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10 June 2019

A basic guide on fitness to practise at the Nursing and Midwifery Council

3 mins

All nurses, midwives and nursing associates are regulated by the Nursing and Midwifery Council (NMC). The NMC has a statutory duty to consider all referrals it receives. It can receive a referral from anybody including a patient or member of the public, an employer or manager, or bodies such as the police.

There are distinct stages in the Fitness to Practise procedure and it is crucial that individuals are properly aware of these and supported through the process.

Is there a case to answer?

If is it decided that a referral received is to be investigated further, the Investigating Committee will review the available information to decide whether there is a case to answer. The NMC aims to complete investigations within 25 weeks with a further 6 weeks to decide on the outcome.

If there is a case to answer, the Investigating Committee may recommend undertakings or refer the matter to the Fitness to Practise Committee, Conduct and Competence Committee or Health Committee. Each committee’s role is to determine whether fitness to practise is currently impaired taking into account guidance and standards set by the NMC.

We advise our clients to immediately start compiling their own written evidence once they are made aware of allegations against them. You are entitled to submit written representations to the Investigating Committee within 28 days. You should also consider which individuals would be able to offer valuable information and ensure that the Investigating Committee is aware of this.


Not all cases are decided at a full hearing. If your case is straightforward or you wish to admit to some of the allegations, it may be decided at a meeting. If a hearing is scheduled, you are entitled to be legally represented. As with other legal hearings, it will usually be held in public and witnesses may be required to attend to give evidence. The matter will ultimately be decided by a panel which will include members of the profession and ‘lay’ members. The NMC usually takes up to 26 weeks to prepare for a hearing. The hearing itself usually lasts between 2 days and 2 weeks.

It is advisable to seek advice from a solicitor and arrange legal representation for your hearing. Your legal representatives will ensure that your evidence is well presented and that you are fully prepared. They will also advise on important procedural matters such as admissibility of evidence which may affect the outcome of your case.

Sanctions and appeals

If a panel decides that your fitness to practise is impaired, it will then consider which sanction is most appropriate to apply. This includes cautions, conditions, suspension and strike offs. In rare cases the panel may decide to take no further action. Outcomes can be searched for indefinitely on the NMC website.

Once an outcome is given you will usually have 28 days (from the day after the date of the outcome letter) to appeal to the High Court. Your legal representatives will be able to advise on the grounds and prospects of such an action.

How can we help you?

We are here to help. If you have any questions for us, please get in touch below.