What Is Probity and Why Does It Matter?
Probity means honesty, integrity, and uprightness. In healthcare, probity is the foundation of the trust that patients, colleagues, employers, and the public place in healthcare professionals. Every UK healthcare regulator places probity at the centre of its professional standards:
- The GMC — Good Medical Practice states that doctors must be honest and trustworthy in all professional and personal dealings. Domain 4 (Maintaining Trust) covers probity, financial conduct, and honesty in all communications
- The NMC — the Code requires nurses, midwives, and nursing associates to act with honesty and integrity at all times, be truthful, and uphold the reputation of the profession
- The GDC — Standards for the Dental Team require dentists and dental care professionals to be honest and act with integrity
- The GPhC — Standards for Pharmacy Professionals require pharmacists and pharmacy technicians to demonstrate honesty and integrity
- The HCPC — Standards of Conduct, Performance and Ethics require all registrants to be honest and trustworthy
When a healthcare professional acts dishonestly, they breach the very foundation on which their professional relationship with patients and colleagues is built. This is why regulators treat dishonesty differently from clinical errors — a clinical mistake may reflect a gap in knowledge that can be filled, but dishonesty suggests a deficiency in character that is far harder to address.
Clinical errors can usually be remediated through training, supervision, and updated knowledge. Dishonesty is a character issue. Regulators must be convinced not just that you have learned something new, but that you have fundamentally changed as a person. This is why remediation for dishonesty requires deeper, more sustained evidence than for any other type of fitness to practise concern.
Common Types of Dishonesty in Healthcare
Dishonesty in healthcare takes many forms. Some are immediately obvious; others are more subtle but equally serious in the eyes of a regulator.
Altering, fabricating, or backdating entries in medical records. This includes recording observations that were not made, documenting medications that were not administered, and amending records after an incident to conceal what happened. Record falsification is treated as extremely serious because it directly endangers patient safety and undermines the reliability of the entire medical record.
Falsifying timesheets to claim payment for shifts not worked, inflating hours, or submitting fraudulent expense claims. NMC fitness to practise data shows this is one of the most common forms of dishonesty leading to striking off. Even relatively small amounts of money can result in erasure because the dishonesty itself — not the amount — is what matters.
Providing false information to patients about their diagnosis, treatment, or prognosis. Misleading colleagues about clinical handovers. Lying to an employer about your qualifications, experience, or registration status. Each instance is assessed on its own merits, but a pattern of lying demonstrates a fundamental integrity problem.
Lying to your regulator during an investigation is treated as an aggravating factor that dramatically increases the severity of the likely sanction. Even if the original concern was relatively minor, dishonesty during the investigation process can elevate a case from one that might have resulted in a warning to one that results in erasure. Your regulator expects complete honesty at every stage of the process.
Falsely claiming qualifications, experience, or competencies that you do not possess. This includes fabricating degree certificates, exaggerating your experience on job applications, and claiming to hold registrations or accreditations that you do not have.
Taking medications, controlled drugs, or equipment from the workplace for personal use or supply. Cases involving controlled drugs are treated particularly seriously due to the risk to patients and the potential criminal implications.
Failing to declare criminal convictions, cautions, or ongoing investigations to your regulator. Failing to disclose conflicts of interest. Failing to be open about errors or adverse incidents — a breach of the duty of candour. Omission can be just as dishonest as commission.
A healthcare professional found to have acted dishonestly is always going to be at severe risk of having their name erased from the register. A professional who does not appear before the panel to demonstrate remorse, insight, and an undertaking that there will be no repetition, effectively forfeits the small chance of a lenient outcome.
The Legal Test for Dishonesty
The legal test for dishonesty in fitness to practise proceedings follows the Supreme Court's ruling in Ivey v Genting Casinos (2017). The test has two stages:
- Subjective stage — the panel first establishes what the professional actually knew or believed about the facts at the time of the alleged conduct
- Objective stage — the panel then assesses whether that conduct would be considered dishonest by the standards of ordinary, decent people
Importantly, there is no requirement that the professional themselves recognised their behaviour as dishonest. If an ordinary, decent person would consider the conduct dishonest based on what the professional knew at the time, then a finding of dishonesty can be made.
How to Demonstrate Remediation for Dishonesty
Remediating dishonesty is exceptionally difficult, but it is not impossible. The key is to start early, go deeper than you think is necessary, and provide evidence that demonstrates genuine, sustained change in your character and values. Here is what regulators and tribunal panels look for.
- Genuine insight — not just acknowledging that you were dishonest, but demonstrating a deep understanding of why you acted dishonestly, the harm it caused or could have caused, and why honesty is essential to professional practice
- CPD in probity and ethics — completing accredited courses that specifically address probity, honesty, and ethical standards. Our Probity for Healthcare Professionals course is designed for exactly this purpose
- Deep reflective writing — reflective accounts that go beyond surface-level acknowledgment and explore the root causes of your behaviour, what you have learned about yourself, and how you have changed
- Evidence of sustained behavioural change — testimonials from colleagues, supervisors, or employers who can speak to your honesty and integrity since the incident
- A clear explanation of what has changed — the panel needs to understand not just that you are sorry, but what is different now. What circumstances have changed? What personal insights have you gained? What safeguards have you put in place?
