Fitness to Practise Investigation
What happens when a healthcare regulator investigates a concern about your professional practice? A fitness to practise investigation is the part of a regulator's process for gathering and assessing information about a concern involving a registered professional.
An investigation does not itself establish that an allegation is proved or that fitness to practise is impaired.
Independent educational information for UK healthcare professionals. Not legal representation or regulator advice.
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What is a fitness to practise investigation?
A fitness to practise investigation is a regulatory process in which the relevant regulator gathers and assesses information about concerns relating to a registered professional.
Its purpose can include establishing what happened, what evidence exists, which professional standards may be relevant, whether there is a regulatory concern requiring further action, and whether the matter should progress under the regulator's procedures.
The HCPC describes it simply: once it has decided a concern is within its remit, it carries out an initial investigation to gather relevant information, often from a number of sources.
Investigation ≠ finding. Nothing is decided by the investigation itself.
What can lead to a fitness to practise investigation?
The existence of a complaint, incident or referral does not automatically mean a regulator will find impaired fitness to practise. As the HCPC explains, its process is concerned with current fitness to practise rather than simply punishing past mistakes.
How can a fitness to practise investigation start?
Depending on the regulator, concerns can come from patients and relatives, employers, colleagues, healthcare organisations, other regulators, the police or courts, professional bodies and other organisations, or from information the regulator identifies itself. Not every regulator accepts exactly the same referral routes.
Does every complaint become an investigation?
No. Regulators first assess whether the matter is within their remit, whether the person is registered, whether there is enough information, whether it raises a regulatory issue, whether their threshold is met and whether investigation is proportionate.
The HCPC triages concerns, carries out an initial investigation, then assesses the concern against its published threshold criteria; if the threshold is not met, the case is closed. The GDC separates initial assessment from a later assessment stage. There is no single UK procedure.
What happens during a fitness to practise investigation?
Depending on the regulator and the case, investigators may:
Gather information
Request relevant documents and information, often from several sources.
Review records
Consider relevant clinical or professional records.
Obtain statements
Seek accounts from the people involved.
Consider standards
Assess the concern against the regulator's standards.
Contact your employer
Some regulators may notify employers and request information directly.
Seek expert evidence
Independent clinical opinion where appropriate.
Consider context
Relevant circumstances, systems and workload.
Invite your response
Usually to formal allegations or specific questions.
Being told. The HCPC says it will usually tell you when it starts an investigation, but in rare cases it may notify you later, and will explain why. Some serious concerns, such as serious violence, sexual offences or serious dishonesty, can go straight to its Investigating Committee without an initial investigation.
What evidence can be considered in an FTP investigation?
| Evidence type | Potential relevance |
|---|---|
| Clinical records | What happened and the care provided |
| Workplace records | Professional context |
| Witness statements | Accounts of events |
| Correspondence | Communications and responses |
| Policies | Applicable workplace or professional procedures |
| Professional standards | Expected professional practice |
| Training records | Relevant learning |
| Assessments | Knowledge or competence |
| Reflection | Learning from the concern |
| Supervision | Supported development |
| Audit | Evidence of review and improvement |
| Remediation evidence | Steps taken to address the concern |
The relevance and weight of evidence depend on the regulator, the allegations, the stage of the case and the circumstances.
If a regulator tells you it is investigating
Identify the regulator
GMC, NMC, GDC, HCPC, GPhC, GOC or another. Processes differ.
Identify the stage
Screening, initial assessment, investigation, case examination or another stage.
Read the correspondence carefully
Identify the allegations, questions, deadlines and information requested.
Understand the relevant standards
The professional standards connected with the concern, as they applied at the time.
Preserve relevant information
Do not alter, delete or retrospectively change records.
Consider appropriate advice
For serious or complex matters, independent regulatory, legal or defence advice.
Consider learning needs
Whether remediation, education, supervision or assessment may be relevant.
How should you respond to an FTP investigation?
There is no universal template, and this page does not provide one. The appropriate response depends on the regulator, the allegations, the evidence, the procedural stage, the deadlines, your circumstances and whether other proceedings are ongoing.
A response may need to address factual matters, relevant context, documents, professional standards, learning, reflection, remediation and evidence of changed practice.
