Outcomes · Registration

Can a Fitness to Practise Concern Affect Your Registration? Possible Outcomes Explained

What each outcome means for your work, what appears on the public register and for how long, what employers and overseas regulators can be told, how to appeal, and why a decision can also be challenged as too lenient.

Reviewed October 2026 against GMC, NMC, HCPC, GDC and PSA policy and legislation

Publication periods Appeal rights PSA appeal data

Short answer: yes, a fitness to practise concern can affect your registration, but most do not. Many concerns close at screening or investigation with no action or advice. Where action is taken, it ranges from a warning or agreed undertakings, through a caution or conditions on your practice, to suspension or removal from the register. Each outcome is published for a set period, and some are disclosed to employers and overseas regulators for much longer. You can appeal hearing decisions to the High Court, and the Professional Standards Authority can also appeal decisions it considers insufficient to protect the public.

Key takeaways

An outcome has three effects: on your work now, on the public register, and on what can be disclosed later.
Publication periods differ by regulator and outcome, from 12 months to 10 years on the public record.
At the GMC, historical sanctions are usually disclosed to current employers and overseas regulators indefinitely.
Health information is protected from publication at the GMC, NMC and HCPC.
Decisions can be challenged in both directions: by you if too severe, and by the PSA if too lenient.

Our fitness to practise guide introduces the outcomes and how panels choose between them, and our guide to remediation timescales sets out the legal limits on each order. This guide answers the practical question that follows: what does each outcome actually mean for you?

Each outcome in real life

The table shows what each outcome means in practice. Names vary between regulators; the effect is broadly the same.

Outcome	Can you practise?	On the public register?	Reviewed?
No further action or advice	Yes, without restriction	No	No
Warning	Yes, without restriction	Yes, for a set period: two years in total at the GMC, 12 months at the NMC, usually up to 24 months at the GDC	No
Undertakings	Yes, in line with what you have agreed	Yes, while in force, except details about health	Monitored
Caution order (NMC, HCPC)	Yes, without restriction	Yes, for the length of the order, 1 to 5 years	No
Conditions of practice	Yes, but only in line with the conditions	Yes, while in effect	Usually, before they end
Suspension	No	Yes, while in effect	Usually, before it ends
Erasure or striking off	No	Yes: 10 years at the GMC, 5 years at the NMC, HCPC and GDC	Only through a restoration application

How long it stays visible, by regulator

Each regulator publishes outcomes according to its own policy. The periods below come from those policies, for the four largest regulators.

GMC

Publication and disclosure policy, August 2025

Warning1 year on the doctor details page, then 1 year on the doctor history page
Undertakings, conditions, suspensionPublished while active
After a suspension of over 3 months ends15 years on the history page
After shorter suspensions, conditions or undertakings end10 years on the history page
Erasure10 years from leaving the register

NMC

Publication guidance, April 2026

Warning12 months
UndertakingsWhile in force
Caution, conditions, suspensionFor the duration of the order
Striking off5 years from when it takes effect
Recent decisions pageListed for 4 months

HCPC

Fitness to practise publication policy

Caution1 year on the tribunal website; on the register for the order's length
Conditions, suspensionWhile the order has effect
Striking off5 years from when it takes effect
Allegations not well foundedNot published unless you ask

GDC

Disclosure and publication policy, July 2024

AdviceNot published
WarningUsually up to 24 months on the register
UndertakingsWhile in force
Conditions, suspensionFor the period, plus one month once no longer impaired
Reprimand1 year
Erasure5 years from erasure

Health information is protected The NMC says it does not publish any information relating to a registrant's health without consent. The HCPC may withhold publication that would disclose confidential health information, and the GMC treats cases solely about health differently in what it publishes and discloses. If your case involves your health, ask how this will apply to you.

Interim orders, voluntary removal and cleared cases

Three other situations also affect what the public can see, and they are often misunderstood.

Interim orders

An interim order is not a finding against you, but it is visible. The GMC displays interim orders on a doctor's record while they are active and removes them when lifted, and the MPTS lists new interim suspensions and conditions on its recent decisions page for six weeks. The NMC shows an interim order against your register entry while it remains in force, and the GDC publishes interim orders for the period of the order.

