has gone wrong, to apologise, and to put things right where you can. If a colleague makes a medication error, this principle requires you to report it through the proper channel and to make sure the patient is informed, rather than dealing with it quietly.
4. Promote Professionalism and Trust
The fourth principle is about how your conduct reflects on the profession as a whole. It asks you to act with honesty and integrity, to uphold the reputation of nursing, and to deal with problems openly and through the right channels.
The Code can apply to your behaviour outside work as well as inside it where that behaviour could affect public trust or your fitness to practise. Being honest in professional dealings, such as providing an accurate reference for a colleague, is a practical example of this principle in action.
Why They Are Called the Four Ps
Each of the four themes begins with the letter P, which is why many student nurses learn them as the four Ps. The mnemonic is a useful memory aid for the CBT, where you may need to recall the structure of the Code and match a scenario to the principle that applies. Learning the four Ps in order gives you a simple framework to fall back on under exam pressure.
How the Four Principles Are Tested in the CBT
The CBT rarely asks you to name a theme directly. Instead, it presents a realistic clinical or professional situation and asks what the most appropriate action would be. Knowing which of the four principles applies helps you reason your way to the right answer rather than guessing.
For a detailed breakdown of the scenario types that come up and how to apply the Code to each one, work through the NMC Code explained.
Practise the NMC Code for Free
The NMC Code is the most important document to understand for the CBT, and the best way to learn it is to apply it to questions until the correct response feels natural.
The first module on NMC Prep, Professional Practice and the NMC Code, is free with no card required, and it includes a dedicated unit on the NMC Code and professional standards. Sign up, read the Code in full on the NMC website, and start practising the scenario questions today.