Probity, Honesty and Integrity Remediation
Facing a concern about honesty, integrity, openness or the accuracy of information you have given? This guide explains what probity concerns can involve, why an error is not the same as dishonesty, how UK regulators approach insight and remediation in these cases, and what evidence may help show meaningful professional change.
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What is probity in healthcare?
Probity means being honest and trustworthy, and acting with integrity, in everything connected with your professional life. It covers what you tell patients and colleagues, what you write in clinical records, what you declare to employers, indemnifiers and your regulator, how you describe your qualifications and experience, how you handle money and conflicts of interest, and how openly you respond when something goes wrong.
Every UK healthcare regulator puts honesty at the centre of its core standards. The NMC Code asks nurses, midwives and nursing associates to act with honesty and integrity at all times (standard 20.2). The HCPC's standards of conduct, performance and ethics include a standard on being honest and trustworthy (standard 9). The GMC's Good medical practice (2024) contains a section on acting with honesty and integrity, covering communication, records, declarations, financial dealings and conflicts of interest. Other regulators express the same expectation in their own words.
Honesty and integrity are related, but not identical
Honesty is about truthfulness: not deceiving others, not making statements you know to be false, and not concealing what should be disclosed. Integrity is broader. It concerns adherence to the ethical standards of your profession. In Wingate and Evans v SRA [2018] EWCA Civ 366, a case often referred to in professional regulation, the Court of Appeal confirmed that a lack of integrity does not necessarily mean dishonesty. That distinction matters, because it affects both how a concern is framed and what remediation needs to address.
Common probity, honesty and integrity concerns
Probity concerns arise in clinical work, in employment and registration processes, in education and research, and occasionally in private life. They tend to fall into four groups.
Truthfulness in what you say or write
- DishonestyKnowingly stating something false or creating a false impression.
- Misleading informationStatements that are technically true but leave a misleading picture.
- Inaccurate documentationRecords that are wrong, incomplete or written after the event without being marked as such.
- Falsification of recordsEntries created or altered to show something that did not happen.
- Public statements and social mediaWhere accuracy, honesty or misrepresentation of professional status is in question.
Openness when things go wrong
- Failure to be openNot telling a patient or employer about an error, contrary to the professional duty of candour.
- Concealment of errorsActively hiding a mistake, near miss or its consequences.
- Failure to cooperateNot engaging honestly with an employer or regulatory investigation.
Declarations and representation
- Failure to discloseNot declaring a caution, conviction, restriction or investigation when required.
- Misrepresenting qualifications or experienceOverstating training, competence or seniority.
- CV and application concernsInaccurate employment history, references or dates.
- Financial and professional declarationsTimesheets, expenses, claims, sick leave and outside work.
Education, research and interests
- Examination or assessment irregularitiesSharing questions, unauthorised help or impersonation.
- Plagiarism and academic misconductPresenting others' work as your own, including in portfolios and CPD.
- Conflicts of interestUndeclared financial or personal interests affecting professional decisions.
The significance of any of these depends on the facts, the context, what the professional knew and intended, whether it was repeated, how they responded, and the standards and process of the relevant regulator. A late timesheet correction and a fabricated qualification are both "probity" issues, but they are nowhere near each other in seriousness.
Is every mistake a probity concern?
No. One of the most important distinctions in this area is between what went wrong and the state of mind behind it. The same outcome, such as an inaccurate record, can sit anywhere on this spectrum.
Genuine error
An honest mistake. The questions are what happened, why, and what stops it recurring.
Poor judgement
A decision that fell below expected standards, without an intention to mislead.
Lack of integrity
A failure to meet the ethical standards of the profession, which need not involve dishonesty.
