A fitness to practise hearing is the point at which a complaint, referral or investigation stops being correspondence and becomes a panel, a bundle of evidence and a decision read out in public. Whether it is a medical practitioners tribunal at the MPTS, an NMC Fitness to Practise Committee, an HCPC final hearing, a GDC practice committee, or the Fitness to Practise Committee of the GPhC or the GOC, the hearing follows the same shape: the panel decides what happened, whether it means your fitness to practise is impaired now, and what, if anything, should be done about it. This guide sets out, from the regulators' own hearing pages and sanctions guidance, read on 28 October 2026, what happens at each stage, what the panels say they weigh, and the practical preparation that puts you in the best position you can be in: the bundle, your statement, your witnesses, your reflective statement, and the dated evidence of remediation and CPD you take into the room. It is written for both situations a registrant is in: facing a hearing, and keeping CPD current so that the record is there if a concern is ever raised. It is not legal advice; take advice from your defence organisation, union, professional body or a solicitor about your own case.
Facing a hearing?
You have a notice of hearing or a letter saying the case is being referred to a tribunal or committee. The question now is what the panel will see from you: your account of the facts, your insight into what went wrong, and dated evidence of what you have done since. The sections below cover the stages, the evidence and the deadlines for each regulator.
Keeping CPD current?
No hearing, but you want your CPD on conduct, ethics, boundaries, records and candour to be complete, dated and ready for revalidation, renewal or audit. A continuous record on these subjects is the evidence a panel asks for if a concern is ever raised, and the same courses count for CPD now.
In short
- Every UK fitness to practise panel makes three decisions in order: are the facts proved, is your fitness to practise impaired now, and what sanction, if any, follows. If the facts are not proved, or impairment is not found, the case ends there.
- Impairment is judged today, not on the day of the events. The MPTS, NMC, GPhC, GOC and GOsC guidance all turn on the same questions: whether the conduct can be put right, whether it has been, and whether it is likely to happen again. Evidence of insight and remediation is what answers them.
- Prepare in this order: take advice; read the bundle and decide what you admit; write your statement and your reflective statement; gather dated evidence of remediation (course certificates, CPD record, supervision, audit); ask for testimonials from people who know about the concern; prepare your witnesses; send everything in by the deadline.
- Courses that speak to the hearing itself: Module on Insight, Module on Reflection and Course on Remediation (£49 and 1.5 CPD hours each), How to Deal with a Complaint or Investigation, Ethics for Healthcare Professionals and Professionalism for Healthcare Professionals (£79 each, £50 with Bulk Buy 10). Not sure which? Request a free 15-minute call.
From referral to hearing: the notice, the bundle and the deadlines
A hearing is listed after the regulator's screening stage has found a case to answer: the GMC's case examiners decide whether there is a realistic prospect of establishing that a doctor's fitness to practise is impaired, and whether the allegations are serious enough to warrant action on registration; the NMC's case examiners, the HCPC's Investigating Committee panel, the GDC's case examiners, the GPhC's Investigating Committee and the GOC's case examiners each apply their own version of that test. The GMC says it will refer a doctor to a medical practitioners tribunal hearing for serious or persistent departures from Good medical practice, and that it also considers whether failings are easily remediable, whether they have been remedied, and whether they are likely to be repeated. Those three questions follow you all the way to the hearing room.
What arrives next is a notice of hearing with the allegation as it will be put to the panel, and a bundle of the evidence the regulator will rely on: witness statements, records, correspondence and interview transcripts. The regulators then set dates for your evidence:
- HCPC: the HCPC shares all the information it plans to rely on at least 42 days before the hearing, and asks you to submit the information you want to rely on at least 28 days before. The Health and Care Professions Tribunal Service publishes the details of the hearing, including the allegation, 28 days before it starts.
- GDC: the Dental Professionals Hearings Service tells dental professionals to start preparing as soon as the GDC has disclosed its case, and says that after disclosure you have around three months to gather and disclose to the GDC the evidence you intend to rely on. A pre-hearing conference call sets the directions; not taking part may delay the hearing date or lead to a refusal of certain evidence requests.
- GMC and MPTS: the GMC writes to the doctor setting out the allegations; case management directions then fix the dates for exchanging witness statements and evidence before the tribunal. The GMC's guide for doctors says hearings can be held virtually or at the MPTS hearing centre in Manchester.
- NMC, GPhC and GOC: directions set at a case management or procedural stage fix the dates. The GOC's guide for registrants says the GOC sends you its witness statements, patient records, correspondence and interview transcripts, and that you must send the GOC your evidence in advance.
Two things in the bundle matter at once. The first is the exact wording of the allegation, because that is what you will be asked to admit or deny, and what your evidence of remediation has to answer. The second is the unused material, which the Dental Professionals Hearings Service describes as information the GDC does not plan to use as evidence; if any of it helps you, you ask for it to be added. Read both before you write anything.