Leaving by agreement

At the NMC, a professional who leaves through agreed removal is recorded on the register as "removed by agreement – outstanding fitness to practise question", with the reasons published for one year. At the GMC, voluntary erasure decisions are published on the MPTS recent decisions page for one year. Leaving is not a way to make a concern disappear; our guide to leaving the register explains the rules.

Cleared cases

The NMC says it does not normally publish a hearing that ends with no finding of impairment, or impairment with no sanction. If allegations are found not proved, you can ask for a declaration to be published, which then appears for four months. The HCPC similarly does not publish allegations found not well founded unless you ask.

A caution order is not a police caution The words are the same, but the meaning is different. A caution order is a sanction imposed by an NMC or HCPC panel after a finding of impairment, and you can keep practising. A police caution is a criminal justice outcome that you may need to report to your regulator. Our self-referral guide explains which police cautions must be declared.

What employers and overseas regulators can be told

Publication is only part of the picture. Even after an outcome no longer appears publicly, it may still be disclosed.

Employers

Often disclosed for longer

The GMC says it will usually disclose historical sanctions and warnings indefinitely to current employers who ask about a doctor's fitness to practise history. The NMC keeps a record of all sanctions, which may be disclosed to employers on request, with exceptions for health information and some interim orders.

Working abroad

Overseas regulators can be told

When a doctor applies to practise abroad, the GMC provides a Certificate of Current Professional Status. Its policy says overseas regulators receive information about historical sanctions indefinitely, excluding cases solely about health, interim orders in most cases, and warnings.

Job applications and registration renewals also ask about your history. Answer them accurately: an outcome that has stopped being published is still yours to declare where a question asks for it. Our guide to self-referral and declarations explains why honesty here matters as much as the original concern.

What outcomes look like at final hearings

Most concerns never reach a hearing. For those that do, the NMC's annual report shows how its fitness to practise panels decided cases in 2024 to 2025.

Striking off289 · 45%

Suspension156 · 24%

Conditions60 · 9%

Caution21 · 3%

Source: NMC Annual Fitness to Practise Report 2024 to 2025. The remaining decisions included other outcomes, such as no finding of impairment.

These figures reflect the cases serious enough to reach a final hearing, not concerns in general. The share of striking-off orders rose from 35% in 2023 to 2024. Our main guide sets out the GMC's equivalent figures.

Can you appeal?

Hearing decisions can be appealed to the courts. For doctors, section 40 of the Medical Act 1983 allows appeals against decisions to erase, suspend or impose conditions, against changes to conditions, and against refusals to restore a name to the register. The appeal must be made within 28 days of the decision being served, to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland. Nurses, midwives and HCPC registrants have equivalent rights under article 38 of their orders; the decision letter will set out the deadline.

Dismiss
The decision stands.
Quash
The decision is set aside.
Substitute
The court replaces the sanction with another.
Remit
The case goes back to a panel to decide again.

An appeal does not always pause the order When a tribunal directs erasure or suspension, it can also make an immediate order so that your registration is suspended or restricted while any appeal is pending. Deadlines are short and appeals are technical. Get legal advice straight away if you are considering one.

Earlier outcomes, such as warnings and case examiner decisions, are challenged differently, for example by asking for an oral hearing or a review. Our guide to writing your response explains these routes.

Outcomes can also be challenged as too lenient

The Professional Standards Authority oversees the health and care regulators. Under section 29 of the NHS Reform and Health Care Professions Act 2002, it can refer a final decision to the court if it considers the decision insufficient to protect the public. Its first report on this work shows how active it is.

2,230

final fitness to practise decisions received by the PSA in 2024 to 2025

detailed case reviews completed

appeals lodged with the courts, 13 of them against NMC panel decisions

26 of 28

appeals resolved in the year were upheld or settled by consent; in 17, the sanction was replaced

The PSA says nearly half of the appeals it lodged involved a failure to properly apply or consider sanctions guidance. In practice, that means a panel's decision is not always final even when it is in your favour. Two cases in our other guides show this: a nurse's suspension replaced with striking off in our probity case files, and a surgeon's whole case sent back for a fresh hearing in our self-referral guide.

