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FtP library
Understanding Fitness to Practise
Aims and principles for fitness to practise
Allegations we consider
Allegations we consider - overview
Misconduct
Lack of competence
Criminal convictions and cautions
Health
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
How we determine seriousness - overview
Serious concerns which are more difficult to put right
Serious concerns which could result in harm to patients if not put right
Serious concerns based on public confidence or professional standards
Why we screen cases
When we use interim orders
Investigations
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
Insight and strengthened practice - overview
Can the concern be addressed?
Has the concern been addressed?
Is it highly unlikely that the conduct will be repeated?
Engaging with your case
Screening
Our overall approach
Our overall approach - overview
The Three Questions we ask when making Screening Decisions
Clinical advice
Referrals to other regulators
Referrers that wish to remain anonymous
Whistleblowing
A decision not to take any further action at this time
Determining the regulatory concern
Determining the regulatory concern - overview
Identifying and explaining regulatory concerns
Regulatory concerns in health cases
Cases that may involve incorrect or fraudulent entry
Interim Orders
Interim orders, their purpose, and our powers to impose them
Decision making factors for interim orders
Decision making factors for interim orders
Interim orders and fraudulent or incorrect entry allegations
Interim orders and not having the necessary knowledge of English
Applications for interim orders
Interim orders and multiple referrals
Investigations
Gathering information
How we investigate health concerns about nurses, midwives and nursing associates
Directions to take a language assessment
Investigating what caused the death or serious harm of a patient
Independent experts
Investigating at the same time as other organisations
Case Examiners
How case examiners decide there is a case to answer
Available outcomes
Available outcomes - overview
Advice
Warnings
Undertakings
Reconsidering closed cases
When we revisit case to answer decisions
Preparing for the FtP Committee
Reviewing cases after they are referred to the FtPC
Drafting charges
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
Disclosure
Notice of our hearings and meetings
Case management
Hearing fitness to practise allegations together
Telephone conferences
Preliminary meetings
Considering cases at meetings and hearings
Removal by Agreement
Removal by Agreement - overview
How does the agreed removal process work?
How we consider removal applications
Circumstances where agreed removal will not be appropriate
Applying the agreed removal criteria to particular cases
Readmission to the register
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
Supporting people to give evidence in hearings
FtP Committee decision making
Impairment
Consensual panel determination
Consensual panel determination - overview
Essential criteria
The process
Offering no evidence
Abuse of process
Directing further investigation during a hearing
Evidence
Making decisions on dishonesty charges
Agreed removal at hearings
Deciding on incorrect or fraudulent entry
Sanctions
Factors to consider before deciding on sanctions
Considering sanctions for serious cases
Available sanction orders
Available sanction orders - overview
No further action
Caution order
Conditions of practice order
Suspension order
Striking-off order
Available orders for fraudulent or incorrect entry
Interim orders after a sanction is imposed
Directing reviews of substantive orders
Reviews
Reviewing case examiner decisions
Reviewing case examiner decisions - overview
Stage one: should we start a review?
Stage two: what happens during the review process?
Interim order reviews
Interim order reviews - overview
What happens at an interim order review?
Early reviews
Notice
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 nurses, midwives or nursing associates to be removed from the register when there is a substantive order in place
Appeals and restoration
Appeals against panel decisions
Restoration
Restoration - overview
Deciding on applications for restoration
Powers of the Fitness to Practise Committee at a restoration hearing
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Case management
17 guides
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FtP Committee decision making
11 guides
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Reviews
16 guides
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Appeals and restoration
4 guides
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Interim Orders
6 guides
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Screening
14 guides
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Understanding Fitness to Practise
40 guides
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Investigations
6 guides
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Case Examiners
7 guides
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Preparing for the FtP Committee
15 guides
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Sanctions
11 guides
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