Blog: Fair, timely and proportionate - our approach to Fitness to Practise

Last month the Professional Standards Authority (PSA) published its 2025/26 performance review for the GCC, assessing our work across several areas including Fitness to Practise (FtP) standards.  

There are lots of positives we can take from this review with four out of five FtP standards met. Following a review of all closed cases from late 2025, the PSA acknowledged that we make reasonable and appropriate decisions when concluding and closing cases, conduct robust investigations and are able to identify and manage risk. The support we provide throughout an FtP case was also noted, singling out our sensitive case handling and the detailed process information and regular updates we provide to all parties. 

While we have made progress in handling cases promptly during the early stages of the FtP process, the findings were clear that there is more to do to speed up the timeframe from referral to final hearing.   

Since I joined the GCC as Director of Fitness to Practise almost one year ago, accelerating Fitness to Practise cases has been one of my priorities. Having worked in regulation across health and social care for over 20 years, with roles leading investigations and presenting cases, I understand that Fitness to Practise can be a stressful experience for all parties. It is paramount that we resolve concerns in a timely manner, which is why we have taken the following action:  

• Investing resources to strengthen our Investigating Committee and hearings team. 
• Changing the way we prepare case material to help resolve cases at the earliest opportunity .  
• Holding preliminary hearings and bringing all parties together to clarify any procedural or legal issues at an early stage to reduce the risk of the adjournment of a formal hearing. 

This work is making a difference. We expect to conclude 14 hearings in 2026, an increase from 9 last year, and we are clearing the number of cases awaiting a hearing. This means registrants and patients are waiting less time for an outcome, reducing the stress and uncertainty of a formal hearing.   

We recognise that we need to continue improving the timeliness of our fitness to practise processes. Alongside the improvements we have made this year we have a programme of additional changes which we think will help us prioritise the most serious cases and reduce our older investigations.    

The value of communication 

When I started in this role, it became clear that some of the concerns raised with the GCC about chiropractic care could be resolved through open, constructive communication between the chiropractor and patient.  

Dialogue can often help prevent concerns from arising in the first place. We find that a lack of communication between a chiropractor and a patient can lead to misunderstandings. This is why we also encourage patients who have a concern to first speak directly to their chiropractor. 

In some cases, mediation can be particularly helpful, giving both parties the opportunity to resolve appropriate concerns through dialogue at an earlier stage with an independent person guiding the conversation.  

To support early resolution, we have launched the independent Chiropractic Complaints Mediation Service (CCMS). Run by Nockolds Resolution, this pilot service provides chiropractors and patients with a structured, independent mediation process to encourage constructive dialogue and mutual understanding.  

They have helped thousands of patients and professionals resolve concerns at an early stage (through the Optical Customer Complaints Service) thus avoiding unnecessary escalation and supporting positive outcomes for all parties. I am pleased we can offer this service and encourage registrants to work with patients to reach a satisfactory resolution.  

The impact of this pilot service will be assessed over the next seven months and adjusted as necessary to ensure it meets the needs of registrants.  

I am passionate about protecting the public, but equally that registrants are treated fairly. This includes acting against unregulated and unregistered individuals and ensuring we have the most effective approach to enforcing the protection of title of chiropractor.  

Where there are concerns that a chiropractor is not meeting the standards set out in the Code of Professional Practice it is the GCC’s legal responsibility to investigate but we remain committed to doing this in a way that is fair, timely and proportionate.