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Available sanction orders
Fitness to Practise Committee panels will consider the full range of sanctions open to them.
The proper approach is to start with the least severe sanction: the panel should decide whether the outcome is right for fitness to practise concern in question after they have considered any less severe sanction.1
This means that panels must explain why they have chosen a particular sanction, and also say why they have rejected other sanctions. The following section of this guidance deals with each of the sanctions in turn, starting with the least serious first. These are:
- taking no further action
- a caution order of between one and five years
- a conditions of practice order of up to three years
- a suspension order of up to twelve months
- a striking-off order
1 See Giele v General Medical Council [2005] EWHC 2143 (Admin)
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- Last Updated: 28/07/2017
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.
FtP library
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Understanding Fitness to Practise
- Aims and principles for fitness to practise
- Allegations we consider
- How we determine seriousness
- 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
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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
- Remediation and insight
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Screening
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Our overall approach
- Our overall approach - overview
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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
- Whistleblowing
- If we don't refer a case
- Determining the regulatory concern
- Screening incorrect or fraudulent entry cases
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Our overall approach
- Interim Orders
- Investigations
- Case Examiners
- Preparing for the FtP Committee
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Case management
- 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
- Sanctions
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Reviews
- Reviewing case examiner decisions
- Interim order reviews
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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