Dishonesty
Conduct found to be dishonest, judged by the standards of ordinary decent people.
| Situation | What may need to be considered | Why the distinction matters for remediation |
|---|---|---|
| Genuine clinical error | What happened, why, and the systems around it | Remediation usually focuses on knowledge, skills and safeguards, not character |
| Poor judgement | Decision-making against professional standards | Focus on reasoning, escalation and seeking advice before acting |
| Failure to document | Accuracy, completeness and the circumstances at the time | Usually a record-keeping issue unless there is evidence of intent |
| Failure to disclose | Why the information was not disclosed, and what you understood was required | Misunderstanding a form and deliberately hiding a conviction lead to very different remediation |
| Misleading statement | Accuracy, what you knew at the time, intent and context | Where the statement was made knowingly, remediation must address honesty directly |
| Deliberate falsification | Honesty and integrity implications, and any risk to patients | Treated as a character concern, which is harder to evidence as remediated |
| Repeated conduct | Pattern, duration and risk of recurrence | A pattern shifts the focus to sustained change over time, not a single fix |
How dishonesty is decided
UK courts and regulators apply the two-stage test from Ivey v Genting Casinos [2017] UKSC 67. First, the decision-maker establishes what the person actually knew or believed about the facts at the time. Second, it asks whether, given that state of mind, the conduct was dishonest by the standards of ordinary decent people. The person does not need to have recognised that their conduct was dishonest by those standards.
The NMC's guidance for its panels (DMA-8, last updated July 2026) reflects this: panels consider what the professional knew or believed, the background circumstances and what was expected of them, and whether there is evidence of alternative explanations. As in most UK regulatory proceedings, the regulator must prove disputed facts on the balance of probabilities.
The same outcome can have very different regulatory implications depending on what happened, why it happened, whether it was deliberate, whether it was repeated, and how the professional responded.
Why are honesty and integrity so important in healthcare?
Healthcare runs on information that other people cannot easily check. Patients consent to treatment based on what they are told. Colleagues make clinical decisions from the records you write. Employers, indemnifiers and regulators rely on your declarations to decide whether you are safe to work. If that information cannot be trusted, the systems built on it stop working, whether or not any patient is harmed on a particular occasion.
That is why regulators treat honesty as a fundamental tenet of professional practice, and why dishonesty can affect public confidence even when it happens outside clinical work. Social Work England's impairment and sanctions guidance, for example, says dishonesty is likely to threaten public confidence both in professional practice and in private life, and that evidence of professional competence cannot mitigate serious or persistent dishonesty. The HCPC's revised sanctions policy, in effect from 2 March 2026, includes a specific section on dishonesty and addresses the duty of candour.
For doctors, the GMC explains that when it assesses concerns it considers factors including seriousness, context and the doctor's response, including insight and remediation. That framing is specific to the GMC; other regulators have their own frameworks, so read the guidance that applies to your profession rather than assuming one approach fits all.
How can a probity concern relate to fitness to practise?
A probity concern usually moves through a recognisable sequence, although the stages, names and decision-makers differ by regulator.
- ConcernRaised by an employer, patient, colleague, the police or through self-declaration
- Assessment or investigationLocal, regulatory, or both, sometimes at the same time
- EvidenceDocuments, statements, records and your response
- Insight and responseWhat you understand, accept and have done since
- Regulatory decisionMade by case examiners, a committee or a tribunal
A probity concern does not automatically mean that your fitness to practise will be found impaired. The process, the evidence and the decision-making framework depend on your profession and regulator. Many concerns are closed at an early stage, and some are resolved with advice or a warning. At the same time, findings of dishonesty are consistently treated as serious across UK regulators, and in some cases the public interest may require action even where a professional has taken genuine remedial steps.
For a broader explanation of how remediation fits into current impairment decisions, see how remediation relates to fitness to practise.
What is probity remediation?
The HCPC's sanctions policy has long described remediation as the steps a registrant takes to address concerns raised about their conduct, competence or health, and links successful remediation to insight and a reduced risk of repetition. Probity remediation applies that idea to honesty, openness and integrity.
It is harder than remediating a skills gap, and it is worth being honest about why. A clinical deficiency can be retrained and then assessed. A concern about honesty is a concern about character and trust, and regulators acknowledge that reformed character is more difficult to show with objective evidence. There is no single course or placement that "fixes" honesty. What can be shown is understanding, accountability, a changed approach to the situations where the problem arose, practical safeguards, and a track record of transparent conduct over time, verified by people who know about the concern.
In practice, probity remediation may involve demonstrating:
- a clear understanding of what happened
- acceptance of your own responsibility
- genuine insight into why it mattered
- structured reflection
- relevant, targeted learning
- changed behaviour and decision-making
- safeguards in the relevant situations
- evidence the issue has been addressed
- a reduced risk of recurrence
A structured approach to probity remediation
These seven steps apply the general remediation process to honesty and integrity concerns. Each builds on the one before it.
