16 April 2018

The HCPC’s Fitness to Practise Process explained

Fitness to Practise (FTP) proceedings can be both personally and professionally daunting for everyone concerned. We know because of the feedback we receive from those involved in the process and from talking to registrants and employers when we meet them at HCPC events. This article is intended to address some of these concerns by explaining simply and clearly what happens when a concern is raised, the types of issues we deal with and what support is available.

What is fitness to practise?

When we say a registrant is ‘fit to practise’, we mean that they have the skills, knowledge and character to practise safely and effectively. The vast majority of our registrants are doing just that, with only 0.64 per cent subject to FTP concerns. This is mirrored in the high levels of public trust and confidence enjoyed by professionals on our Register – 91 per cent in our most recent polling. 

Importantly, the process is not designed to punish registrants for past mistakes, it is there to protect the public from those who are not fit to practice.  This also includes acts by a registrant, which may affect public protection or confidence in the profession, or the regulatory process.


This may mean that they should not practise at all, or that they should be limited in what they are allowed to do. Some registrants make mistakes that they are unlikely to repeat. Our processes do not mean that we will pursue every isolated or minor mistake.

Who can raise a concern?

Anyone can raise a concern about a registrant, this includes the public, registrants themselves, employers and service users. The police can tell us about criminal proceedings against a registrant if they decide there is a pressing social need.

What constitutes a concern?

We consider every case individually. However, a registrant's fitness to practise is likely to be impaired if the evidence shows that they were dishonest, committed fraud or abused someone’s trust; exploited a vulnerable person; hid mistakes or tried to block our investigation; had an improper relationship with a service user; carried out reckless or deliberately harmful acts;  were involved in sexual misconduct or have been violent or displayed threatening behaviour.

What happens when a concern is received?

Every case is considered individually. HCPC review the concern to decide whether it’s an issue, we can deal with. If it is, we will open a case and assess the available information to decide whether it meets our Standard of acceptance (SOA). If the concern doesn’t meet our SOA, the case closes and there is no further action. If it does, HCPC will go ahead with an investigation. At any stage of the process we can apply for an interim order if we believe it will protect the public or the registrant themselves. This could prevent the registrant from practising or place them under conditions of practice until the case has been closed.

What happens when a concern is investigated?

We will gather other relevant information about the concern and once there is enough information, HCPC will draft a formal fitness to practise allegation. We send the allegation and the information we have gathered to the registrant. They then have 28 days to respond.

The investigating committee

The details are then passed to a HCPC Investigating Committee Panel. The Panel will decide whether there is a ‘case to answer’. The meeting is held in private, as is set out in the HCPC legislation, and their task is to look at the paper evidence and decide whether the allegation can be proven. The Panel can decide that they need more information, there is ‘no case to answer’ or there is ‘a case to answer’ – and will give reasons for their decision.

The hearing

If there is a ‘case to answer’, it will proceed to a hearing managed by the Health and Care Professions Tribunal Service (HCPTS).  At the hearing, the registrant or their representative will have an opportunity to challenge the allegations made by the HCPC. They can tell their side of the story, question the HCPC's witnesses, give evidence and call their own witnesses. The HCPTS panel carefully consider each case and make a decision on whether the facts are proved, whether the registrant’s FTP is currently impaired, on what grounds, and what (if any) sanction will be imposed. Each Panel is independent and includes a Partner, who is a representative from the profession of the registrant.

What powers do the panel have?

The panel can do a number of things:
• take no further action or order mediation
• caution you (place a warning against your name on the Register for between one to five years);
• set conditions of practice that you must meet (for no longer than three years);
• suspend you from practice (for no longer than one year); or
• strike your name from our Register (which means you cannot practise).

After the hearing

The HCPTS will send the registrant a copy of the Panel's decision. The registrant may appeal against the decision if they think it is wrong or unfair. An appeal must be lodged within 28 days of the hearing. Appeals are made directly to the High Court in England and Wales, the High Court in Northern Ireland or, in Scotland, the Court of Session.

Support and talk

We know FTP proceedings can be stressful. For this reason, we have a range of resources available to support registrants – this includes guides on what to expect, what the purpose of FTP is, adjournment information and scheduling processes.

You can also contact your professional body or union who will be able to assist further.

Find out more information:
What happens if a concern is raised about me?
The fitness to practise process – information for employers and managers
Standards of conduct, performance and ethics

28 March 2018

5 facts you need to know about the changes to Set 1 for paramedics

Acting Director of Policy and Standards Katherine Timms discusses the change to the threshold qualification level for entry to the Register for paramedics to degree level, and what it means for those on the register or looking to join.

On 21 March 2018 the HCPC Council agreed that the threshold level for paramedics should change from 'Equivalent to Certificate of Higher Education' to 'Bachelor degree with honours'. In basic terms this means that paramedics will eventually need a degree in order to gain entry to the HCPC Register and practice their profession. Following a consultation we concluded this was necessary to ensure that paramedics in the UK were trained to the depth required for contemporary practice.