Take advice before you respond to the notice. The GMC's guide for doctors says that "It is strongly recommended that you seek advice from a defence organisation or a solicitor"; the HCPC says that if you are a member of a union or a professional body, you should contact them. The deadlines above are the regulators' published figures on the day this guide was written; your own directions letter is the one that applies to you.
The three decisions every panel makes
Whatever the regulator calls its panel, it decides the same three questions in the same order, and it says so in its own guidance. The GPhC's hearings and outcomes guidance sets them out as whether the facts alleged have been found proved, whether the professional's fitness to practise is impaired, and whether any action should be taken. The GOC's hearings and indicative sanctions guidance lists the determination the committee must write: whether the facts alleged have been found proved; whether they amount to misconduct, deficient professional performance or adverse health; whether that ground leads to a finding that the registrant's fitness to practise is currently impaired; what sanction, if any, applies; and whether an immediate order should be imposed. The Health and Care Professions Tribunal Service describes the same sequence as facts, grounds, impairment and sanction, and says you have the right to give oral evidence on oath or affirmation at each of them.
| Stage | What the panel decides | What you can do |
|---|---|---|
| 1. Facts | Whether each allegation is proved on the balance of probabilities: the GMC describes the standard as "more likely than not that the alleged events occurred", and the GPhC and GOC use the same civil standard. If none of the facts are proved, the case ends. | Admit what is true at the start (an admission shortens the hearing and may mean witnesses need not give evidence), deny what is not, give your own evidence, call witnesses and question the regulator's. |
| 2. Grounds and impairment | Whether the proved facts amount to misconduct, deficient performance, a conviction or caution, or a health ground, and whether your fitness to practise is impaired today. The HCPTS describes a personal component (your insight, remedial steps, risk of repetition and current competence) and a public component (protecting the public, upholding standards and maintaining confidence in the profession). | This is where insight, the reflective statement, dated evidence of remediation, your CPD record and testimonials are read. The GPhC guidance says evidence from colleagues of steps taken to remedy the behaviour, and of current practice, is relevant to impairment and should not be left until the outcome stage. |
| 3. Sanction | If impairment is found, what restriction protects the public, starting from the least restrictive option. The MPTS guidance says "The main reason for imposing sanctions is to protect the public" and that "Sanctions are not imposed to punish or discipline doctors, but they may have a punitive effect." If impairment is not found, the GMC, NMC, GPhC and GOC panels can still issue a warning, and the GPhC can give advice. | Submissions on mitigation and on which sanction is proportionate, with the same evidence again: what has changed, what supervision or conditions you would accept, what your employer says about your practice now. |
The HCPTS says its panels consider facts, grounds and impairment together rather than retiring at each step, and that it is the discretion of the panel whether or not to break them into separate steps. The GOsC's Professional Conduct Committee decides facts first, then whether they amount to unacceptable professional conduct, professional incompetence or a relevant conviction, then sanction. The order is the same; only the labels change.
What panels weigh: insight, remediation and the risk of repetition
Impairment is judged at the date of the hearing, not the date of the events. The GOC's guidance puts it in one sentence: "The Committee must look forward, not back when determining impairment." The NMC says the events that led to a referral will have happened some time previously, and that evidence of the registrant's insight and any steps they have taken to strengthen their practice is central to deciding whether their fitness to practise is currently impaired. The NMC's decision makers are told to take into account three questions, and they are the questions to prepare against whichever regulator you are before:
- Can the concern be addressed?The MPTS guidance says remediation covers steps such as coaching, mentoring, training and rehabilitation, but that "there are some cases where a doctor's failings are difficult to remediate." The GPhC guidance says some conduct is so serious that the committee should not weigh evidence of insight and remediation, giving discriminatory behaviour and sexual misconduct as examples.
- Has the concern been addressed?The NMC's guidance says the steps should be relevant, in that they are directly linked to the nature of the concerns, measurable, and must clearly show that past failings have been objectively understood, appreciated and tackled. It names training courses, ideally with a practical element and some form of assessment, supervised practice targeted at the concerns, and reflective work in which the registrant gives examples of what they have learned.
- Is it highly unlikely that the conduct will be repeated?The GOC asks "whether it is likely to be repeated"; the MPTS lists "No evidence of repetition of similar behaviour since incident" as a factor; the NMC looks at whether problems continued to happen after the registrant was made aware of them.
- Is the insight real?The MPTS guidance says "Expressing insight involves demonstrating reflection and remediation", and that a doctor is likely to have insight if they accept they should have behaved differently, take timely steps to remediate and apologise, and show insight developing during the investigation and hearing. The GPhC says insight means the professional "can accept and understand that they should have behaved differently", and asks whether it is genuine and shown after the incident as well as during the hearing. The GOsC asks for a real reason to believe the osteopath has learned a lesson from the experience.