Understand the concern
What exactly is being alleged or questioned? Separate the facts alleged from any characterisation of them, such as "dishonest" or "lacking integrity", and note which applies.
Understand the professional standard
Identify the regulatory and professional standards engaged, in the version in force at the time of the events, and what they required of you.
Reflect on what happened
What happened, what contributed to it, and what could and should have been done differently? Include pressures and context without using them as an excuse.
Develop insight
Show you understand why honesty mattered in that situation, who was or could have been affected, and the effect on trust in you and in your profession.
Address the learning need
Choose education, supervision or mentoring that addresses the actual issue, such as candour, declarations, record-keeping or conflicts of interest.
Change practice
Put safeguards in place where the problem arose: how you complete declarations, correct records, escalate errors or manage interests.
Gather evidence
Collect objective evidence of the change from people aware of the concern, and keep it dated and organised.
Insight in probity remediation
"I made a mistake and I'm sorry" is rarely enough in a probity case, and describing deliberate conduct as a "mistake" can itself suggest limited insight. Meaningful insight usually involves understanding:
What happened
An accurate account, in your own words, that matches the evidence.
Your own role
What you did or failed to do, without shifting responsibility to others.
Why it was a problem
How the conduct departed from the standards of your profession.
The impact
On patients, colleagues, your employer and public trust, not just on you.
The standards involved
Which specific standards were engaged and what they require.
Contributing factors
What led you there, so the same pressures can be recognised early.
What you'd do differently
How you would handle a similar situation now, concretely.
Your safeguards
What you have put in place to reduce the chance of recurrence.
Two points from current regulator guidance are particularly relevant to probity. First, remorse focused on the consequences for yourself is unlikely to count as insight; Social Work England's guidance makes this point expressly. Second, both the NMC and Social Work England say that denying the facts is not necessarily a bar to demonstrating insight, although the NMC's guidance also shows that when and why a professional changes their position can matter. An admission made only after the evidence becomes undeniable is likely to be viewed differently from one reached through genuine reflection.
The NMC's guidance on whether a concern has been addressed emphasises that before effective steps can be taken, the professional must recognise the problem, which is why insight is treated as crucially important.
Reflection and insight are not the same thing
Reflection is the process. Insight is what the process should produce.
Reflection asks
- What happened?
- What did I learn?
- What could I have done differently?
- What will I change?
Insight shows
- Why the conduct was significant
- What my responsibility was
- What impact it had, or could have had
- What it tells me about my professional practice
- Why recurrence is now less likely
Reflection can contribute to insight, but a reflective statement on its own does not necessarily show that a probity concern has been addressed. It needs to be specific, consistent with the evidence, and supported by what you have actually done since.
Evidence of probity remediation
Because honesty is harder to demonstrate than a clinical skill, the quality and source of evidence matter even more in probity cases.
| Evidence | What it may demonstrate | In a probity case, look for |
|---|---|---|
| Relevant course | Targeted learning | Content on honesty, candour or the specific issue, not general CPD |
| Assessment | Knowledge gained | Results kept with the certificate and learning outcomes |
| Reflective account | Reflection and learning | Specific to the events, consistent with the evidence, free of blame-shifting |
| Supervision or mentoring | Supported development | Discussion of ethical decision-making, recorded by the supervisor |
| Workplace feedback | Behaviour and practice change | From managers who know the full details of the concern |
| Appraisal evidence | Ongoing development | Explicit discussion of the probity concern and progress since |
| Audit | Application of learning | Records, claims or declarations reviewed and found accurate |
| Action plan | Structured improvement | Measurable steps with dates, completed and verified |
| Updated procedures | Practical safeguards | How you now check declarations, correct records or declare interests |
| Competence assessment | Demonstrated capability | Relevant only where the concern also involves clinical practice |
| Professional reference | External evidence of change | Signed and dated, from someone aware of the allegations, speaking to current conduct |
No single type of evidence is automatically sufficient. Its relevance, quality and relationship to the concern matter. In probity cases, glowing references about clinical skill carry little weight on their own, because clinical competence does not answer a question about honesty. Evidence that speaks directly to your conduct, candour and judgement since the concern arose is far more useful.