However we realise that a change such as this can generate a lot of questions and some concerns. Below you’ll find the need-to-know facts about the changes, and how this effects current paramedics, students and those thinking of joining the Register. 

1. If you’re registered you will remain registered
The change to SET 1 does not affect the ability of paramedics to remain registered with us. This is because SET 1 is about the contemporary level of education and training required for entry to the Register and only applies to approved programmes.
All existing registrants will be able to remain registered with the HCPC. No top up education will be required of paramedics in order to remain registered.

2. If you’ve completed a HCPC approved qualification you can still apply
The change to SET 1 does not affect your ability to apply for registration with HCPC, even if you decide not to apply for registration until after SET 1 has changed. This is because SET 1 is about the contemporary level of education and training required for entry to the Register. It applies to approved programmes for registration going forward and is not applied retrospectively.

If you have been out of practice since you qualified, you may need to meet our returners to practice requirements before you register. You can find out more information here.

3. You can still apply if you’re completing an approved diploma
Any student who is currently enrolled on an approved programme - now or when the change is fully implemented on 1 September 2021 - will be eligible to apply for registration with us when they complete their programme.
Enrolled students do not need to have complete their approved programme by 1 September 2021. They can graduate after this date and still be eligible to register.

4. You may have to complete a degree if you wish to train as a paramedic in the future
We will be implementing the change to SET 1 as a phased approach. Students will still be able to start approved certificate, diploma and foundation degree level programmes up until 31 August 2021 and will graduate with eligibility to apply for registration when they finish their studies.
From 1 September 2021, only education programmes delivered at degree level or above will be approved to take on new students. From this date, you will need to enrol on to a degree level programme if you want to train to be a paramedic.

We anticipate that education providers will phase out their certificate, diploma and foundation degree level programmes between 2018 and 2021. Individual education providers will decide when to close approved certificate, diploma and foundation degree level programmes to new entrants. We expect the timelines to vary from provider to provider. We strongly recommend that you contact any providers you are considering applying to as soon as possible to find out their specific plans.

5. If you are waiting to start an approved course you will still be eligible to join the Register upon completion
There is no requirement for education providers to close approved certificate, diploma and foundation degree level programmes immediately. Individual education providers will decide when to close approved certificate, diploma and foundation degree level programmes to new entrants. We anticipate that education providers will phase out this provision at different times between now and September 2021. If you are considering deferring your place, we strongly recommend that you contact the provider as soon as possible as there may not be any guarantee that the programme will run in the next academic year.

The change to SET 1 is being implemented as a phased approach. Students will still be able to start approved certificate, diploma and foundation degree level programmes up until 31 August 2021 and will graduate with eligibility to apply for registration when they finish their studies.

To learn more about these changes click here.

09 February 2018

Speaking up when things go wrong: Discussing the Dr Bawa-Garba case

Michael Guthrie, HCPC’s Director of Policy and Standards talks about how the HCPC encourages registrants to discuss mistakes.

The case of Dr Hadiza Bawa-Garba, who was struck off by the General Medical Council after she was found guilty of mistakes in the care of a six-year-old boy who died of sepsis, has received widespread media coverage.

Health secretary Jeremy Hunt has since ordered an urgent review of medical malpractice cases, stating: "The only way we can reduce mistakes in the NHS is to learn from every single one, and the tragic case of Dr Bawa-Garba raises many important questions about how the health system supports staff to be open and transparent when things go wrong."

The HCPC recognises that cases like this can cause concern amongst registrants. However, it is important to remember that discussing when mistakes are made forms a key part of any health and care professional’s practice.

Standard Eight of our Standards of conduct, performance and ethics says that registrants need to be open and honest when something has gone wrong with the care, treatment or other services that they provide. This includes letting service users and carers know; apologising; and taking action to put matters right if they can. The standard also says that registrants need to support service users and carers to raise concerns and be helpful and honest in their responses to complaints.

The HCPC introduced this standard in 2016, following the introduction of a statutory duty of candour which some organisations in health and social care have to meet. The aim was to make a small, but important, contribution to creating a culture that supports professionals being open and honest with service users and carers about mistakes and errors and one which is open to, and acts on, feedback – both positive and negative.

The work that health and care professionals do is very often highly pressured and rarely risk free, and the vast majority of our registrants practise safely and effectively - sometimes in difficult circumstances. We recognise that sometimes mistakes happen. Our processes are designed to protect the public from those who are not fit to practise. We will, therefore, only act if a professional is found to have fallen below our standards and there are serious concerns about an individual's practise or behaviour.

As with any of our standards, we expect registrants to use their professional judgement. For example, some registrants will work in teams where it might be more appropriate for another professional to inform a service user or to make an apology. It is also important to remember that an apology is not an admission of guilt.

Speaking to colleagues, employers and service users about issues or mistakes is an important part of health care, and one which forms a vital part of the continued professional development of any health or care professional.

To learn more about the Standards of conduct, performance and ethics click here. 

Students can see our animated guide on being open when things go wrong here.

To read our response to the urgent review click here.