The NMC's guidance on whether a concern has been addressed is the fullest statement of what decision makers look for in insight, and it applies, in substance, across the regulators: whether the registrant recognises what went wrong, appreciates what could and should have been done differently, understands how to act differently in the future, understands the harm or risk of harm to patients and how colleagues may have been affected, and accepts their own responsibility without seeking to blame others or excuse their actions. It also asks whether the registrant accepted the concerns when first raised by their employer: insight that arrives early is read differently from insight that arrives at the hearing.
"Apologising for mistakes or failings should be encouraged", and an apology "may be taken into account as evidence" of insight and of compliance with the duty of candour.
NMC, Has the concern been addressed? (fitness to practise library)
The MPTS says the same from the other direction: "an apology by itself will not be treated as an admission of guilt", whether as to the facts or to impairment. The GPhC, GOC and GOsC guidance each add that cultural differences, English as a second language, ill health, disability and neurodiversity can affect how a professional expresses insight or an apology, and that panels must allow for that.
On testimonials, the regulators agree. The MPTS says the tribunal is "likely to place greater emphasis on testimonials that have been verified", and considers how long the author has known the doctor and any conflict of interest. The GPhC says references and testimonials are of use where they address remediation, reflection, insight or remorse, that generic character references are "unlikely to be directly relevant", and that verified testimonials carry more weight. The NMC's guidance gives more weight to testimonials from a manager or supervisor than to those from friends or colleagues, and says little, if any, weight should be placed on character references that lack informed comment on practice. The GOC says a letter which attests to the steps taken by the registrant to remedy the conduct is relevant to impairment, not only to sanction.
Regulator by regulator: what to expect at the hearing
GMC: a medical practitioners tribunal at the MPTS
The GMC investigates; the Medical Practitioners Tribunal Service hears. The GMC's page on referral says "The MPTS operates a public hearing service and their decisions are fully independent of our investigations." A doctor's fitness to practise can only be impaired by reason of misconduct, deficient professional performance, a criminal conviction or caution, adverse physical or mental health, a determination by another regulator, or not having the necessary knowledge of English. The GMC's guide for doctors says "Hearings are held in public, except when they are considering evidence about a doctor's health", that tribunals include "specially trained people, both medical and non-medical", and that the hearing can be virtual or at the MPTS hearing centre in Manchester.
The tribunal decides the facts, then impairment, then sanction, and the MPTS sanctions guidance (5 February 2024) is the document it works from at the third stage. The guidance says the determination "must show that it started by considering the least restrictive option", that where fitness to practise is not impaired the tribunal "cannot impose a sanction" but must consider whether to issue a warning, and that "The tribunal may wish to see evidence that the doctor has taken responsibility for, or has taken steps to mitigate, their actions." It lists evidence that the doctor keeps knowledge and skills up to date as a mitigating factor, and says a responsible officer's statement may cover current practice, practical steps taken, any apology and cooperation with the employer's enquiries, while adding that "Tribunals should not draw any adverse inference in cases where a statement from a responsible officer is not present." If the tribunal finds impairment it can take no action, agree to undertakings offered by the doctor at the hearing, put conditions on registration, suspend, or erase; if it finds no impairment it may still issue a warning. The GMC's guide says a sanction takes effect 28 days after the doctor receives the decision unless an appeal is lodged with the High Court or Court of Session within those 28 days, that suspension or erasure means the GMC withdraws the licence to practise, and that "Receiving a warning does not affect your entitlement to a licence to practise." Our guides to the MPTS hearing, writing a reflective statement for a GMC hearing and GMC sanctions go further.
NMC: the Fitness to Practise Committee
The NMC's Fitness to Practise Committee is made up of registered nurses or midwives and lay members, and it considers alleged impairment by reason of misconduct, lack of competence, a conviction or caution, insufficient knowledge of English, physical or mental health, or a finding by another regulator. The NMC says its hearings are held in public because it is accountable to the public, that a panel may hold all or part of a case in private to protect an alleged victim's anonymity or where confidential medical evidence is shared, and that health cases are heard in private. On impairment the NMC's page is clear: panels judge against the standards expected of someone ordinarily working at that level, not the highest possible level; a past breach does not automatically mean current impairment; and the panel considers what has happened since the breach or failure. That is where the three questions above, and the evidence that answers them, are read.
