Once our case examiners have considered an allegation, they decide whether there is a case to answer, based on the statement of regulatory concern which we prepare during our investigation, drawn from the evidence we’ve gathered.
If they decide there's a case to answer, they will refer the case to the Fitness to Practise Committee.
Once the case has been referred to the Fitness to Practise Committee, we’ll identify which category (or categories) of fitness to practise allegation the case involves:
- lack of competence
- criminal offences
- not having the necessary knowledge of English
- or decisions by other health or social care organisations.
We’ll then draft a charge explaining this and set out all the relevant facts on which the allegation is based.
When does the charge become the final version?
When we send the nurse, midwife or nursing associate the notice of hearing, it will contain the charge.
We must send this to the nurse, midwife or nursing associate no later than 28 days before the date fixed for the hearing.
If we’ve sent a notice of hearing more than 28 days before the date fixed for the hearing, we're allowed to change the charge that's contained within the earlier notice. We’re allowed to do this, as long as we send a further notice containing the revised charge no later than 28 days before the date of the hearing.
If we do this, we’ll always make it clear that the second notice is meant to replace the first notice.
Can the charge be changed less than 28 days before the hearing?
If we want to amend the charge in the notice of hearing, and the hearing is less than 28 days away, we’ll have to make an application to the panel once the hearing begins.
The panel, at any stage before making its findings, can allow an amendment to the charge or the facts set out within the charge. When considering whether to amend a charge, the panel will consider fairness and the overarching objective to protect the public.
If we don’t want to proceed with our case on all or part of the charge, we have to offer no evidence.
The guidance in our library, needs to be read alongside our NMC Guidance during the Covid-19 emergency period. We have new rules that are in force during the period of the coronavirus emergency that are relevant to how it applies.
Want to download and print whole sections of this FtP library? Visit the downloads page.
Understanding Fitness to Practise
- Aims and principles for fitness to practise
Allegations we consider
- Allegations we consider - overview
- Lack of competence
- Criminal convictions and cautions
- Not having the necessary knowledge of English
- Determinations by other health or social care organisations
- Fraudulent or incorrect entry to the register
- How we determine seriousness
- Why we screen cases
- When we use interim orders
- Examining cases
- How we manage cases
- Meetings and hearings
- Resolving cases by agreement
- What sanctions are and when we might use them
Taking account of context
- Taking account of context - overview
- 1: We’ll approach cases on the basis that most people referred to us are normally safe
- 2: We’ll seek to build an accurate picture about the nurse, midwife or nursing associate’s practising history
- 3: We’ll always carefully consider evidence of discrimination, victimisation, bullying or harassment
- 4: Where risks are caused by system and process failures, we’ll concentrate on the action we can take to help resolve the underlying issues
- 5: In cases where a nurse, midwife or nursing associate was required to use their professional judgement we’ll respond proportionately
- 6: Evidence of steps the nurse, midwife or nursing associate has taken to address serious concerns caused by a gap in knowledge or training or personal context factors
- 7: We’ll always look into whether group norms or culture influenced an individual’s behaviour before taking action
- 8: Where an incident has occurred because of cultural problems, we’ll concentrate on taking action to minimise the risk of the same thing happening again
- What context factors we think are important to know about when considering a case
- Insight and strengthened practice
- Engaging with your case
Our overall approach
- Our overall approach - overview
The Three Stages of our Screening Decision
- The Three Stages of our Screening Decision - overview
- Stage One: Do we have a written concern about a nurse, midwife or nursing associate on our register?
- Stage Two: Is there evidence of a serious concern that could require us to take regulatory action to protect the public
- Stage Three: Is there clear evidence to show that the nurse, midwife or nursing associate is currently fit to practise?
- Clinical advice
- Referrals to other regulators
- Referrers that wish to remain anonymous
- If we don't refer a case
- Determining the regulatory concern
- Screening incorrect or fraudulent entry cases
- Our overall approach
- Interim orders, their purpose, and our powers to impose them
- Applying the interim order test
- Applications for interim orders
- Review periods, extensions and multiple referrals
- Case Examiners
Preparing for the FtP Committee
- Reviewing cases after they get referred to the FtPC
- Why do we have guidance on charges?
- Jargon buster
- General approach
- How a charge becomes final
- Practical drafting issues
- Particular features of misconduct charging
- Drafting charges in health cases
- Other fitness to practise charges
- Multiple allegations
- Drafting charges in incorrect or fraudulent entry cases
- Documents panels use when deciding cases
- Gathering further evidence after the investigation
- Notice of our hearings and meetings
- Hearing fitness to practise allegations together
- Telephone conferences
- Preliminary meetings
- Dealing with cases at hearings or meetings
- Voluntary removal
- Cancelling hearings
- Constitution of panels
- Proceeding with hearings when the nurse, midwife or nursing associate is absent
- Case management during hearings
- Hearings in private and in public
- When we postpone or adjourn hearings
FtP Committee decision making
- Consensual panel determination
- Offering no evidence
- Abuse of process
- Directing further investigation during a hearing
- Making decisions on dishonesty charges
- Voluntary removal at hearings
- Deciding on incorrect or fraudulent entry
- Factors to consider before deciding on sanctions
- Considering sanctions for serious cases
- Available sanction orders
- Available orders for fraudulent or incorrect entry
- Interim orders after a sanction is imposed
- Directing reviews of substantive orders
- Reviewing case examiner decisions
- Interim order reviews
Substantive order reviews
- Substantive order reviews - overview
- Standard reviews before expiry
- Early review
- Exceptional cases: changing orders with immediate effect at a standard review
- Review of striking-off orders
- New allegations
- Reviewing orders when there may have been a breach
- Reviews where an interim order is in place
- Allowing orders to expire when a nurse or midwife’s registration will lapse
- Appeals and restoration