The HCPC launches two new policies for Fitness to Practise Investigations

The HCPC (Health and Care Professions Council) launched its new Threshold Policy for Fitness to Practise Investigations and Approach to the Investigation of Health Matters on 14 January 2019.

The new threshold policy sets out a new approach to investigating fitness to practise concerns, and to decision making in the early stages of the investigation process, and replaces the previous Standard of Acceptance policy. The HCPC hope this will help prioritise more serious and high-risk fitness to practise cases.

The Investigation of Health Matters policy sets out how the HCPC will investigate concerns that a registrant’s fitness to practise may be impaired because of their physical or mental health.

Both policies came into effect on 14 January 2019 and will apply to existing fitness to practise cases, as well as new concerns received from that date. The policies will not apply retrospectively to any cases that have already been considered against HCPC’s previous Standard of Acceptance policy.

Threshold Policy for Fitness to Practise Investigations

Once a concern has been received by the HCPC a Case Manager applies the Triage Test and carries out a risk assessment. The triage test is a simple assessment as to whether a concern is within their remit to deal with. It is necessarily a low bar and only those concerns that do not meet this test may be closed at this stage. However, if the concern is one that the HCPC can deal with it will move forward through their process for an initial investigation.

This initial investigation involves applying the threshold test which is whether the concern which has been received amounts to an allegation that the registrant’s fitness to practise may be impaired on one or more of the statutory grounds set out in the order. The main criteria when assessing whether the information received meets the threshold test includes the following:
The actual or potential risk to public safety;

• Whether the matter undermines public confidence in the profession;
• Whether the matters complained of could amount to a breach of HCPC’s standards of conduct, performance and ethics, standards of proficiency and other relevant guidance for registrants;
• Whether the information calls into doubt the registrant’s honesty or integrity;
• If the registrant has a physical or mental health condition that may present a risk to their ability to practise safely or effectively;
• Whether the matter relates to an isolated incident or indicates a wider pattern of behaviour;
• If the registrant has taken action to remediate their practise;
• Whether there have been previous, similar concerns about the registrant;
• Any other public interest considerations.

The length of time that has passed since the incidents that gave rise to a concern can affect the quality and availability of relevant information. This in turn may affect whether that information meets the threshold.

If the HCPC consider that the threshold has been met draft allegations will then be prepared and referred to a panel known as the Investigating Committee.

If the HCPC consider that the threshold test has not been met then the case may be closed.

Once this decision against the threshold test has been made the HCPC will then notify the parties of the outcome. The HCPC will explain why they decided that the case should be closed or referred to the Investigating Committee and will set out how they assessed the matter in relation to the standards of conduct, performance and ethics, standards of proficiency and other relevant guidance.

Approach to the Investigation of Health Matters

The HCPC’s new Approach to the Investigation of Health Matters policy deals with concerns which indicate that a registrant may have a health problem. This could be either physical or mental health which results in a registrant’s fitness to practise being impaired, meaning a registrant is unfit or unsafe to practise without restriction.

The HCPC’s approach to assessing health matters as set out in this policy applies to all stages of the fitness to practise process.

The HCPC’s standards of conduct, performance and ethics makes it clear that registrants have a professional duty to make changes to their practise, or cease practising, where their physical or mental health may affect their performance, judgment or place others at risk (standard 6.3). However, they will not normally take action in relation to a registrant’s practise on health grounds, unless there is a risk to public safety, to public confidence in the profession or to the registrant themselves.

An initial investigation is likely to be carried out to satisfy the HCPC as to the nature and extent of a registrant’s health condition, and whether it may impair their ability to practise safely and effectively. When making their assessment of a health matter the relevant tests and thresholds as set out in the new Threshold Policy for fitness to practise investigations, above, will be applied.

Depending on the type or nature of the health condition, the availability of other suitable medical information, or where it is unclear whether the registrant has an underlying health condition, we may need to ask a registrant to undergo an assessment with a medical assessor if a medical report is required to determine whether there is an underlying health issue that calls a registrant’s fitness to practise into question.