If the panel finds impairment it must first consider whether no further action is appropriate; if not, it can issue a caution order of between one and five years, a conditions of practice order of up to three years, a suspension order of up to 12 months, or a striking-off order, using the NMC's sanctions guidance. In health, lack of competence and English-language cases a striking-off order is not available at the first hearing; it can only be made where the registrant has been continuously suspended or under conditions for the previous two years, and interim orders do not count. The NMC's library says a sanction is "a sanction that is enough to achieve public protection", and that its purpose is to "make sure we protect patients, maintain confidence in the nursing and midwifery professions". Our guide to NMC sanctions covers each order; writing NMC reflective accounts covers the reflective form the NMC already asks you to use.
HCPC: a final hearing before the Health and Care Professions Tribunal Service
If the HCPC's Investigating Committee panel finds a case to answer, the allegation goes to a Conduct and Competence Panel (misconduct, lack of competence, a conviction or caution, or a determination by another regulator), a Health Panel, or an Investigating Panel (an incorrect or fraudulent register entry). The HCPC says it asks solicitors to prepare the case and act for it at the hearing, that the evidence may include a witness statement from the person who raised the concern, who may also attend, and that your case manager will write to you regularly about progress. For adjustments to document formats, contact the Tribunal Service team at least four weeks before the hearing; for an interpreter, a learning difficulty or mobility needs, raise it when you are first asked to attend.
The HCPTS's published stages of a final hearing run: preliminary matters (service, proceeding in absence, adjournment, amending the allegation, a private hearing, special measures for witnesses); the Hearings Officer reads the allegation and the Chair asks whether you admit any part of it; the HCPC Presenting Officer sets out the facts and calls witnesses, each examined by the HCPC, cross-examined by you, re-examined and then questioned by the panel; you give evidence on oath or affirmation and call your own witnesses; the HCPC states whether the facts amount to misconduct, lack of competence, ill health or conviction and refers to the relevant standards; the panel considers impairment, including your insight, remedial steps, risk of repetition and current competence, and the need to protect the public, uphold standards and maintain confidence in the profession; closing submissions from the HCPC and then from you; the panel retires in private, takes legal advice from the legal assessor and announces its decision; if impairment is found, submissions on sanction from the HCPC and then from you, and the sanction is announced; an interim order may follow with immediate effect; and you may appeal within 28 days of being served with the decision. The outcomes are no further action, a caution order (the register entry is marked "caution" for the duration of the order), a conditions of practice order (reviewed before it expires; "The Registrant is responsible for providing evidence of compliance with the conditions put in place"), a suspension order (reviewed before it expires) or a strike off order, after which the registrant can apply for restoration after five years. Our guides to what happens at an HCPC hearing and the HCPC fitness to practise stages go step by step.
GDC: a practice committee at the Dental Professionals Hearings Service
The GDC's case examiners can refer a case to a practice committee at the Dental Professionals Hearings Service, which the GDC describes as "an independent adjudication service". The three practice committees are the Professional Conduct Committee, the Professional Performance Committee and the Health Committee, drawn from fitness to practise panellists who are both dental professionals and lay members. The Professional Conduct Committee decides whether the allegation amounts to misconduct and, if so, whether that misconduct means the registrant's fitness to practise is impaired; hearings are open to the public and may be held in private where it is in the parties' interests, to protect the dental professional's personal life, or where publicity would prejudice the interests of justice. The GDC's updated Guidance for the Practice Committees, published 11 December 2025 and in effect from 6 January 2026, follows the chronological stages of a hearing, covers reasonable adjustments for registrants and witnesses, and "makes clear that sexual misconduct involving members of the dental team is as serious as cases involving patients".
The Hearings Service's preparation page tells you to "Start preparing for your hearing as soon as the GDC has disclosed its case to you." You receive a notice of hearing with the allegations and a hearing bundle of the GDC's evidence, and may also receive unused material. You tell your GDC contact as soon as possible if you want unused material added, object to documents, want to question GDC witnesses, or see a problem with the bundle. After disclosure you have around three months to gather and disclose the evidence you intend to rely on. The service encourages attendance: you can make oral opening and closing submissions, call and question witnesses and give evidence under oath; if you do not attend you can send written submissions, though the committee may not consider all of them. "An admission is when you agree with some, or all of the alleged facts set out in the notice of hearing", and admissions can shorten stage one. The hearing has two stages: a factual inquiry (facts, admissions, the GDC's case and yours), then current impairment and sanction (fitness to practise history, submissions on impairment and sanction, and the committee's determination). Written submissions should be typed, with headings, numbered points and bundle page references, and the party relying on a document is responsible for removing personal data such as patient details. The outcomes are no impairment and the case closed, a reprimand, conditions for up to 36 months with a review, suspension for up to 12 months with or without a review, or erasure; immediate conditions or suspension can be applied where required.
