Registrants with complex needs benefitting from Fitness to Practise Health Pilot

Launched in January 2025, the pilot set up a multi-disciplinary team (MDT), including clinical and safeguarding advisers, to recognise registrants’ health needs earlier so that proportionate investigations are planned from the outset.

The MDT Case Clinic has now reviewed more than 100 cases. Analysis shows that, on average, cases reviewed by the Clinic are taking four months less to investigate than similar cases would typically take.

One registrant’s representative told the NMC that the pilot’s earlier clinical insight had made a meaningful difference: “It shows the NMC is able to pick up on the seriousness of members’ mental health conditions in some cases themselves without the representative asking them to consider it.”

What this means in practice

Cases reviewed by the pilot have involved registrants with a variety of complex needs – including mental health conditions and long-term neurological conditions.

The Clinic has supported these cases by coordinating with registrants’ treating clinicians, advising on the level of investigation needed, and ensuring requests for information are proportionate.

The Clinic has also helped to plan how registrants are contacted and supported throughout the process – including tailored communication adjustments that prioritise their wellbeing.

Next steps

The pilot is helping to strengthen early case planning, improve the experience for people with complex health needs, and build confidence among registrants and those supporting them.

Over the coming months, the NMC will continue developing this model. Building on feedback, the regulator will develop additional resources and training, with learning being shared more widely with FtP teams to make the process more compassionate and person-centred.

Paul Johnson, Deputy Director of Professional Regulation, said:

“We know the Fitness to Practise process can be even more challenging to engage with for registrants with complex needs. We are addressing this through targeted work focused on making our processes more compassionate.

“It’s encouraging that early data from our Health Pilot has been positive. Continuing to better understand people’s needs will be key to making FtP a faster and more supportive experience, particularly at the investigation stage.

“We know there is a long way to go before this becomes the norm for everyone. We will keep listening and learning from those involved in our processes to make this a reality.”

Editor’s note

Where we say cases are taking four months less to investigate, this is based on the time taken from a case being allocated to an investigator, through to the completed investigation report being sent to case examiners.

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