How do case examiners apply the realistic prospect test?

Reference: CAS-1c

Last Updated 04/08/2017

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Are the facts capable of being proved?

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Case examiners first consider whether the facts are capable of being proved, thoroughly considering all of the relevant information. They will assess any representations or evidence the nurse or midwife may have provided with particular care. Case examiners will also have careful regard to any comments from the person who originally referred the concerns to us, as they may have responded to the representations made by the nurse or midwife.

If the allegation about a nurse or midwife’s fitness to practise relates to more than one area of concern, case examiners will consider the evidence about each incident or issue separately. Because the case to answer decision applies to the allegation of impaired fitness to practise as a whole, and not to individual factual scenarios, case examiners will not necessarily highlight particular sections of evidence in support of each individual incident.

It is not the case examiners’ role to test the evidence, or resolve conflicts of evidence – these are fact-finding functions of the Fitness to Practise Committee. Case examiners do not have to refer every case where there are facts in dispute to a hearing. They can, and should, assess the overall weight of the evidence. There may be cases where, on the strength of the information provided, there is no realistic prospect that the Fitness to Practise Committee would find the facts are proved.

Currently impaired fitness to practise

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When considering whether there is a realistic prospect of finding that the nurse or midwife’s fitness to practise is currently impaired, case examiners will ask themselves two questions:

  • First, does the nurse or midwife currently pose a risk to the health, safety or wellbeing of the public, which requires some form of restriction on their registration?
  • Second, is a finding of impaired fitness to practise before the Fitness to Practise Committee required in the public interest?

Assessing risk to patients or members of the public

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When considering whether the nurse or midwife poses a risk to the health, safety or wellbeing of the public, case examiners will consider the guidance on remediation and insight. When they do so, some questions will always be important:

  • are the nurse or midwife’s past failings easily addressed?
  • how much insight have they shown?
  • what steps have they taken to remedy the failings?
  • what is the risk of reoccurrence?

Upholding the public interest

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When deciding whether there is a real prospect of a finding of currently impaired fitness to practise where the nurse or midwife presents no current risk to members of the public, case examiners will have regard to our overarching objective, which is to protect the public. This objective includes promoting and maintaining public confidence in the nursing and midwifery professions, and promoting and maintaining proper professional standards and conduct.

In cases where the nurse or midwife does not present a current risk to public safety, there is more likely to be a case for the nurse or midwife to answer if one of the other factors included in our overarching objective is involved. That is, without a declaration by the Fitness to Practise Committee that the nurse or midwife’s fitness to practise is currently impaired, either:

  • the public may be deterred from using the services of nurses or midwives in general, or
  • the professional standards of nurses and midwives generally are likely to be undermined


In deciding whether or not a public finding of impaired fitness to practise may be required to maintain public confidence in the professions or proper professional standards and conduct, case examiners should always be aware of their power to issue warnings to nurses and midwives as a public marking of their past conduct. 

In cases which would meet the thresholds for a warning, case examiners should explain why this way of dealing the case would not be sufficient to maintain public confidence or proper professional standards and conduct, and why a hearing would be required to do so.