For the general principles of remediation evidence across all concern types, see the remediation evidence guide.
Learning that may be relevant to probity concerns
Not everyone needs all of this. Start from the concern you are actually addressing and choose learning that matches it.
| If the concern involves | Learning that may be relevant |
|---|---|
| Dishonest or misleading statements | Probity and honesty; rebuilding trust; reflective practice |
| Inaccurate or altered records | Documentation and record-keeping; duty of candour; probity |
| Concealing an error or not being open | Duty of candour; insight; preventing repeated mistakes |
| Declarations, CVs or applications | Probity; professionalism and regulatory standards; fitness to practise |
| Financial conduct or conflicts of interest | Financial integrity; professional ethics |
| Academic or assessment irregularities | Probity; professional ethics; reflective practice |
| Social media or public statements | Social media professionalism; confidentiality |
Is completing a probity course enough?
A relevant course may form part of a remediation plan, but completing a course does not automatically show that a probity concern has been resolved. A course gives you knowledge. What a decision-maker is usually looking for is what you have done with that knowledge.
The NMC's guidance for its decision-makers, for example, asks whether course content is relevant and sufficiently comprehensive, gives more weight to courses with assessment, and gives more weight to reflection that shows how learning has been applied. In probity cases, that application is often about behaviour: how you now complete declarations, correct records, raise errors and handle conflicts.
How IRR Practice can support your learning
IRR Practice provides structured educational resources designed to help healthcare professionals address relevant learning and development needs, as one part of a wider remediation process.
Understand
Regulatory and professional concepts behind probity, candour and integrity.
Learn
Structured education matched to the specific concern you are addressing.
Evidence
A certificate and learning record to include in your wider remediation evidence.
IRR Practice does not determine regulatory outcomes and cannot guarantee that a regulator, employer or panel will accept a particular course or form of evidence.
Related learning
Insight
- What insight means to regulators and how it is assessed
- Recognising impact on patients, colleagues and trust
- Expressing insight without minimising
Structured CPD · 1.5 CPD ptsReflection and Reflective Practice
- Structured reflection on a specific concern
- Linking learning to changed behaviour
- Writing a focused, honest reflective account
Structured CPD · 1.5 CPD ptsRemediation
- What remediation involves and why it matters
- Building a relevant, measurable plan
- Gathering and presenting evidence of change
Structured CPD · 1.5 CPD ptsProbity for Healthcare Professionals
- Honesty and integrity in UK professional standards
- Declarations, records, conflicts and candour
- Reflecting on and addressing probity concerns
Structured CPD · 1.5 CPD ptsDuty of Candour
- The professional duty of candour and why it exists
- Being open when things go wrong
- Apology, explanation and escalation
Structured CPD · 1.5 CPD ptsRebuilding Trust
- How trust is damaged and how it is rebuilt
- Accountability with patients, colleagues and employers
- Showing sustained change over time
Structured CPD · 2 CPD ptsWhere the concern involves money, claims or outside interests, the Financial Integrity course may also be relevant. For a structured multi-course pathway, see the Probity and Professional Integrity programme.
How probity concerns may differ between UK regulators
Every regulator expects honesty, but each has its own standards, fitness to practise rules and guidance for decision-makers. Start with your regulator's page.
Common probity remediation mistakes
These are the patterns that most often weaken remediation in honesty and integrity cases.
- Taking irrelevant courses. A clinical update does not address a concern about a declaration.
- Collecting certificates without application. Volume is not evidence of change.
- Writing a generic reflection. A template account that could apply to anyone says little about you.
- Missing the actual concern. Reflecting on the clinical outcome rather than the honesty issue.
- Blaming others or circumstances. Context matters, but not as a substitute for personal responsibility.
- Focusing on outcome, not conduct. "No harm was caused" does not answer a question about honesty.
- Not showing what has changed. Understanding without practical safeguards is incomplete.
- Unexplained evidence. Documents with no explanation of how they relate to the concern.
- Borrowing another regulator's approach. What applies to a GMC case may not apply to an NMC or HCPC case.
- Waiting until the hearing. Late remediation tends to carry less weight than early, genuine action.
