FAQs on our fitness to practise process

The purpose of the fitness to practise procedures is about protecting the public rather than a general complaints resolution process. The procedures are designed to protect the public from those who are not fit to practise. If a regulator finds a registrant’s fitness to practise is ‘impaired’, it means that there are concerns about their ability to practise safely and effectively. As such, the actions the regulators can take if it finds a registrant’s fitness to practise is impaired by reason of misconduct, poor performance or ill health are:

• Reprimand
• Conditions
• Suspension with or without a review
• Erasure
• Immediate suspension
• Immediate conditional registration.

During the hearing, the panel will determine whether there is evidence to support the concerns raised. They will also decide on a sanction if they find the health and care professional to be ‘impaired’. This means there are concerns about their ability to practise safely and effectively. A professional can be found to be impaired, for example, due to misconduct, poor performance or ill health. The panel will explain the reasons for their decisions.

The type of sanction a panel can impose varies from regulator to regulator,  but may include:

• taking no further action
• offering advice
• issuing a warning or reprimand
• imposing conditions (for example, requiring additional training or a supervision period)
• suspension (with or without a review)
• erasure/striking off/removal from the regulator’s register (this is the most serious sanction, which means the professional can no longer practice in that profession).

This information appears on each regulator’s online register alongside the professional’s name, sometimes with a link to the panel’s decision .

We can also examine other types of panel decisions including to restore a professional to the regulator’s registrar.

*From December 2024, we will be able to review other types of decisions in relation to  physician associates and anaesthesia associates.*

Our powers in relation to fitness to practise decisions are limited to:

• Reviewing all final fitness to practise committee decisions to assess whether they are insufficient to protect the public and do not protect the public. If we consider that is the case we can refer the matter to Court but have only a limited legal timeframe in which to do so
• Auditing a random sample of fitness to practise cases closed by investigating committees/case examiners and staff at the initial stages of the fitness to practise process. In carrying out the audit we consider whether the decisions made by the regulator protect the public and if the regulator has followed its own processes. In this instance we are limited to feeding back any concerns to the regulatory body by way of audit reports.

There are some things we can't do under our Section 29 power:

• We can't review decisions made by individual staff members of regulators, especially at the beginning of the fitness to practise process.  We can only review final fitness to practise panel decisions.
• We can't ask regulators to reconsider their decisions.  We can only refer final fitness to practise panel decisions to Court or we can provide the regulators with our concerns and with learning for how to better handle such decisions in the future. 

You may be able to ask the regulator to review their decision about your complaint.

You could also seek a judicial review of the regulator’s decision, but we recommend that you get independent legal advice before taking this step. We are unable to give you advice about this course of action.

Judicial reviews can be costly and are bound by strict time limits: the normal time limit is three months from the date of the decision. Your local Citizens Advice might be able to provide you with information.