NMC case examiners: what they decide and what each outcome means

If your case has been investigated, it will go to the case examiners. For many registrants this is the most important stage, because it is where the NMC decides whether the case goes any further. Knowing what case examiners can and cannot do helps you write a response that speaks to the questions they actually ask.

Who are the NMC case examiners?

Case examiners are NMC decision-makers who work in pairs: one is a nurse, midwife or nursing associate and the other is a lay person. They decide on the papers. There is no hearing, and they do not hear from witnesses in person. They must agree on the decision.

What do case examiners decide?

They decide whether there is a case to answer: whether there is a realistic prospect that a panel would find the facts proved, find a statutory ground such as misconduct or lack of competence, and find your fitness to practise currently impaired. Current impairment is often where insight and strengthened practice make the difference.

What are the possible outcomes if there is no case to answer?

If there is no case to answer, the case examiners can close the case with no further action, close it with advice, or issue a warning. Advice reminds you of your professional responsibilities. A warning is more serious and is used where the conduct was a significant departure from the standards expected; it is published on the register for 12 months.

Note the terminology: a warning is a case examiner outcome. It is not one of the sanctions a Fitness to Practise Committee panel imposes after a hearing. Those are caution, conditions of practice, suspension and striking-off orders.

We explain the panel sanctions separately in NMC sanctions explained.

What are the possible outcomes if there is a case to answer?

If there is a case to answer, the case examiners can recommend undertakings or refer the case to the Fitness to Practise Committee for a hearing or meeting. Undertakings are commitments you agree to, such as training, supervision or reporting, which address the concerns without a hearing.

Read NMC undertakings: what they are and how they work for more on what agreeing undertakings involves.

How long do I have to respond to the case examiners?

When your case is referred to the case examiners, the NMC sends you the evidence and invites your written representations. Under the NMC's Fitness to Practise Rules, representations should be received within 28 days of the documents being sent. If you need longer, ask before the deadline.

What should my response to the case examiners include?

Your response should help the case examiners answer one question above all: is there a real risk now? Take advice on how to respond to the facts. Then focus on what you understand about the concern, what you have done about it and what your practice looks like today.

• Your position on the facts, agreed with your adviser (accepting facts where they are true is part of insight).
• A reflective statement that shows you understand the impact on patients, colleagues and public confidence.
• Evidence of strengthened practice: targeted training, supervision, audits, changed ways of working.
• Current testimonials from people who know about the concern and see your practice now.
• Any relevant context, such as health, workload or support, presented as context rather than excuse.

Case examiners are asking about risk today. Your evidence should answer that question.

For help with the writing itself, see how to structure an NMC reflective statement and how to show insight and strengthened practice. The Reflection Writing course and the reflective statement template give you a structure to work from.

Can a case examiner decision be reviewed?

In some circumstances the NMC can review a decision that there is no case to answer, for example if new information comes to light or the decision may have been materially flawed. There are rules about who can ask for a review and when, set out in the NMC's guidance on reviewing case examiner decisions.