Fitness to practise · Remediation evidence

Evidence of Remediation: What UK Regulators Look For

A practical guide to building a remediation evidence portfolio: the documents that carry weight, what good looks like for each, how testimonials should be written, what to submit at each stage, and why the seriousness of the concern changes how much evidence counts.

Latest MPTS tribunal guidance 8 document types Stage-by-stage

Short answer: regulators look for evidence that you understand the concern, have addressed it, and are unlikely to repeat it. The most persuasive evidence is objective and independent: supervisor reports, audits of your own work, workplace assessments and informed testimonials, alongside assessed learning and honest reflection. Every item should link to the specific concern. How much difference it makes depends on how serious the concern is. The latest MPTS guidance says insight and remediation usually have more impact in less serious cases and less impact in the most serious ones.

Key takeaways

Evidence is judged for relevance and quality, not quantity.
The MPTS’s tribunal guidance, in force since 24 November 2025, says testimonials have limited, if any, relevance in sexual misconduct, dishonesty and violence cases.
Testimonials carry most weight when the author knows about the concern and describes your current practice.
HCPTS guidance says it is wrong to treat maintaining your innocence as a lack of insight.
At a review hearing, case law places a persuasive burden on you to show past impairment has been addressed.

First principle: evidence is weighed against seriousness

The same remediation evidence can make a large difference in one case and very little in another. The reason is seriousness. The MPTS published new Guidance for MPTS tribunals in September 2025, which came into effect on 24 November 2025. It sets out how tribunals should approach different types of concern, and it is explicit about this point.

Lower seriousnessHigher seriousness

Usually more impact

For lower-seriousness concerns, such as many clinical or communication issues, the guidance says evidence of insight and remediation will usually have more impact.

Usually less impact

For the most serious concerns, such as sexual misconduct, serious dishonesty or violence, the same evidence will usually have less impact, and testimonials have limited, if any, relevance.

This does not make evidence pointless in serious cases. It still matters for sanction, for any later review and for restoration. It does mean the evidence you gather should be realistic about the concern, and it is one reason the type of concern should shape your plan from the start. Our guide to where remediation has limits explains more.

The remediation evidence portfolio: eight document types

Most strong portfolios draw on the same eight types of evidence. For each one, here is what tends to make it persuasive, and the weakness decision-makers see most often.

Reflective statement

Strong: specific to the concern, takes responsibility without blaming others, explains impact on patients and trust, and shows what you now do differently, with examples.

Weak: a narrative of events, a generic template, or wording that reads as if someone else wrote it.

Learning certificates

Strong: course title clearly linked to the concern, the provider, date, CPD hours, learning outcomes, and whether there was a formal assessment.

Weak: a large stack of short, unrelated certificates.

Learning log

Strong: a short note for each piece of learning on what you took from it and how you have applied it in practice.

Weak: certificates with no explanation of what changed.

Remediation plan

Strong: objectives tied to each part of the concern, activities, evidence and review dates, ideally agreed with a supervisor, with progress recorded.

Weak: a plan written once and never updated.

Supervisor or mentor reports

Strong: from someone senior who knows the concern, has observed your practice over time, and describes specific improvements.

Weak: brief, general comments with no detail about what was observed.

Audits and workplace assessments

Strong: objective data on your own work over months, such as record audits, case-based discussions or observed procedures.

Weak: a single snapshot taken just before a deadline.

Testimonials

Strong: signed, dated, on headed paper, from managers or supervisors who know about the concern and describe your current practice.

Weak: general praise from friends or peers who are unaware of the allegations.

Health evidence, where relevant

Strong: up-to-date reports from treating clinicians or occupational health, showing insight into the condition and how it is managed.

Weak: old or vague reports that do not address current fitness to practise.

What makes a learning certificate carry weight

The NMC’s guidance on evidence that a concern has been addressed is specific. It looks at how long a course was and how much of it focused on the relevant concern, and it gives more weight to courses with practical elements and formal assessment. The GDC’s 2025 research found the same pattern from the decision-maker’s side: online courses completed in minutes were seen as weak evidence.

Before you choose a course, check that the certificate will show:

A title and learning outcomes that clearly match the concern
The CPD hours or points, and the date completed
That there was a formal assessment, and that you passed it
The provider’s name and, where relevant, CPD accreditation

Then add a short note to your learning log explaining what you learned and how you now apply it. The certificate shows you completed the course. The note shows it made a difference.

Core course

Fitness to Practise for Healthcare Professionals

Our most complete remediation course: 4 CPD hours and 40 scenario questions on impairment, insight, remediation and reflection, with a certificate when you pass.

£150 Enrol now See the full curriculum

Completing a course does not change or predict any regulator’s decision. Courses are educational and support your own reflection and development.

Testimonials: getting them right

Testimonials are often the most misunderstood part of a portfolio. Done well, they are some of the most valuable evidence you can provide. Done badly, they can carry almost no weight.

What decision-makers look for

The author knows about the concern. The NMC and HCPC both give more weight to references from people who are aware of the allegations. A referee who does not know cannot speak to whether you have addressed them.
The right author. The NMC gives more weight to managers and supervisors than to peers.
Specific, current observations, rather than general praise of your character.
Proper form. Signed, dated and on headed paper, with the author’s role and how long they have known your work.

A checklist for asking a referee

Tell them about the concern, in enough detail for them to comment honestly.
Ask them to confirm, in the testimonial, that they know about it.
Ask them to describe what they have observed in your practice, and when.
Ask them not to comment on the facts of the allegations, which they are unlikely to have witnessed.
Never draft it for them. It must be in their own words.

