Conditions of Practice: What They Mean and How to Comply

Our guide to fitness to practise outcomes compares conditions with the other sanctions and explains how long they stay on the register. This guide is about living with conditions: what they ask of you and how to comply.

How often conditions are imposed

At final hearings, conditions are one of the least common outcomes. Official figures show they are imposed far less often than suspension or removal.

One reason is that conditions only work where the concern can be addressed through retraining, supervision or restriction, and where the professional can realistically comply. Conditions are more common earlier, as interim orders while a case is investigated, and in the form of agreed undertakings. The rules in this guide apply to all of them.

Interim conditions, substantive conditions and undertakings

Our guide to interim orders sets out their legal limits. The practical rules for compliance are the same for all three.

When panels choose conditions

NMC sanctions guidance lists factors that suggest conditions may be appropriate, including:

• No evidence of harmful deep-seated personality or attitudinal problems
• Identifiable areas of practice in need of assessment or retraining
• No evidence of general incompetence
• Potential and willingness to respond positively to retraining
• Patients will not be put in danger, directly or indirectly, as a result of the conditions

The willingness factor matters. Panels look for evidence that you will engage with conditions, which is why early insight and remediation, explained in our guide to demonstrating insight, can make the difference between conditions and suspension.

The four tests every condition must pass

The NMC says conditions must be relevant, proportionate, workable and measurable. These tests are useful for any professional facing conditions, because they are also the grounds on which you can sensibly raise concerns about a proposed condition.

What conditions look like in practice

Regulators use banks of standard wording, adapted to each case. These examples come from the MPTS conditions bank for doctors and the NMC conditions of practice library.

Separately from your conditions, doctors have a duty under paragraph 100 of Good medical practice: if your practice is restricted, you must tell, without delay, any organisations you carry out medical work for and any patients you see independently of those organisations. That includes private patients.

Some conditions are public, and some, particularly those about health, are confidential. The NMC library marks each condition as public or confidential, and health details are not published.

Supervision levels explained

Supervision is one of the most common conditions, and its level makes a big practical difference. The GMC describes three levels for doctors:

NMC conditions can be equally specific, for example requiring you to work "at all times while being directly observed by a registered nurse of band 6 or above". Make sure your rota and your employer's arrangements can deliver exactly what the condition says on every shift.

Who monitors you

For doctors, the responsible officer helps monitor restrictions, nominates or approves a workplace reporter, and may nominate a clinical supervisor. The GMC writes for updates on the doctor's progress at least every six months. For nurses, midwives and nursing associates, a named NMC case officer receives notifications and reports. In every case, the regulator may contact the people involved in your conditions directly, and standard conditions require you to allow that exchange of information.

Building a compliance record

At any review, the first question is whether you complied. Your word is not enough; records are. A simple log, kept from the first day, makes that easy to prove.

The example is fictional. Keep copies of every email, report and certificate, and note any time a condition was difficult to meet and what you did about it. The same log becomes the backbone of your review evidence, explained in our guide to review hearings.

If a condition is breached

GMC guidance published in November 2025 explains how it responds when a doctor may have breached conditions or undertakings. It gathers information from the doctor, supervisors, the workplace and others, and may use assessments or testing. Where a breach is minor or isolated and does not suggest increased risk, it may take no further action, but will tell the doctor privately about the importance of compliance. Where a breach suggests a substantially increased risk, it can seek an early review hearing or refer the doctor to an interim orders tribunal. The guidance says a breach of undertakings "is likely to suggest that the doctor continues to pose a current and ongoing risk".

Two recent High Court cases show how seriously breaches are treated.

If a condition becomes hard to meet

1. Stop before you breach. If you cannot meet a condition on a shift, do not work that shift.
2. Tell the regulator in writing. Explain the problem, for example a supervisor leaving, and what you are doing to fix it.
3. Ask for an early review. NMC guidance says a nurse, midwife or nursing associate can request a review at any time, and lists conditions becoming unworkable as a reason to hold one. A request made openly is very different from a quiet workaround.
4. Record everything. Add the problem and your response to your compliance log.

How conditions end

Conditions orders last up to three years and are usually reviewed before they expire. The NMC usually schedules the review about eight weeks before the order is due to end, and a panel cannot extend conditions by more than three years at a time. At review, a panel can let the order lapse, extend or vary it, or, where conditions have not worked, impose a more restrictive sanction.

NMC guidance says there is a persuasive burden on the professional at review, and that the panel looks at compliance with the conditions and the quality of the evidence, the level of insight, the steps taken to keep skills and knowledge up to date, and the record of safe practice. Conditions do not always run their full course: the NMC lists full compliance, or effective steps to address the problems, as a reason it may hold an early review. Our guides to remediation timescales and remediation evidence explain what to prepare.

Frequently asked questions