GPhC: the Fitness to Practise Committee
The GPhC's Fitness to Practise Committee decides whether a pharmacy professional is fit to practise; it operates independently of the GPhC and uses the GPhC's guidance when considering cases. A hearing is held by a three-person panel of a chair, a registered pharmacy professional and a lay member, with a committee secretary and a case presenter, and, depending on the case, a legal adviser, a clinical adviser, witnesses, the professional and their representatives. Hearings are held in public, may be wholly or partly private where the professional's interests outweigh the public interest, and must be private where they concern the professional's health. The committee decides whether the facts are proved on the balance of probabilities (more likely than not, not the criminal standard of being sure), whether fitness to practise is impaired, and whether any action should be taken. The GPhC's Good decision making: fitness to practise hearings and outcomes guidance (March 2024) calls insight and remediation "key factors", defines insight as the professional's ability to accept and understand that they should have behaved differently, defines remediation as taking steps to prevent a repeat of the conduct, and lists as relevant remorse or steps to put things right including an apology, demonstrated insight and actions taken to avoid repetition, honesty with the committee and cooperation with the investigation, and references and testimonials that address remediation, reflection, insight or remorse.
The outcomes are no action (the case closes and nothing is recorded on the register, which can apply even where impairment is found if there is no risk), advice (only where no impairment is found; not recorded), a warning (recorded on the register), conditions for up to three years (used where the professional may respond to retraining and supervision), suspension for up to 12 months, and removal for conduct fundamentally incompatible with registration, which cannot be used in a case relating solely to health; the committee can also agree undertakings where the professional admits impairment. The guidance says outcomes protect the public and the wider public interest and are not intended to punish. A written determination is added to the register entry, there are 28 days to appeal to the High Court, and the Professional Standards Authority may refer a decision it considers unduly lenient within 40 days. Our guide to what happens at a GPhC hearing and the GPhC fitness to practise stages go further.
GOC: the Fitness to Practise Committee
The GOC's guide for registrants, How Hearings Work, lists who is in the room: the Chair and Committee members, a legal adviser, a note taker and the hearings manager, a clinical adviser where the hearing concerns your health, the GOC's presenting officer, and your representative if you have one. Hearings take place in public, but health issues are considered in private and interim order hearings are always private. The GOC must prove the allegations on the balance of probabilities; if none are proved, proceedings stop. The Committee then considers whether there are grounds for impairment (misconduct, deficient professional performance, a criminal conviction or caution, or adverse health) and whether fitness to practise is currently impaired; if it is not, the Committee may take no action or issue a warning and proceedings stop; if it is, the Committee moves to sanction. You can make an opening statement, call witnesses, question the GOC's witnesses, address the Committee on the facts, impairment, sanction and any immediate order, make applications (an adjournment, an amendment to the allegation, a private hearing), give evidence and be questioned, and ask for a break at any point. The guide suggests bringing your CV and your CPD record, and written references from employers and colleagues, especially from people who know the facts.
The GOC's Hearings and Indicative Sanctions Guidance (revised November 2021, in effect from 20 December 2021) sets the test: the Committee considers "whether the conduct which led to the allegation is remediable", "whether it has been remedied" and "whether it is likely to be repeated", and "must look forward, not back when determining impairment". Where it finds no impairment it must state which remedial steps it took into account and why they mitigate recurrence. Remediation can take the form of "coaching, mentoring, or training"; the guidance refers to "demonstrating the timely development of insight", and says insight should be approached carefully where facts were denied and then found proved. The sanctions after a finding of impairment are no further action (reserved for exceptional circumstances), a financial penalty of up to £50,000 except in a health case, conditions for up to three years with a review, suspension for up to 12 months with a review, and erasure except in a health case; a warning is available where there is no current impairment, and an immediate order can accompany erasure, suspension or conditions. Our guide to what happens at a GOC hearing goes step by step.
GCC, GOsC and Social Work England
GCC (chiropractors). The Professional Conduct Committee must impose a sanction if it finds unacceptable professional conduct or professional incompetence proved; the GCC's page lists a formal warning that stays on file, conditions on registration such as supervision or further training, suspension, and removal from the register, and the Health Committee can impose conditions or suspend. The GCC says "The purpose of a sanction is not to punish the chiropractor but to protect the public" and that the committee follows its Guidance on Sanctions. Our guide to what happens at a GCC hearing covers the stages.
GOsC (osteopaths). The GOsC's Hearings and Sanctions Guidance (May 2025) describes the Professional Conduct Committee deciding the facts on the balance of probabilities, then whether they amount to unacceptable professional conduct, professional incompetence or a conviction of material relevance, then, after hearing further circumstances, character evidence and mitigation, the sanction. The committee looks for real evidence that the osteopath can review their conduct self-critically, has acknowledged fault, and has expressed contrition or apologised, and must allow for cultural differences in how insight and apology are expressed. The four sanctions are admonishment, a conditions of practice order of up to three years, suspension of up to three years with a review before it ends, and removal; the committee chooses the least severe sanction that adequately deals with the issues, and each takes effect 28 days after notice unless appealed. Our guide to what happens at a GOsC hearing goes further.