If you are facing an allegation of dishonesty
Allegations involving dishonesty, falsification, fraud or serious probity concerns can have significant regulatory consequences, including in some cases removal from the register. Educational remediation resources cannot determine how an individual case will be assessed.
If you are involved in an active investigation, hearing or regulatory proceeding, consider obtaining independent advice from your professional defence organisation, trade union or professional body, or a solicitor experienced in healthcare regulation, before you respond. How you frame your response, including any admissions, reflection and remediation, is best decided with that advice.
IRR Practice is an independent education provider. It is not a regulator and does not provide legal representation.
Probity remediation: frequently asked questions
What is probity in healthcare?
Probity means being honest and trustworthy and acting with integrity in all aspects of professional life, including communication with patients, clinical records, declarations to employers and regulators, financial dealings, conflicts of interest and openness when things go wrong.
What is probity remediation?
Probity remediation is the process of addressing a concern about honesty, openness or integrity and showing, through insight, reflection, relevant learning, changed practice and credible evidence, that the concern has been understood and is unlikely to recur.
What is a probity concern?
A probity concern is any question about a professional's honesty, openness or integrity. Examples include misleading statements, inaccurate or falsified records, failure to disclose required information, misrepresenting qualifications, concealing errors, academic misconduct and undeclared conflicts of interest.
Is every mistake a probity issue?
No. A genuine error or poor judgement is not the same as dishonesty. Whether conduct was dishonest depends on what the person actually knew or believed at the time and whether their conduct was dishonest by the standards of ordinary decent people. That is decided on evidence by the decision-maker.
What is the difference between honesty and integrity?
Honesty is about truthfulness and not deceiving others. Integrity is broader and concerns adherence to the ethical standards of your profession. The Court of Appeal in Wingate and Evans v SRA confirmed that a lack of integrity does not necessarily involve dishonesty.
What does insight mean in a probity case?
Insight means understanding what happened, your own role, why the conduct departed from professional standards, its impact on patients, colleagues and public trust, and what you now do differently. Remorse focused only on the consequences for yourself is unlikely to be treated as insight.
Can a course help with probity remediation?
Yes, where it is relevant to the specific concern. A course can provide structured learning on honesty, candour, declarations or record-keeping, which you can then reflect on and apply. It works best as one part of a wider remediation plan.
Is a course certificate enough to demonstrate remediation?
Usually not on its own. Decision-makers tend to look for relevant learning combined with reflection, insight, application in practice and evidence of change, particularly in probity cases where the concern is about conduct rather than knowledge.
What evidence can demonstrate probity remediation?
Useful evidence can include a relevant course with assessment, a specific reflective account, a completed action plan, supervision or mentoring records, appraisal discussion, audits of records or declarations, updated personal procedures, and references from managers who know the full details of the concern.
Does the approach differ between UK regulators?
Yes. The GMC, NMC, HCPC, GDC, GPhC, GOC, GOsC, GCC, Social Work England, SSSC and PSNI each have their own standards, rules and guidance. The core expectation of honesty is shared, but processes and terminology differ, so read your own regulator's current guidance.
Can remediation guarantee the outcome of a fitness to practise case?
No. Remediation is one factor among many, and in serious dishonesty cases the public interest may require action even where genuine remedial steps have been taken. Only the regulator or tribunal decides the outcome.
Should I obtain legal advice during a probity investigation?
If you are subject to an active investigation or hearing, it is sensible to seek advice from your defence organisation, union or a solicitor experienced in healthcare regulation as early as possible, and before responding formally.
Regulatory sources for this guide
This guide draws on current published standards, guidance and case law. Naming a regulator does not imply that it endorses IRR Practice or its courses.
Guidance changes. Always check the current version published by your regulator and take independent advice where appropriate.
- GMC Good medical practice (2024)In effect from 30 January 2024
- NMC The Code; FtP library DMA-8 and FTP-16DMA-8 updated July 2026; "Has the concern been addressed?" updated 25 March 2026
- HCPC Sanctions policy; Standards of conduct, performance and ethicsSanctions policy in effect from 2 March 2026
- Social Work England Impairment and sanctions guidanceLast updated 23 April 2026
- Case law Ivey v Genting Casinos [2017] UKSC 67; Wingate and Evans v SRA [2018] EWCA Civ 366Tests for dishonesty and integrity
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Last reviewed: September 2026