The HCPC gives a useful illustration of how one regulator approaches this. When it sends drafted allegations, it invites a written response within 28 days, can extend this by up to a further 28 days, and suggests registrants may want to include a timeline of events and, where relevant, any learning and actions taken to put things right. It also states that registrants are not obliged to respond, though a response helps its Investigating Committee, and that it will not share the response with the person who raised the concern.
Can remediation help during an FTP investigation?
Where relevant, professionals may take steps to address concerns while the regulatory process is ongoing. Depending on the circumstances, this may include targeted education, reflection, supervision, competency assessment, workplace feedback, audit, changes to practice, professional development and remediation planning.
The GMC's own explanation of its outcomes shows why this matters. It says it will only decide no further action is needed after investigating a doctor when the doctor has made a great effort to make sure they won't make the mistake again and does not pose a risk to patient safety. Its undertakings can include specific training or working under supervision.
Completing remediation does not automatically end an investigation or guarantee a particular regulatory outcome.
| Concept | Purpose |
|---|---|
| Investigation | The regulator gathers and assesses information |
| Response | The professional addresses the regulator's questions or concerns |
| Reflection | The professional considers what they have learned |
| Insight | The professional demonstrates understanding |
| Remediation | The professional takes steps to address the concern |
| Evidence | Demonstrates relevant learning and change |
| Legal or regulatory advice | Case-specific professional advice |
Can a regulator restrict practice during an investigation?
In some circumstances, yes, but the rules differ between regulators. Most regulators can seek interim measures, such as temporary conditions or suspension, where they consider it necessary to protect the public, or otherwise in the public interest, while a case is being considered. The GMC, for example, says that where a doctor, physician associate or anaesthesia associate may continue to pose a risk while it investigates, it can ask the MPTS to temporarily limit or suspend their practice.
An interim order is not a finding that allegations are proved. It is a temporary protective measure, and it is usually reviewed. The details are covered in the outcomes and sanctions guide.
How long does an FTP investigation take?
There is no single timeframe. Duration can depend on complexity, the number of allegations, the amount of evidence, witnesses and expert reports, cooperation, parallel proceedings, interim measures, regulator workload and hearing availability.
Published data helps set expectations. The GDC reported that its assessment stage took an average of 78 working weeks in 2025, though a streamlined route for single-patient clinical concerns averaged 16 weeks.
Your regulator's published process is more relevant than a generic internet timeframe. See the process guide for more detail.
Can an investigation end without a hearing?
Yes. Depending on the regulator and circumstances, an investigation may conclude with no further action, advice, a warning, undertakings, closure, referral to another stage, or a hearing. The GMC's options after investigating a doctor illustrate this.
No further action
Where the doctor has worked hard to prevent a repeat and poses no risk to patient safety.
Warning
Behaviour fell below the expected standard, but restricting practice is not necessary.
Undertakings
An agreement to improve, which may include training or supervision.
Referral to a tribunal
The MPTS holds a hearing to decide whether to restrict or remove the right to practise.
Source: GMC, What happens if we investigate your concern. The GMC uses a different model for physician associates and anaesthesia associates, where restrictions can be agreed without a tribunal. Other regulators' options differ.
What does "case to answer" mean?
It is a procedural decision about whether the evidence warrants the case progressing, not a final finding of guilt or impairment. The HCPC, for example, refers formal allegations that meet its threshold to its Investigating Committee, which decides whether there is a case to answer. More detail is in the process guide.
Investigation or hearing: what is the difference?
| Investigation | Hearing |
|---|---|
| Information is gathered and assessed | A formal decision-making stage, where applicable |
| Evidence is developed | Evidence may be tested and considered |
| The professional may be asked for information | The professional may be represented and heard |
| May conclude without a hearing | May determine the regulatory outcome |
| Procedure varies by regulator | Procedure varies by regulator |
How FTP investigations differ between UK regulators
Common mistakes to avoid during an investigation
- Ignoring correspondence.
- Missing a deadline. Ask for more time early instead.
- Providing irrelevant information.
- Giving inconsistent accounts.
- Altering records retrospectively. This can create a new, serious concern.
- Sharing patient information unnecessarily.
- Treating a certificate as the entire remediation strategy.
- Reflection without genuine analysis.
- Not understanding the relevant standard.
- Assuming it works like another regulator.
- Assuming investigation means a finding.
- Waiting until a hearing to consider learning needs.