Social Work England. Final hearings are decided by adjudicators. If they decide a social worker's fitness to practise is impaired they may impose sanctions: advice (on the register for one, three or five years), a warning (up to five years, not reviewed, no restriction on practice), conditions of practice for up to three years, suspension for up to three years, or a removal order; no further action is published for one month. Social Work England describes conditions and suspension as protecting the public "while the social worker takes any necessary steps to remediate their fitness to practise". Our Social Work England courses page lists the courses for each concern.
The sanctions each panel can impose
The lists below are taken from each regulator's own page or guidance on the day of writing. Every one of them says the purpose is to protect the public and that the panel starts from the least restrictive option. No one can tell you in advance which a panel will choose; what you control is the evidence it has in front of it when it decides.
| Regulator and panel | If impairment is not found | If impairment is found |
|---|---|---|
| GMC: medical practitioners tribunal (MPTS) | No action, or a warning | No action; undertakings; conditions (up to three years); suspension (up to 12 months); erasure |
| NMC: Fitness to Practise Committee | Case closed | No further action; caution order (one to five years); conditions of practice order (up to three years); suspension order (up to 12 months); striking-off order |
| HCPC: HCPTS panel | Not well founded, case closed | No further action; caution order; conditions of practice order; suspension order; strike off order (restoration after five years) |
| GDC: practice committee | Case closed | Reprimand; conditions (up to 36 months, with review); suspension (up to 12 months); erasure |
| GPhC: Fitness to Practise Committee | No action, or advice | No action; warning; undertakings; conditions (up to three years); suspension (up to 12 months); removal |
| GOC: Fitness to Practise Committee | No action, or a warning | No further action; financial penalty (up to £50,000); conditions (up to three years); suspension (up to 12 months); erasure |
| GCC: Professional Conduct Committee | Allegation not proved | Formal warning; conditions; suspension; removal |
| GOsC: Professional Conduct Committee | Allegation not proved | Admonishment; conditions of practice order (up to three years); suspension (up to three years); removal |
| Social Work England: adjudicators | No further action | Advice; warning (up to five years); conditions of practice (up to three years); suspension (up to three years); removal |
How to prepare: a step-by-step list
The order below follows the order in which the panel will read your case. Each step produces something that goes into the bundle or into the room.
- Take advice, then diary the deadlines. Your defence organisation, union, professional body or solicitor first; then write down every date in the directions: the regulator's disclosure, your disclosure, witness statements, the pre-hearing call, the hearing itself. Missing a date can affect whether the hearing proceeds as planned and whether your evidence is admitted.
- Read the bundle against the allegation, line by line. Note which facts you accept and which you dispute, and the evidence for each. Ask for unused material that helps you, and object to documents that should not be there. Decide what you admit: an early admission of what is true is itself read as insight, and shortens the facts stage.
- Write your witness statement. Your account of the events, in order, with dates, referring to the bundle by page number, in plain words. It is your evidence at the facts stage, and you will be questioned on it. Keep it to what you know; what you have learned goes in the next document.
- Write your reflective statement. This is the document the impairment stage turns on. Follow the questions the panels say they ask: what went wrong and why; what you should have done; what harm or risk of harm there was to patients, and how colleagues were affected; what you accept as your own responsibility; what you have done since, with dates; what you would do now in the same situation; and what you have put in place so that it does not happen again. Our reflective statement guide sets out the structure, and the Module on Reflection works through it.
- Gather dated evidence of remediation. Match each item to the allegation it answers, in the words the regulators use: relevant, measurable, verifiable. Dated certificates for courses on the subject of the concern (boundaries with a patient or a colleague, honesty, records, confidentiality, consent, candour, communication, prescribing), your CPD record for the period since the concern, evidence of supervision, mentoring or audit, an apology made at the time, and a note of what you changed in your practice after each. A certificate on its own shows attendance; the reflection on it shows learning.
- Ask for testimonials from people who know about the concern. A manager, supervisor, responsible officer or clinical lead who has seen your practice since the events, who knows the allegation, and who can say what has changed, signed and dated, with their role and how long they have known you. The panels say verified testimonials from people in that position carry weight and generic character references do not.
- Prepare your witnesses, and prepare for theirs. Statements from anyone present at the events; a list of the questions you will put to the regulator's witnesses; an interpreter or adjustments requested in time (the HCPC asks for document-format adjustments at least four weeks before).
- Write your submissions. Typed, with headings, numbered points, bundle page references and, for the sanction stage, the conditions or undertakings you would accept and the evidence that they would work. Keep patient data out of what you file, or redact it.
