Our legal powers allow us to investigate two kinds of concern:

  • allegations of fraudulent or incorrect entry of an individual nurse, midwife or nursing associate in our register
  • allegations about the fitness to practise of nurses, midwives or nursing associates.

Allegations about fitness to practise can be based on:


The Code sets the professional standards of practice and behaviour for nurses, midwives and nursing associates.

If nurses, midwives or nursing associate’s conduct falls seriously short of the expectations in the Code, what they did or failed to do could be professional misconduct.

Lack of competence

Lack of competence would usually involve an unacceptably low standard of professional performance. For instance, if a nurse, midwife or nursing associate demonstrates a lack of knowledge, skill or judgment, which shows they’re incapable of safe and effective practice.

Unless it's exceptionally serious, a single clinical incident wouldn't usually indicate a general lack of competence.

Criminal convictions and cautions

Nurses, midwives or nursing associates have to declare any cautions or convictions unless these are protected cautions or convictions.

If you've received a criminal conviction or caution, find out more information about what steps you need to take


We won’t normally need to get involved in a nurse, midwife or nursing associate’s practice because of ill health unless there is a risk of harm to patients or to the public’s confidence and trust in nursing or midwifery professions.

We don't need look into health conditions if they’re being effectively managed and don’t make the mean the registrant is unable to carry out their professional role.

This is relevant if someone living with a condition but managing through medication or therapy, or if they've been given appropriate support or adjustments to help carry out their work.

Not having the necessary knowledge of English

Not every language concern raised will need us to carry out an investigation.

Language concerns that could place the public at risk of harm include serious failures to give appropriate care to patients because of an inability to understand verbal or written communications from other health professionals or patients.

Determinations by other health or social care organisations

Nurses, midwives, and nursing associates can be registered members of other health or social care professions regulated by different legal bodies in the UK or overseas.

Sometimes we receive referrals from these other organisations, that we’ll look into.