A safety net helping to protect the public

Protecting the public: why is it so important to double-check fitness to practise decisions?

A drop in the ocean?

If you look at the statistics about how many fitness to practise decisions we check versus how many we actually go on to appeal – you may wonder what difference our double-check makes and how it contributes to public protection?

The impact of our power to appeal as well as our scrutiny of these decisions is akin to throwing a pebble into a pond – it has a greater impact than one lone, small statistic would suggest.

The difference our power to scrutinise and appeal fitness to practise decisions can make and the value this can add, includes:

Protecting the public

Removing from practice, or restricting the practice of a professional who is currently not fit to practise and could pose a risk to the public - any one healthcare professional could go on to treat or care for a 1,000 patients over the course of a year. Our independent oversight also ensures the public interest is represented and counterbalances the registrant’s right of appeal in the process.

Creating case law and helping to clarify the process

Our double-check of the regulators' final fitness to practise decisions has helped to drive up standards in decision-making and recording by regulators through the learning points we feedback. It also improves transparency and holds regulators to account to ensure that the most serious concerns are dealt with by their fitness to practise panels. Another key benefit is that our appeals have created case law which has helped to clarify the purpose of the fitness to practise process.

A bird's eye view across all 10 regulators' fitness to practise decisions

We scrutinise all final fitness practise decisions across the 10 professional regulators so this gives us a bird's eye and means we can highlight issues and identify themes. These can then be picked up by our performance review team and explored in more detail as part of our annual reviews on how the regulators are meeting our Standards of Good Regulation; or passed on to our policy team to delve deeper into the detail – for example, we noticed that panels were treating sexual misconduct with colleagues less seriously than with patients. The panels believed that this type of misconduct would not put the public at risk – we believed otherwise and carried out research to find out more. We can then share findings with the regulators, system regulators and other key stakeholders to help improve regulation.

A rich source of data

Our database of around 40,000 decisions checked since 2003 provides a wealth of data and has been used by researchers and academics to identify common causes of misconduct and can help us improve regulation – find out more about our research published into sexual misconduct, dishonesty and the professional duty of candour.

See our key stats

See our key statistics and the number of decisions we have appealed in the last 20 years.

Read a personal perspective

A powerful personal account in this guest blog about our power to appeal

Read our explainer

Find out more about the regulators' fitness to practise processes and our role from our Decisions about Practitioners page.

The road to regulatory reform

Find out more about the key milestones over the last 20 years in the reform of professional regulation or see this one-page explainer.

See our power to appeal in practice in these case studies

Find out more about how our power to appeal fitness to practise decisions improves public protection in our case studies: a doctor who sexually assaulted a nurse; a social worker who sexually harassed his female colleagues; a nurse who repeatedly mistreated a vulnerable patient in her care; or a dental nurse who turned a blind eye to unhygienic practices putting her patients at risk

How does this protect the public in practice?

Ask yourself?

'Would I want to be treated by a dentist who has been convicted of possessing large amounts of child pornography?	'Would I want a member of my family to be treated by a paramedic who deliberately targeted a vulnerable young woman and groomed her?'	'Would I want to work with a doctor who made a mistake during surgery, covered it up, falsified the notes, subjecting their patient to an unnecessary operation to correct the first mistake and making their colleagues part of the deception?'
The original General Dental Council panel decision we appealed imposed a 12-month suspension on the dentist. This meant that he would be returning to practice while still on the sex offenders register, and before the completion of the sexual offenders’ treatment programme. The judge agreed with us and the dentist was struck off.	We appealed the original Health and Care Professions Council panel decision as we believed the panel had not brought charges to address all the registrant’s potential misconduct, nor addressed his potential for having groomed the patient once he became aware of her particular vulnerabilities. The judge allowed our appeal and remitted the case to the HCPC for a fresh hearing with new charges.	The original decision found no impairment - our appeal resulted in the Court imposing a warning which will be published on the GMC register.

These are all cases where our appeal was upheld - if we had not appealed all these registrants would either have returned to practise or had no warnings entered on to the register.