Know when testimonials count for less The MPTS’s 2025 tribunal guidance states that testimonials have limited, if any, relevance in cases involving sexual misconduct, dishonesty, or violent or abusive behaviour. In those cases, focus your evidence on insight, specific learning and objective evidence of change.

Insight is not the same as admitting everything

Many professionals worry that if they dispute an allegation, they will be seen as lacking insight. The HCPTS practice note on finding impairment, updated in August 2025, addresses this directly. It describes insight as understanding how and why something occurred and its consequences, and says insight is distinct from remorse. It also states that it is wrong to equate maintaining your innocence with a lack of insight.

In practice, this means you can dispute facts you genuinely believe are wrong and still show insight. You can do that by showing you understand why the concern matters, what the risks would be if it were true, and what you do to protect against them. Take advice on how to strike that balance in your own case. Our reflective account guide shows how to write it.

What to submit at each stage

The same portfolio grows over time, but each stage asks a slightly different question, so the emphasis changes. For the investigation stage in detail, see our investigation guide.

Stage	The question being asked	Evidence to emphasise
Response to allegations	Is there a realistic prospect of a finding of current impairment?	Early reflection, targeted learning already completed, employer support and supervision in place
Interim order hearing	Is there a risk that needs managing while the case continues?	Current role, supervision and safeguards, employer confirmation, health management where relevant
Final hearing: impairment	Is fitness to practise impaired now?	The full portfolio: insight, remediation, objective evidence of sustained change, informed testimonials
Final hearing: sanction	What is the least restrictive outcome that protects the public?	Mitigation, the remediation journey, and what supervision or conditions would work
Review hearing	Has the impairment been addressed?	Compliance with conditions, new evidence since the last hearing, updated reflection on the panel’s previous concerns

Review hearings: the burden is on you

If you have conditions or a suspension, a review hearing usually takes place before it ends. The approach is different from a first hearing. In Abrahaem v GMC (2008), the High Court described a “persuasive burden on the practitioner” at review. You need to show that you fully understand why your past practice was deficient, and that through insight, education, supervision or other achievement you have sufficiently addressed it.

In practice, a strong review portfolio usually includes:

Evidence you complied with every condition, with confirmation from supervisors or employers.
Updated reflection that responds directly to the concerns in the last panel’s decision.
New evidence since the last hearing, not the same documents again.
Evidence you kept your skills and knowledge up to date, particularly if you were suspended and not practising.
Testimonials from people who know about both the original concern and the panel’s decision.

Building the bundle: practical presentation

Good evidence can lose its impact if it is hard to follow. Panels read a lot of paper. Make yours easy to use.

Start with an index listing each document, its date and its page number.
Number every page and refer to page numbers in your written response, as the HCPC advises.
Group documents by concern, and put them in date order within each group.
Label each document with a short title explaining what it shows.
Remove patient-identifiable information, or follow the anonymisation pattern used in the allegations.
Keep originals and signed copies safe, and send what your adviser recommends, by the deadline.

Evidence that can backfire

Anything inaccurate or exaggerated. Overstated claims can create a new concern about honesty.
Testimonials from people who do not know about the concern, which can suggest you have not been open with them.
Reflection that reads as generic or ghost-written. Panels value your own voice, even if it is less polished.
Promises without delivery. MPTS sanctions guidance treats promising remediation and then not doing it as a sign of lacking insight.
Evidence that shows a breach of conditions, even a technical one. Read your conditions carefully and comply exactly.

A hypothetical example

Hypothetical example

A GP’s review hearing. A GP received conditions after concerns about prescribing high-risk medicines without adequate monitoring. Ahead of the review hearing, she builds her portfolio around the previous panel’s concerns. It includes an index, a reflective statement that responds point by point to the panel’s decision, and a certificate for an assessed course on safe prescribing with a note on what she changed.

It also includes six months of prescribing audits run by her clinical supervisor, monthly supervisor reports, confirmation from her practice manager that she complied with every condition, and testimonials from two partners who know the history.

Each document answers the review question: has the impairment been addressed? The decision remains the panel’s, but the evidence is relevant, objective and easy to follow.

Frequently asked questions

What evidence do regulators want for remediation?

Evidence that you understand the concern, have addressed it and are unlikely to repeat it. The most persuasive evidence is objective and linked to the concern: supervisor reports, audits, workplace assessments, informed testimonials, assessed learning and honest reflection.

How many CPD certificates should I submit?

There is no target number. Quality and relevance matter far more than quantity. A few assessed courses that clearly match the concern, each with a note on how you applied the learning, are worth more than many unrelated certificates.

Who should write my testimonials?

Ideally managers or supervisors who know about the concern and have observed your current practice. Testimonials should be signed, dated and on headed paper, and confirm that the author knows about the allegations.

Do testimonials help in dishonesty cases?

Much less. The MPTS’s 2025 guidance for tribunals says testimonials have limited, if any, relevance in dishonesty, sexual misconduct and violence cases. Focus on insight and specific evidence of change instead.

Can I show insight if I deny the allegations?

Yes. HCPTS guidance says it is wrong to equate maintaining your innocence with a lack of insight. You can show you understand why the concern matters and how you protect against the risk, without accepting facts you dispute.

What do I need for a review hearing?

Evidence that you complied with any conditions, updated reflection responding to the last panel’s concerns, new evidence since that hearing, and evidence you kept up to date. Case law places a persuasive burden on you to show the impairment has been addressed.

How should I organise my evidence bundle?

Start with an index, number every page, group documents by concern in date order, label each document, remove patient-identifiable information, and refer to page numbers in your written response.

When should I start gathering evidence?

As early as possible, with advice. Objective evidence of sustained change takes months to build, so starting early gives you something meaningful to show at each stage.