A Guide to Fitness to Practise

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1. What is fitness to practise?

Fitness to practise is explained by all regulators as having the skills, knowledge, good character and health necessary to practise safely and effectively. It requires the registrant to be suitable to be on the relevant register without restrictions.

When a regulator investigates a registrant for fitness to practise issues, it is most frequently in relation to allegations of misconduct, but can also be due to poor performance, a conviction or caution for a criminal offence, physical or mental ill health, or a decision by another regulatory body.

Many registrants are surprised when they face a fitness to practise investigation, in relation to an incident arising out of their personal life. Many registrants will question why such allegations are relevant, where the allegations do not appear to be relevant to their ability to perform their professional role. However, registrants are subject to the regulator’s duty to uphold the public’s confidence in the profession as well as to protect patients and service users.



2. Which organisations have fitness to practise procedures?

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3. Who do we help with fitness to practise allegations?

We have experience in assisting healthcare professionals with allegations regarding their fitness to practise at all stages of their career; from students at universities to trainees, to those working at specialist or consultant level.



4. Who makes fitness to practise complaints?

Complaints about a professional’s practise can come from a variety of sources including, other professionals, patients/service users, employers, the police and through fitness to practise declarations made by registrants.



5. What will happen in a fitness to practise investigation?

  1. If an allegation has been made that questions your fitness to practise, your regulator will carry out initial enquiries, writing to you to inform you of this and inviting you to respond. At this stage, there is no obligation at this stage to reply.
  2. Your regulator will then investigate the allegations, taking witness statements whilst collating documentary evidence and liaising with the relevant parties. The regulator will keep you up to date with their progress and ultimately, will ask for your written response to their allegations.
  3. The case will then be considered by either Case Examiners or an Investigating Committee, who will review the paperwork from both sides and decide if the registrant needs to be referred for a full fitness to practise hearing. This is a critical stage of the fitness to practise process. Richard Nelson LLP have a proven track record of preparing written representations to Case Examiners/Investigating Committees and persuading them not to refer a registrant for a fitness to practise hearing.
  4. If the Case Examiners/Investigating Committee decides to refer a registrant for a fitness to practise hearing, the hearing will usually be listed within 6 months.



6. What will happen in a fitness to practise hearing?

Each regulator has a panel, usually of 3 members, who are the decision makers. The Panel will rely on the fitness to practise guidance to assist them to make appropriate decisions.

The procedures for fitness to practise hearings vary a little, but they all tend to proceed in the following 3 stages:

  1. Facts – The panel are presented with evidence and will make a decision whether the allegations are proven;
  2. Impairment – if the allegations are found proven, the panel will consider whether the registrant’s fitness to practise is impaired;
  3. Sanctions – if the panel decides that the registrant’s fitness to practise is impaired, they then make a decision on what sanction to impose.



7. What is impairment of fitness to practise?

Generally, the panel will conclude that a registrant’s fitness to practise is impaired because

  1. You present a risk to patients; or
  2. You have brought the profession into disrepute; or
  3. You have breached one of the fundamental tenets of the profession; or
  4. Your integrity can not be relied upon.



8. What sanctions can a regulator impose in fitness to practise hearings?

Sanctions do vary slightly between the regulators. Each regulator has a fitness to practise sanctions guidance. The type of sanctions available tend to include:

  • Warning/caution;
  • Conditions being imposed on the registrant;
  • Suspension, which means that the registrant is prevented from working in their profession for a stipulated period;
  • Erasure/removal/strike off, which means that the registrant is removed from the register.



9. How can we help you with your Fitness to Practise Investigation?

Our expert lawyers can assist you in a variety of ways, depending on your circumstances and what your individual case requires.

We have flexibility to offer a variety of pricing models, including agreed fixed fees, or third-party funding.

We can:

  • Offer you an initial free telephone consultation to give you preliminary advice about any fitness to practise allegation;
  • Prepare written representations to a regulator, explaining your position in relation to a fitness to practise allegation;
  • Provide expert legal representation for fitness to practise hearings;
  • Provide clear and practical advice at all stages of a fitness to practise investigation;
  • Devise a clear strategy for your case to ensure the best possible outcome.



10. Ask another question

Do you have another question relating to fitness to practise that hasn’t been covered in our guide? Feel free to ask Richard Nelson LLP’s fitness to practise solicitors and we’ll endeavour to get back in touch with you as soon as possible.

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Get in touch

Please do not hesitate to contact us with any queries you may have about a fitness to practise issue. We will happily speak to you for free and without obligation.

To get in touch, either:

  • Make an enquiry using the blue button below
  • Phone us during office hours on 0333 888 4040
  • Email us at

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