Stage one: concerns that are serious enough to affect fitness to practise

Reference: SCR-2a

Last Updated 28/07/2017


Firstly, we assess whether the facts involved are so serious that they call into question the fitness to practise of the nurse or midwife concerned. This is what we mean by an allegation that the fitness to practise of a nurse or midwife may be impaired.  

Impaired fitness to practise means more than a suggestion that a nurse or midwife has done something wrong or failed to do something that they should have. It means a concern which is serious enough to raise doubts about whether they should be allowed to continue to practise as a registered professional, either with some form of restriction on their practice, or at all. 

We focus on current impairment of fitness to practise. Our process does not exist to punish nurses or midwives or provide redress for past incidents, although we need to take into account past acts or failings in assessing current fitness to practise. Some cases are about events which, although the nurse or midwife presents no current risk to patients, are so serious that we may need to take action against the nurse or midwife’s registration to promote and maintain public confidence in nurses and midwives, or proper professional standards and conduct.

The fitness to practise of a nurse or midwife may be impaired by reason of one of six grounds set out in our governing legislation, which are misconduct, lack of competence, convictions or cautions, health, not having the necessary knowledge of English, or a findings by another regulatory or licensing body. In our guidance on different types of fitness to practise allegation we explain how our decision makers assess the different categories of case, and when an example of each case, such as a conviction, will be serious enough for us to become involved in a nurse or midwife’s practice.