Fitness to Practise Hearings: What Healthcare Professionals Should Expect

Most concerns never reach a hearing. If yours has, our guides to investigations and possible outcomes explain how you got here and what can follow. This guide is about the hearing itself.

Hearings by the numbers

Official figures from five regulators show what hearings actually look like: how many there are, how they are held, how often professionals attend, and how often cases end without a sanction.

Three points stand out. First, a hearing is not a foregone conclusion: at the NMC, around one in five final decisions in 2024 to 2025 ended with no sanction because the facts were not proved or fitness to practise was not impaired, and at the GDC almost a third of substantive decisions in 2024 found no impairment. Second, about a quarter of doctors in 2023 neither attended nor sent a legal representative, which means the panel heard nothing from them directly. Third, about one in four HCPTS final hearings did not finish as planned, so be ready for your case to run longer than listed.

A meeting or a hearing?

Not every case is decided at a hearing with people present. The NMC can decide cases at a meeting, where the panel considers only the documents and the professional does not attend, or at a hearing, where people can give live evidence and be questioned. Its guidance is clear: "We'll always hold a hearing to conclude a case if the nurse, midwife or nursing associate wants one." If you do not ask for a hearing or do not respond, the NMC will usually hold a meeting, unless the panel decides a hearing is desirable. Hearings can be held remotely or at a hearing centre, decided case by case.

Who is in the room

Whether the hearing is in person or online, the same roles are present.

How the three main tribunals compare

Sources: MPTS resource for doctors on new MPT hearings; NMC guidance on meetings and hearings and on attending a hearing; HCPC substantive hearings fact sheet; HCPTS stages of a final hearing.

Before the hearing: the timetable that matters

A great deal is decided before the first day. Missing a deadline can limit what evidence the panel will consider.

1. Listing

   The hearing is scheduled

   The MPTS's service target is to list a hearing within nine months of the GMC's referral.

2. Case management

   Directions are set

   At the MPTS, listing calls and pre-hearing meetings with legally qualified case managers set deadlines for witness statements, expert reports, bundles and witness timetables. Failing to comply can lead to evidence being excluded, adverse inferences or costs.

3. Bundles

   The documents are exchanged

   At the HCPTS, the hearing bundle is sent at least 42 days before the hearing, and documents you want the panel to have must be sent at least 28 days before.

4. Admissions

   What is agreed is narrowed

   Facts, documents and witness statements can be agreed, so witnesses do not need to attend for points nobody disputes.

5. Legal points

   Arguments are filed

   At the MPTS, preliminary legal arguments are set out in skeleton arguments of no more than five pages.

This is also the time to update your evidence of insight and remediation. Our guides to remediation evidence and demonstrating insight explain what to prepare.

The three stages, and your part in each

The panel usually retires in private to decide each stage, then announces its decision in the hearing, with a written copy. At the HCPTS, the panel usually considers facts, grounds and impairment together, unless the case is complex enough to separate them.

Giving evidence

At the MPTS, your written statement will normally stand as your evidence-in-chief, and you may then be questioned by the regulator's representative and the panel. At the HCPTS, you have the right to give oral evidence on oath or affirmation at the facts, grounds, impairment and sanction stages.

• Know your own statement. You will be questioned on it. Inconsistency damages credibility on everything else.
• Listen to the whole question. Answer what is asked, briefly. It is fine to ask for a question to be repeated.
• It is acceptable not to remember. Say so rather than guess. A confident wrong answer is worse than an honest "I don't recall".
• Speak to the panel. They are the decision-makers, not the person asking the question.
• Ask for breaks and adjustments. Hearings have regular breaks, and reasonable adjustments can be requested in advance.
• Show insight in your own words. Panels test whether your written reflection reflects real understanding. Our insight guide lists questions to prepare for.

A hearing-day checklist

Public, private and the press

Fitness to practise hearings are usually held in public, so that the public can see how professionals are regulated. The MPTS hears matters about a doctor's health in private, and other matters can be heard in private where the circumstances outweigh the public interest. The NMC says a panel can hear all or part of a hearing in private when it is reasonable and proportionate, and health cases are heard privately. For virtual NMC hearings, a limited number of observers are given audio-only access. The HCPC holds hearings in public in all but exceptional circumstances, and publicises them in advance.

If there is a reason for part of your case to be heard in private, such as your health or a third party's private information, raise it with your representative before the hearing.

If you cannot, or do not, attend

A hearing can go ahead in your absence. Regulators must take reasonable steps to tell you about it, but you are expected to keep your contact details up to date and engage with the process.

Support during a hearing

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