Fitness to practice - the importance of engaging with the process

As Director of Fitness to Practise, I regularly hear concerns about the impact that proceedings have on individual registrants. While I fully acknowledge it can be a stressful process, I also see the difference that the registrant’s engagement in proceedings can make.

Every complaint is heard by a panel of the Investigating Committee (IC), who consider if the registrant has a case to answer. If there is a possibility that (if the facts were proven) the registrant could be found guilty of Unacceptable Professional Conduct, the case is heard in full by the Professional Conduct Committee (PCC).

Although The Code contains a duty (B9) to cooperate with the GCC when asked for information, the level to which a registrant engages with proceedings can vary greatly. Two recent cases have elegantly illustrated the difference that engaging with the process can make to the outcome, and the experience, for the registrant.

In the first case, considered by the Investigating Committee, a registrant acknowledged that her record keeping for the patient in question was lacking in detail. She apologised and shared the steps she had taken to improve, including taking a course in clinical record keeping. The panel were satisfied she had shown insight, and that while her conduct fell below the expected level, the IC determined that a case for unacceptable professional conduct could not be proved, so they acknowledged her remorse and directed that the case should be closed with no action taken.

In the second case, this time a case to be determined by the PCC, record keeping was also a substantial part of the complaint. The registrant had emigrated between the time of the complaint and the hearing, so we held hearings early in the morning (to match her local timezone), provided additional support in view of the fact that she was representing herself and allowed extra time for responses due to the time difference.

The registrant and her defence expert attended the first hearing in December 2022, then chose to disengage from the hearings process. Despite correspondence from the GCC, she decided not to attend the conclusion of the reconvened proceedings in May and June and she was found guilty of unacceptable professional conduct, having failed to provide any insight, explanation or evidence.

Before deciding on a sanction, the panel wrote to her again. This time sharing their findings and giving her a final opportunity to put forward her response including any mitigation.

Once again she did not engage to take up the opportunity to provide a response or any mitigation. This meant that, as the PCC could not evidence insight or willingness to learn from her failures, the case could not be dealt with by way of conditions of practice and a more severe sanction was imposed. The registrant was suspended for 6 months. This will now likely impact on her registration to practise as a chiropractor in her current country. The sanction is still subject to appeal. 

While not wholly comparable, the difference in the outcome of these two cases is stark. By engaging fully, constructively, candidly and at an early stage in the proceedings, registrants can demonstrate insight and efforts to remediate which is likely to seen favourably by the Committee. 

I hope you would agree this must be a more positive outcome for all concerned.

Niru Uddin
Director of Fitness to Practise