Stage one: Determine if the concern is serious enough to affect fitness to practise
We consider if the concern is serious enough to raise doubts on whether the nurse, midwife or nursing associate should be allowed to continue to practise as a registered professional, without us putting a restriction on how they work.
We use this to decide whether we need to investigate further.
For example, we may not need to take regulatory action for a clinical mistake, even where there has been serious harm to a patient or service-user, if there is no longer a risk to patient safety and the nurse, midwife or nursing associate has been open about what went wrong and can demonstrate that they have learned from it.
Our guidance on seriousness explains how decision makers at our screening stage might consider the seriousness of different kinds of concerns.
There’s further guidance about the different kinds of fitness to practise concern in our sections on misconduct, lack of competence, criminal offending, health, not having the necessary knowledge of English, or decisions by other health or social care organisations.
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- Last Updated: 18/01/2021
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
- Remediation and insight
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Screening
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The four stages of our screening decision
- The four stages of our screening decision - overview
- Stage one: Determine if the concern is serious enough to affect fitness to practise
- Stage two: Check it meets our formal requirements
- Stage three: Check whether we can obtain credible evidence
- Stage four: Check for evidence of remediation
- Cases not referred for further investigation
- Determining the regulatory concern
- Screening incorrect or fraudulent entry cases
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The four stages of our screening decision
- 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