Facing a fitness to practise investigation — process for healthcare professionals explained

Healthcare professionals are facing increasing pressure in a tightly regulated environment. If a report is made about a healthcare professional to their regulator — for any reason — the regulator has a duty to investigate. Yet since many regulated professionals receive complaints at some point during their careers, this doesn’t necessarily indicate poor clinical performance. 

Your ability to deal with a complaint and apply the correct legal advice will result in the best possible outcome. Here, we explain the process that many healthcare regulators will follow when investigating fitness to practise and outlines the actions to take if you find yourself subject to an investigation.

What is being ‘fit to practise’?

Being ‘fit to practise’ means that you have the skills, knowledge, fitness and character to perform your job safely and effectively. You must also act professionally and adhere to the principles of good practice set out by your regulator in its standards and guidance. 

Your regulator will only investigate concerns that could lead to a risk to patient safety or affect public confidence in the profession. 

Such concerns include instances of:

• dispensing errors
• dishonesty or fraud
• working under the influence of drinks or drugs
• unprofessional or inappropriate behaviour
• criminal conduct. 

The investigation process

Receiving a complaint

After receiving a complaint, your regulator will examine the information in accordance with its guidelines and standards (as well as any legislation) and launch an investigation if the information received raises a fitness to practise concern.

You’ll be informed if your regulator is investigating an allegation against you. At this initial stage, you may be invited to comment on the allegations and provide any supporting documentation.

It’s important to seek expert legal advice here as you’re unlikely to know the full picture — and anything you say could have an impact on the case as it progresses. 

Regulator action

Once the initial investigation has concluded, your regulator will decide what action to take. Any cases that meet the threshold criteria will be referred to an Investigating Committee or Case Examiners. 

The Investigating Committee will decide whether to close a case:

• with no further action taken
• by giving advice or a warning
• with an agreed set of undertakings. 

While you’re not permitted to attend an Investigating Committee or Case Examiners meeting, you may submit a written response to the allegation. We recommend seeking legal assistance when drafting a written response to ensure that it address the concerns raised professionally and adequately. 

Serious cases

More serious cases may go straight to a Fitness to Practise Committee for a full hearing.

These are typically held in public and may issue a warning, impose restrictions on your practice, suspend you or even remove you from the register. 

Before the hearing, you can submit evidence in the form of written statements — both from yourself and other witnesses — as well as other documents such as reflections and evidence of relearning. Time limits and formalities apply here, so again it’s crucial to take expert legal advice when preparing evidence as this can have a significant impact on the hearing’s outcome. 

While it’s possible to appear at a Fitness to Practise hearing without legal representation, having a lawyer with experience in healthcare settings fighting your corner can make a huge difference. Your lawyer will know exactly what questions to ask and how to effectively present your case.

How we can help

Facing a fitness to practise investigation can be incredibly stressful and time consuming. It can impact your mental health, livelihood and home life. When under this kind of pressure, you may not always have a clear enough head to respond in the best possible way.

Our professional conduct team contains specialist lawyers with unrivalled expertise in case presenting and defending regulated professionals across multiple sectors. Our team handles professional misconduct and discipline cases and investigations of all types and complexities, including those in healthcare — from doctors and dentists to pharmacists, opticians, chiropractors, paramedics, veterinary surgeons and more.

We’ll consider the complaint or allegations against you and any information obtained. After speaking with you, we’ll formulate a strategy to support your case and consider whether any expert input — whether from our extensive range of colleagues or trusted external sources — is required. 

If you’re looking to formulate a robust, positive response to an investigation, talk to us by giving us a call, sending us an email or completing our contact form below.

We encourage you to seek advice as soon as you’re made aware that you’re under investigation — even if you’ve done nothing wrong.