If you are currently under investigation
The information on this page is general educational information. It is not legal representation or case-specific regulatory advice.
Depending on the seriousness and circumstances, consider obtaining advice from a regulatory solicitor, a professional defence organisation, your union where applicable, or another appropriately qualified adviser.
Please do not send sensitive case information to IRR Practice to obtain generic educational guidance.
Structured learning during an investigation
IRR Practice courses are educational resources that can form one documented part of your response. They do not guarantee any regulatory outcome.
Dealing with a Complaint or Investigation
- Responding to a referral
- Managing the process and its pressure
- Engaging constructively
Structured CPD · 2 CPD ptsFitness to Practise
- How investigations work
- Current impairment explained
- Where remediation fits
Structured CPD · 3 CPD ptsReflection and Reflective Practice
- Structured reflection on a concern
- Genuine analysis, not description
- Linking learning to practice
Structured CPD · 1.5 CPD ptsRemediation
- Starting remediation early
- Building a remediation plan
- Presenting evidence of change
Structured CPD · 1.5 CPD ptsFrequently asked questions about FTP investigations
What is a fitness to practise investigation?
It is a regulatory process in which the relevant regulator gathers and assesses information about concerns relating to a registered professional. It does not itself establish that allegations are proved or that fitness to practise is impaired.
What happens during an FTP investigation?
The regulator may gather documents and records, obtain statements, contact employers, consider the relevant standards, seek expert evidence, consider context and invite your response before decision-makers consider the case.
Why might a healthcare professional be investigated?
Concerns about clinical practice, competence, conduct, probity, medication, documentation, confidentiality, boundaries, performance, or criminal and other regulatory matters, depending on the regulator's grounds.
Does every FTP complaint lead to an investigation?
No. Regulators first assess whether a concern is within their remit and meets their threshold. Many concerns close at this stage.
What evidence can a regulator consider?
Clinical and workplace records, witness statements, correspondence, policies, standards, training records, assessments and, where relevant, reflection, supervision, audit and remediation evidence.
What happens when a regulator contacts you about an investigation?
You will usually be told the concern and what information is requested, with any deadline. Read it carefully, identify the stage, preserve records and consider advice before responding.
Do I have to respond to a fitness to practise investigation?
Requirements differ between regulators and stages, so read your regulator's correspondence and rules and take appropriate advice. The HCPC, for example, says registrants are not obliged to provide information in response to allegations, but that a response helps its Investigating Committee.
How long does an FTP investigation take?
There is no single timeframe. It depends on complexity, evidence and the regulator. GDC data for 2025, for example, shows an average of 78 working weeks for its assessment stage. Check your regulator's published data.
Can an FTP investigation end without a hearing?
Yes. Depending on the regulator, it may end with no further action, advice, a warning or undertakings. The GMC, for example, can take no further action, issue a warning, agree undertakings or refer to a tribunal.
What does "case to answer" mean?
It is a procedural decision about whether the evidence warrants the case progressing. It is not a final finding of guilt or impairment.
Can remediation be undertaken during an FTP investigation?
Yes, where relevant. Targeted learning, reflection, supervision and evidence of changed practice can be relevant to decisions. It does not guarantee any outcome.
Can a regulator restrict or suspend practice during an investigation?
In some circumstances, yes, through interim measures, where necessary to protect the public or otherwise in the public interest. The rules differ by regulator, and an interim order is not a finding.
Sources for this guide
Naming a regulator does not imply that it endorses IRR Practice or its courses.
Last reviewed September 2026. Always check your regulator's current guidance.
- HCPC What our investigation would involvePage updated 7 July 2025
- GMC What happens if we investigate your concernCurrent published version
- NMC FtP library: investigations and examining casesFTP-7 updated 25 March 2026
- GDC Fitness to Practise Statistical Report 2025Published June 2026
Understand your investigation and your next steps
Fitness to practise investigations can involve complex evidence and regulator-specific procedures. Start by identifying the regulator and stage of the process, then explore the information most relevant to your situation.
More from the IRR Practice blog
Practical articles on fitness to practise, insight, reflection, remediation and each UK regulator.
Dr Anthony Whitfield
Writes for IRR Practice on professional standards, fitness to practise, insight, reflection and remediation for UK healthcare professionals.
Last reviewed: September 2026