What is fitness to practise?
6Fitness to practise is the ability to meet professional standards; it is about character, professional competence and health. According to the Health and Care Professions Council (HCPC), someone is fit to practise if they have "the skills, knowledge, character and health to practise their profession safely and effectively"[1].
7Providers have a duty
- to ensure that students on a professional course are fit to practise in that profession, or will be when they complete the course;
- to protect present or future patients, clients, service users and members of the public;
- to safeguard public confidence in the profession;
- to comply with the requirements of professional/regulatory bodies; and
- to ensure that students are not awarded a qualification that permits them to practise a profession if they are not fit to do so.
Where providers have concerns about a student who is already a registered member of a profession, then they have a responsibility to raise those concerns with the relevant professional body, the Disclosure and Barring Service, and/or the student’s employer.
8Different professions have different regulatory systems and structures and different routes to qualifying and practising. Some professions have a professional body and a separate regulator. This means that providers are likely to have different levels of responsibility for assuring fitness to practise for the variety of professional courses they deliver.
9The provider will have a close relationship with the professional body or regulator, which will generally have some requirements for the structure and content of the course. Professional bodies may need to approve some core or compulsory requirements for course content, to set assessment criteria, and to carry out inspections. They may request that the provider certifies (at a minimum) that the student has not only met the provider's assessment criteria, but is also of good character at the end of the course. Professional bodies normally publish guidance to providers and students about fitness to practise issues. Providers should pay close attention to that guidance, and make sure that their students know about it and understand it.
10Examples of issues that may lead to fitness to practise concerns, if the student’s ability to meet professional standards may be impaired, include:
- academic misconduct (for example plagiarism, cheating in examinations, forging records);
- other disciplinary offences (for example antisocial, abusive or threatening behaviour, sexual misconduct, violence, bullying or harassment, damage to property, internet access abuse, substance/alcohol abuse);
- health and safety breaches;
- failure to disclose convictions or other information that the student is required to disclose;
- inaccurate or falsified placement documentation;
- unsafe practice, incompetence or requiring too much supervision;
- unprofessional behaviour, including:
- lack of respect, aggressive or poor attitude, laziness;
- indiscipline, failure to follow dress code, inappropriate use of mobile phone, poor time keeping, poor attendance;
- failure to self-reflect, lack of insight;
- failure to engage with investigations into unprofessional behaviour;
- poor self-management, lack of personal accountability;
- dishonesty;
- breaking patient confidentiality
- behaviour away from the student’s studies, including:
- criminal conviction eg violent offence; offence of dishonesty
- disruptive behaviour in the community;
- inappropriate use of social media;
- safeguarding concerns;
- poor mental or physical health or serious physical impairment that interferes with the student’s ability to practise safely (see section on Health and disability issues);
- failure to seek help or engage with appropriate services in relation to health issues;
- poor communication or language skills.
11As these examples indicate, concerns about a student’s fitness to practise may arise at any time throughout the student’s studies. Providers should ensure that all staff who may be aware of any of these matters are alert to the possibility of fitness to practise implications for students on professional courses.
12The Nursing & Midwifery Council (NMC) publishes guidance that applies to qualified nurses and midwives which gives a helpful example of fitness to practise principles. A link to this guidance, along with links to guidance from other professional bodies, can be found in the Useful resources section.