Real case · Court of Appeal · 2018

Bawa-Garba v General Medical Council [2018] EWCA Civ 1879

The background. A paediatric trainee was convicted of gross negligence manslaughter following the death of a child in her care. A medical practitioners tribunal suspended her for 12 months, taking into account systemic failings at the hospital and her personal mitigation.

What happened next. The GMC appealed, arguing the sanction was too lenient. The High Court agreed and substituted erasure. The doctor then appealed to the Court of Appeal.

The outcome. The Court of Appeal restored the 12-month suspension. It held that a tribunal's decision on sanction is an evaluative judgment deserving considerable respect from appeal courts, and that the tribunal had been entitled to consider the systemic failings and mitigation when deciding what was needed to protect the public.

The lesson: an outcome can be challenged in both directions, and appeal courts give real weight to the panel that heard the case. The evidence you put before the panel, including about context and remediation, can still matter years later.

After an outcome: the first steps

Whatever the outcome, the days after a decision matter. These steps apply to most professionals with a warning, undertakings, conditions or a suspension.

Read the decision in full. The reasons tell you exactly what the panel or case examiners were concerned about, and what any review will look for.
Check your register entry. Make sure what is published is accurate, and raise any error with the regulator promptly.
Tell the people you must tell. Conditions often require you to inform employers, and your standards may require you to tell every organisation you work for. Do it in writing and keep a copy.
Set up a compliance record. For conditions or undertakings, keep dated evidence of every requirement you meet, such as supervision notes and reports. It is the first thing a review will ask for.
Decide on any appeal quickly. For doctors the deadline is 28 days. Take advice before it passes.
Plan the period ahead. Map out the learning, reflection and evidence you will need by the review date, using our guide to review hearings.

Core course

Fitness to Practise for Healthcare Professionals

4 CPD hours and 40 scenario questions on impairment, insight, remediation and reflection, with a certificate when you pass. Built for professionals whose registration is at stake.

£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.

Frequently asked questions

Will a fitness to practise concern always affect my registration?

No. Many concerns close at screening or investigation with no action or advice. Only a minority lead to a warning, undertakings or a hearing.

Does a warning go on the register?

Yes. At the GMC, a warning is published for one year on the doctor details page and a further year on the doctor history page. NMC warnings are published for 12 months.

Can I work with conditions on my registration?

Yes, as long as you comply with the conditions. They might require supervision, limit certain procedures or require you to tell employers. Breaching them is itself a serious concern.

How long does striking off stay on the register?

The NMC and HCPC publish striking-off orders for five years from when they take effect. The GMC states erasure on a doctor's record for 10 years from when they leave the register.

Will my employer find out about an old sanction?

Possibly. The GMC says it usually discloses historical sanctions and warnings indefinitely to current employers who ask. The NMC keeps a record of all sanctions and may disclose them to employers on request.

Will a sanction affect working abroad?

It can. For doctors, the GMC's policy says overseas regulators receive information about historical sanctions indefinitely, except cases solely about health, most interim orders and warnings.

How long do I have to appeal?

For doctors, 28 days from the date the decision was served, under section 40 of the Medical Act 1983. Nurses, midwives and HCPC registrants have equivalent appeal rights, and the decision letter sets out the deadline. Get advice immediately.

Can my sanction be increased after the hearing?

Yes. The Professional Standards Authority can refer a decision to the court if it considers it insufficient to protect the public. In 2024 to 2025 it lodged 21 such appeals, and the regulator itself can sometimes appeal too.

Is a case where I was cleared published?

Not normally. The NMC does not usually publish a finding of no impairment, but you can ask for a declaration to be published if allegations were not proved. The HCPC does not publish allegations found not well founded unless you request it.

Is an interim order shown on the register?

Yes, while it is in force, at the GMC, NMC and GDC. It is removed when the order is lifted. An interim order is not a finding that the allegations are true.

Is information about my health published?

Generally not. The NMC does not publish health information without consent, the HCPC may withhold it, and the GMC treats health-only cases differently in what it publishes and discloses.

Primary sources

10 official documents and judgments