AllegationsBack to top
One of our key statutory functions is to investigate allegations about the fitness to practise of nurses, midwives and nursing associates, or their entry in the register. Fitness to practise allegations involve us alleging that the nurse, midwife or nursing associate’s fitness to practise is ‘impaired’.
For this reason, when we first assess, investigate, and when our case examiners consider ‘allegations’, we define ‘allegation’ as meaning simply an allegation to the effect that the nurse, midwife or nursing associate’s fitness to practise is impaired.
Regulatory concernsBack to top
During the early stages of a case we draft regulatory concerns to express what appears to have happened in a particular case, and why this set of facts justifies us intervening in the nurse, midwife or nursing associate’s practice.
ChargesBack to top
A charge only comes into existence when we send the nurse, midwife or nursing associate notice of their final hearing or meeting before the Fitness to Practise Committee.
Before then, if we any refer to a charge, we mean a ‘draft charge’.
The notice of a substantive hearing will contain a charge ‘particularising’ (or setting out) the alleged facts on which the allegation of impaired fitness to practise is based.
The charge is the public statement of the basis on which we are saying the nurse, midwife or nursing associate’s fitness to practise is impaired.
It will allege that the nurse, midwife or nursing associate’s fitness to practise is impaired because of one or more of the following (as set out in our legislation):
- lack of competence
- a conviction or caution
- not having the necessary knowledge of English
- a determination by another health or social care organisation.
So, the meaning of ‘charge’ within our rules is:
- an assertion that a nurse, midwife or nursing associate’s fitness to practise is impaired, making particular reference to one of the kinds of impairment from our Order (for example, ‘your fitness to practise is impaired by reason of your lack of competence’); and
- the schedule of alleged facts which we send together with a notice of hearing, which ‘particularises’ the allegation of impaired fitness to practise.
Additionally, in everyday language, people taking part in Fitness to Practise Committee hearings will often refer to one or more of the individual ‘alleged facts’ within a schedule of charge as ‘charge 1’, ‘charge 6(a)(ii)’, and so on.
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: We’ll look for evidence of remediation where a serious concern was 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