- Keep your CPD and your practice running. The panel looks at what has happened since the events; a continuous CPD record, a job you are doing well, and an employer who can say so are all evidence. Time out of practice is, in the NMC's words, of limited relevance to whether a concern has been addressed.
- On the day. Attend if you can: the GOC says arrive at least 30 minutes early, the Dental Professionals Hearings Service says attendance lets you present your side and answer questions in person, and the HCPTS lists proceeding in your absence among the preliminary matters a panel can decide at the start. Dress and speak as you would for a court hearing; answer the question asked; and when you are asked about what went wrong, say what you have written in your reflective statement, in your own words.
Where a course fits
A course does three things in a hearing bundle. It is a dated action on the subject of the concern; it gives you the vocabulary of the standard you are said to have breached, so your reflective statement is written against the right standard; and the certificate is a CPD record entry for the same period. What the panel reads is the certificate, the date, and what you write about it. The course to take is the one on the subject of the allegation, with the three modules for the response itself. If the hearing is weeks away, finish the course before your disclosure date so the certificate is in the bundle.
Keeping CPD current: the other situation
The second reader of this guide has no hearing and wants to keep it that way. For them the point is the same evidence, built in advance: the GMC's revalidation, the NMC's 35 hours of CPD for revalidation, the HCPC's audit of a written profile, the GDC's enhanced CPD cycle, the GPhC's revalidation record and the GOC's CPD cycle all ask for a continuous, dated record of learning relevant to practice, with a note of how it changed what you do. CPD on the standards that give rise to referrals, which is to say conduct, honesty, boundaries with a patient or a colleague, records, confidentiality, consent, candour and communication, is the part of a CPD record that is read if a concern is ever raised, and it is the part with the smallest share of a working year's learning. Our two-hour courses on those subjects each give a dated certificate for the record, and the reflection you write for CPD is the same reflection a panel would read.
- DoctorsGMC courses
- Nurses and midwivesNMC courses
- HCPC professionsHCPC courses
- Dental teamGDC courses
- Pharmacy professionalsGPhC courses
- Optometrists and dispensing opticiansGOC courses
- ChiropractorsGCC courses
- OsteopathsGOsC courses
- Social workersSocial Work England courses
A free call, and the courses for the hearing stage
Not sure where to start?
A free 15-minute call with Dr Shehzad Iqbal
If you have a notice of hearing, or a letter saying your case is being referred, and you are not sure how to show insight, reflection and remediation, which courses fit the allegation, or how to deal with the investigation, request a free, confidential 15-minute call. Dr Shehzad Iqbal (MBBS, MRCS, MRCGP, Postgraduate Certificate in Healthcare Law and Ethics) is the author of the courses and the founder of Probity & Ethics. The call is about remediation and the courses; it is not legal advice and does not replace your defence organisation, union or solicitor.
Courses for the hearing itself
Three short modules are written for the response to a concern: insight, reflection and remediation, which are the three words every regulator's guidance above uses. Each is £49 for 1.5 CPD hours. Around them, the courses on dealing with a complaint or investigation, on ethics and on professionalism give the standards your reflective statement is written against. Each is £79 (£50 with Bulk Buy 10) for 2 CPD hours, online and self-paced, with a dated certificate, and Probity & Ethics is CPD certified by The CPD Certification Service.
Then the course on the subject of the allegation: Probity for honesty; Professional Boundaries for Clinicians or Ethical Boundaries with Patients and Colleagues for a boundary with a patient or a colleague, including a dual relationship; Professionalism in Documentation for records; Ensuring Confidentiality; Privacy, Consent and Chaperone; Duty of Candour; Effective Communication; Prescribing. The Bulk Buy offer is any 3 courses for £200, 5 for £300 or 10 for £500, so the subject course, the complaint course and the ethics and professionalism courses go in one order (the £49 modules are bought separately). Our chooser page, Which course do I need?, names the course from the wording of the allegation.
This guide is part of our Professional Misconduct hub, which brings together every Probity & Ethics guide and course on the subject.
Frequently asked questions
How long before a hearing should I start preparing?
From the day you are told the case is going to a hearing, and before that if you can. The regulators set deadlines that run back from the hearing date: the HCPC asks for the evidence you intend to rely on at least 28 days before the hearing, the Dental Professionals Hearings Service says a dental professional has around three months after disclosure to gather and disclose their evidence, and the GMC, NMC, GPhC and GOC set directions with dates for exchanging evidence. A course certificate, a reflective statement and a testimonial all take time to produce, and the panels say they give more weight to insight shown early than to insight that appears at the hearing itself, so start as soon as the referral is made.
Do I need a lawyer at a fitness to practise hearing?