- Full engagement with the regulatory process — cooperating fully, attending hearings, and being completely truthful throughout
CPD Courses for Dishonesty and Probity Concerns
CPD Courses for Probity and Dishonesty Cases
- ✓ Probity for Healthcare Professionals Enrol Now →
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- ✓ How to Ensure a Mistake Will Not Be Repeated Enrol Now →
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Facing a Dishonesty Allegation? Start Your Remediation Now
Dishonesty cases carry the highest risk of erasure. Our Probity course and Ethics courses provide the documented CPD evidence that demonstrates you understand why honesty matters and what you have done to change.
Enrol in Probity Course →Frequently Asked Questions
What counts as dishonesty in healthcare fitness to practise?
Dishonesty includes any action or omission that an ordinary, honest person would consider dishonest. Common examples include falsifying records, fabricating timesheets, lying to patients or colleagues, plagiarising research, fraud, theft of medications, falsely claiming qualifications, and failing to disclose criminal convictions to your regulator.
Why do regulators treat dishonesty more seriously than clinical errors?
Regulators view dishonesty as a fundamental character flaw that undermines professional trust. Clinical errors can be addressed through training, but dishonesty suggests an integrity deficiency that is harder to remediate. GMC data consistently shows dishonesty as the highest category of complaints. A professional found dishonest is always at severe risk of erasure.
Can you be struck off for dishonesty even if no patient was harmed?
Yes. Regulators can strike off professionals for dishonesty even without direct patient harm. Dishonesty undermines public confidence in the profession, which is a separate overarching objective of fitness to practise proceedings alongside patient protection.
What is the legal test for dishonesty in fitness to practise?
The test follows the Ivey v Genting Casinos ruling (2017). First, the panel establishes what the professional knew or believed at the time. Second, it assesses whether that behaviour would be considered dishonest by the standards of ordinary decent people. The professional does not need to have recognised their behaviour as dishonest.
Which CPD course should I take if I am facing a dishonesty allegation?
Our Probity for Healthcare Professionals course is specifically designed for dishonesty and probity cases. Combined with our Ethics and Ethical Standards course and Professional Ethics Course, these form the core of a remediation portfolio. Our Bulk Buy offer (10 courses for £500) provides comprehensive coverage.
Is it possible to remediate dishonesty in a fitness to practise case?
Yes, but it is exceptionally difficult. It requires demonstrating genuine insight into why the dishonesty occurred, completing CPD courses in probity and ethics, providing deep reflective writing, and presenting evidence of sustained behavioural change over time. Starting remediation early is critical.
What is the difference between dishonesty and a probity failure?
Probity is the broader concept meaning honesty, integrity, and uprightness. Dishonesty is a specific type of probity failure. Other probity failures include conflicts of interest, failure to maintain financial probity, and failing to be open when things go wrong. Deliberate dishonesty carries the greatest risk of erasure.
What happens if I am dishonest during a regulatory investigation?
Being dishonest during an investigation is an aggravating factor that significantly increases the likely severity of sanction. Even if the original concern was minor, dishonesty during the process can elevate a case to erasure. Always be truthful with your regulator.
Do CPD certificates in probity help demonstrate remediation for dishonesty?
Yes. CPD certificates demonstrate engagement with professional standards around honesty. However, certificates alone are not enough. You must combine them with reflective writing that shows genuine understanding of why honesty matters and how you have changed. Our Probity course provides both the certificate and the reflective material.
Can dishonesty outside of work lead to fitness to practise proceedings?
Yes. Financial fraud, benefit fraud, tax evasion, shoplifting, and dishonesty in personal matters can all trigger fitness to practise proceedings. Good Medical Practice and the NMC Code apply to conduct outside the workplace when it raises concerns about integrity and trustworthiness.
How long does a probity-related fitness to practise case take?
Dishonesty cases can be among the longest to resolve, often taking longer than typical investigations due to complex evidence-gathering. Use the time to build your remediation portfolio with CPD courses, reflective writing, and evidence of behavioural change.
What sanctions can be imposed for dishonesty?
Sanctions range from a warning through conditions of practice and suspension to erasure. For deliberate, premeditated, or repeated dishonesty, erasure is the most likely outcome. However, where a professional demonstrates exceptional insight and meaningful remediation, lesser sanctions are possible.
This article is for general informational purposes only and does not constitute legal or professional regulatory advice. If you are facing a dishonesty or probity allegation, seek independent legal advice from a specialist regulatory solicitor and contact your medical defence organisation or professional body without delay.