At an NMC Fitness to Practise hearing, a panel of usually three independent members, at least one registrant and one lay member, decides the case in three stages: whether the facts are proved, whether those facts amount to misconduct (or another ground) and your fitness to practise is currently impaired, and, if so, what sanction is needed. A legal assessor advises the panel.
Key takeaways
- Three stages: facts, then grounds and impairment, then sanction.
- The NMC must prove the facts on the balance of probabilities.
- You can attend with or without representation; the panel will guide you.
- Hearings are usually public, but health matters are generally heard in private.
Fear of the unknown is one of the hardest parts of a hearing. Knowing who will be there, what order things happen in and what the panel is deciding at each point removes a great deal of that anxiety.
Who is at an NMC hearing?
The panel usually has three members who are independent of the NMC: at least one nurse, midwife or nursing associate and at least one lay member, one of whom chairs. A legal assessor, usually a barrister or solicitor, advises the panel on the law but takes no part in the decision.
- The panel: decides the case.
- Legal assessor: advises on law and fairness.
- NMC case presenter: a lawyer who presents the NMC's case.
- Hearings coordinator: an NMC employee who manages the day and helps record the decision (the determination).
- You, and your representative if you have one. Witnesses may attend for parts of the hearing.
What are the three stages of an NMC hearing?
The panel decides the case in three separate stages and announces its decision on each before moving to the next. You have the chance to give evidence or make submissions at each stage.
- 1. FactsAre the allegations proved on the balance of probabilities?
- 2. Grounds and impairmentDo the facts amount to misconduct (or another ground)? Is fitness to practise impaired today?
- 3. SanctionWhat outcome is needed to protect the public?
Stage 1: how does the panel decide the facts?
The NMC has to prove each allegation on the balance of probabilities, meaning it is more likely than not that it happened. Admitted facts are found proved. For disputed facts, the panel hears witnesses and reads documents, and you or your representative can ask questions and give your own evidence.
Stage 2: what are grounds and impairment?
If facts are proved, the panel decides whether they amount to a statutory ground, most commonly misconduct, and then whether your fitness to practise is currently impaired. Impairment looks forward: would you pose a risk to the public, to public confidence in the profession, or to professional standards if you practised without restriction today? This is where evidence of insight and strengthened practice matters most.
Stage 3: how is a sanction decided?
If your fitness to practise is impaired, the panel considers the available sanctions, starting with the least restrictive, and chooses the one that is proportionate to protect the public. The options are no further action, a caution order, a conditions of practice order, a suspension order or a striking-off order.
Each is explained in NMC sanctions explained.
Knowing the shape of the day removes much of the fear.
Are NMC hearings public?
Usually, yes: panels hold as much of a hearing in public as they can. Parts can be heard in private, for example to protect the privacy of a witness or discuss your health, and hearings that are only about your health are generally held in private. Decisions are published.
Are NMC hearings held virtually?
Hearings can take place in person or virtually, and the NMC publishes guidance for both. Check your notice of hearing for the format. If the hearing is virtual, test your technology in advance, choose a quiet private space, and have your documents printed or on a second screen.
What is the difference between a hearing and a meeting?
Some cases are decided at a meeting instead of a hearing. At a meeting, the panel decides on the papers, without you or the NMC attending. You are told in advance and can send written submissions. Whether your case is dealt with at a hearing or a meeting depends on the circumstances and on whether you ask for a hearing.
How should I prepare for an NMC hearing?
- Read the charges and the NMC's evidence bundle carefully, with your representative if you have one.
- Prepare your reflective statement and evidence of strengthened practice.
- Collect testimonials that show the author knows about the charges.
- Plan logistics: travel or tech, childcare, time off, and someone to talk to afterwards.
- Remember you can ask for breaks, and ask the legal assessor or chair if you do not understand something.
Our Attending a Fitness to Practise Hearing course walks through the day in detail, and the hearing preparation checklist covers the weeks before, the night before and the day itself. For testimonials, read character references for an NMC hearing.
Frequently asked questions
It varies with the number of charges and witnesses. Simple cases may take a day or two; complex ones can run for a week or more, sometimes over separate sittings.
Yes. You can attend without representation, and the panel, legal assessor and hearings coordinator will guide you through the process. If you choose representation, you arrange and pay for it yourself unless your union or insurer covers it.
You are not obliged to, but panels usually find it helpful to hear from you directly, particularly about insight at the impairment stage. Discuss it with your representative.
Yes. The NMC publishes hearing outcomes and reasons, with private matters such as health information removed.