You are entitled to represent yourself, and every regulator's hearing guidance explains how to do that: you can make opening and closing submissions, question the regulator's witnesses, call your own and give evidence on oath. The GMC's guide for doctors says it is strongly recommended that you seek advice from a defence organisation or a solicitor, and the HCPC and NMC say the same about your union or professional body. A hearing is a legal process with a legal assessor advising the panel, the regulator is represented by a lawyer, and the sanction can end your registration, so take advice from your defence organisation, union, professional body or a solicitor before you decide. This guide is about preparing the evidence; it is not legal advice.
What evidence of remediation helps at a hearing?
Evidence that is relevant to the concern, dated, and verifiable. The NMC's guidance on whether a concern has been addressed says the steps should be directly linked to the nature of the concerns, measurable, and show that the failings have been objectively understood and tackled; it names training courses, supervised practice, reflective work and testimonials from a manager or supervisor. The MPTS sanctions guidance says the tribunal may wish to see evidence that the doctor has taken responsibility for, or taken steps to mitigate, their actions, and that it places greater emphasis on testimonials that have been verified. In practice that means dated certificates for courses on the subject of the concern, a CPD record, a reflective statement that explains what you learned and changed, evidence of supervision or audit where that applies, and testimonials from people who know about the concern and have seen your practice since.
Can I still complete courses before the hearing?
Yes, and the time to do it is before the hearing bundle is finalised, so the certificates and your reflection on them go in as evidence. Our courses are online and self-paced, so a course can be completed within days of a referral, and the certificate shows the course title, the hours and the date. The panel will look at when the course was taken: a course completed soon after the concern was raised reads as insight developing early, which is what the MPTS, NMC, GPhC and GOC guidance all describe as carrying weight. A course completed the week before the hearing is still worth more than no course, but write honestly in your reflection about when and why you took it.
What sanctions can a fitness to practise panel impose?
It depends on the regulator, and each publishes its own list. A medical practitioners tribunal can take no action, accept undertakings, impose conditions for up to three years, suspend for up to 12 months or erase a doctor, and can issue a warning where fitness to practise is not impaired. An NMC panel can take no further action, issue a caution order of one to five years, a conditions of practice order of up to three years, a suspension order of up to 12 months, or a striking-off order. HCPC panels can impose a caution order, a conditions of practice order, a suspension order or a striking-off order. GDC practice committees can issue a reprimand, conditions for up to 36 months, suspension for up to 12 months or erasure. The GPhC's committee can give advice or a warning, agree undertakings, impose conditions for up to three years, suspend for up to 12 months or remove a registrant. The GOC's committee can impose a financial penalty of up to £50,000, conditions for up to three years, suspension for up to 12 months or erasure. The GOsC's and GCC's committees and Social Work England's adjudicators have their own lists, set out in the guide. Every regulator says the purpose of a sanction is to protect the public, not to punish, and no one can promise you which outcome a panel will reach.
Is CPD relevant to a fitness to practise hearing?
Yes, in two ways. First, the MPTS sanctions guidance lists evidence that a doctor keeps their knowledge and skills up to date as a mitigating factor, and the NMC and GOC guidance look at what the registrant has done since the events: a complete, current CPD record with learning on the subject of the concern is part of that picture. Second, the same courses count towards your CPD, revalidation or renewal with your regulator, so the work you do for the hearing is not wasted whatever the outcome. Keep your CPD record continuous through the investigation and the hearing period; a gap in it is one more thing the panel will notice.
Sources
This guide is based on the following regulator pages and documents, read on 28 October 2026. Your own notice of hearing and directions are the documents that apply to your case.
- GMC: Referral for a hearing at the MPTS
- GMC: Our fitness to practise processes: a guide for doctors (updated January 2025)
- MPTS: Sanctions guidance (5 February 2024)
- NMC: Fitness to Practise Committee
- NMC: Insight and strengthened practice
- NMC: Has the concern been addressed?
- NMC: What sanctions are and when we might use them
- HCPC: What happens if a concern about me goes to a hearing
- HCPTS: Stages of a final hearing and the download version
- HCPTS: Final hearings and What happens after a final hearing (factsheet)
- GDC: The Professional Conduct Committee
- GDC: Updated decision-making guidance for practice committees (11 December 2025)
- GDC: Dental professionals facing a concern and the Dental Professionals Hearings Service page "Hearing preparation for dental professionals"
- GPhC: What the Fitness to Practise Committee does
- GPhC: Good decision making: fitness to practise hearings and outcomes guidance (March 2024)
- GOC: How hearings work: a guide for registrants
- GOC: Hearings and indicative sanctions guidance (revised November 2021)
- GCC: Sanctions
- GOsC: Hearings and sanctions guidance (May 2025)
- Social Work England: Hearing outcomes
