Healthcare Ethics Ireland
Complaints and fitness to practise inquiries · Ireland · The process, explained
A letter has arrived
The fitness to practise process in Ireland, explained
what happens between a complaint and a decision at the Medical Council, NMBI, the Dental Council, the Pharmaceutical Society of Ireland and CORU: the committees, the inquiry, the sanctions and the High Court, what is considered, and where remediation courses fit
- A complaint is not a finding
- The Preliminary Proceedings Committee first
- Then, if needed, an inquiry
- High Court confirmation of sanctions
In one line
Every regulatory statement on this page is drawn from the regulators’ own published pages and the Acts, linked at the foot of the page. This is general information about the process, not advice on your matter. For that, speak to your indemnifier, your union or professional body, or a solicitor.
The short version
What happens after a complaint
A complaint is a concern about your conduct, your performance or your health, raised with your regulator. In Ireland there are five, each under its own Act: the Medical Council (Medical Practitioners Act 2007), the Nursing and Midwifery Board of Ireland (Nurses and Midwives Act 2011), the Dental Council (Dentists Act 1985), the Pharmaceutical Society of Ireland (Pharmacy Act 2007) and CORU (Health and Social Care Professionals Act 2005). Making a complaint is not a finding that anything went wrong.
At the Medical Council, NMBI, the PSI and CORU, a Preliminary Proceedings Committee decides whether there is enough to take the complaint further; at the Dental Council, the Fitness to Practise Committee considers whether there is a prima facie case. If the complaint goes further, a committee holds a fitness to practise inquiry and decides whether the allegations are proven. If they are, the regulator decides the sanction, and the heavier sanctions are confirmed by the High Court.
At each stage you are told what is alleged and given the chance to respond. Complaints can end with no further action, mediation, or an undertaking, well before an inquiry.
Step by step
The stages, in order
Not every complaint passes through every stage.
- A complaint is made Anyone can complain. At the Medical Council and NMBI a complaint goes to the chief executive officer; at the Pharmaceutical Society of Ireland (PSI) it can be made by or on behalf of any person or by the registrar; at CORU, by or on behalf of any person or by a registration board. At the Dental Council the Council or any person may apply to its Fitness to Practise Committee for an inquiry. A complaint is a concern raised, not a finding.
- You are told, and asked for your response The regulator writes to you with the complaint. The Medical Council notifies you in writing; NMBI’s case officer sends a copy of the complaint and its supporting documents; the PSI invites your initial observations; CORU explains the nature of the complaint and who made it. None of the five publishes a fixed deadline for a first response. Take advice before you write anything.
- Screening and investigation At the Medical Council the chief executive officer looks at the complaint first and may reject one that is frivolous or vexatious, then may assign an Authorised Officer, who can obtain records and expert opinion and gives you the chance to reply. CORU’s Preliminary Proceedings Committee screens out complaints that are trivial, vexatious, without substance or made in bad faith.
- The Preliminary Proceedings Committee decides At the Medical Council, NMBI, the PSI and CORU, the Preliminary Proceedings Committee (PPC) decides whether there is enough to take the complaint further. Its options include no further action, mediation or informal resolution, asking for more information, and referral to an inquiry; at the Medical Council it can also ask you for an undertaking or a consent. At the Dental Council, its Fitness to Practise Committee considers whether there is a prima facie case.
- The inquiry An inquiry is heard by the Fitness to Practise Committee at the Medical Council, NMBI and the Dental Council, and by the Professional Conduct Committee or the Health Committee at the PSI and CORU. The committee hears the evidence and decides whether the allegations are proven.
- Sanction, and the High Court If allegations are proven, the regulator decides the sanction. Under the Acts as amended by the Regulated Professions (Health and Social Care) (Amendment) Act 2020, the heavier sanctions need confirmation by the High Court, and advice, admonishment or censure takes effect when confirmed or when the appeal window passes without an appeal: 21 days for doctors, nurses and midwives, and dentists, 30 days for pharmacists and CORU registrants.
Five Acts, five processes
Five regulators, five processes
The stages above are shared; the committees, the grounds and the sanctions differ. Find your regulator.
Medical Council Medical Practitioners Act 2007 · doctors
A complaint goes to the chief executive officer, who looks at it first (from 6 May 2025). The grounds include professional misconduct, poor professional performance and a relevant medical disability (section 57).
An Authorised Officer may investigate, and you get at least two weeks to respond to the Investigation Report. The PPC may take no further action, suggest mediation, refer the complaint to the Fitness to Practise Committee, or ask you to undertake not to repeat the conduct, to be referred to a professional competence scheme, to consent to medical treatment or to consent to censure; if you agree, the investigation is treated as completed (2025 PPC procedures).
Inquiries are held in public unless the Council decides on a private or part-private hearing. Sanctions under section 71 run from advice, admonishment or censure to a fine of up to €5,000 with censure, conditions, suspension and cancellation (section 71). In 2023 the PPC made 286 decisions: 225 no further action and 61 referrals to the Fitness to Practise Committee.
Nursing and Midwifery Board of Ireland (NMBI) Nurses and Midwives Act 2011 · nurses and midwives
A complaint is made in writing. The grounds include professional misconduct, poor professional performance, non-compliance with a code of professional conduct and a relevant medical disability (section 55).
A case officer assists the PPC, which may refer the complaint to the Fitness to Practise Committee for a sworn oral inquiry, find insufficient cause, refer it to another body, or suggest mediation or informal resolution (NMBI).
Inquiries are heard in public unless the committee decides otherwise, and allegations must be proven beyond reasonable doubt (NMBI inquiries). Sanctions under section 69 include censure with a fine of up to €2,000, conditions, suspension and cancellation. In 2024 NMBI received 109 new complaints and referred 45 to the Fitness to Practise Committee.
Dental Council Dentists Act 1985 · dentists and dental professionals
The Council or any person may apply to the Fitness to Practise Committee for an inquiry, on grounds that include alleged professional misconduct and alleged unfitness to practise by reason of physical or mental disability (section 38).
The Fitness to Practise Committee considers whether there is a prima facie case; if there is, it holds the inquiry and reports to the Council. Findings are not published without the dentist’s consent, except findings of misconduct or unfitness.
The Council may erase or suspend (section 39), attach conditions (section 40), or advise, admonish or censure (section 41); there is no fine. Erasure, suspension and conditions go to the High Court for confirmation, and since 6 May 2025 advice, admonishment or censure takes effect on confirmation or after 21 days (section 41).
Pharmaceutical Society of Ireland (PSI) Pharmacy Act 2007 · pharmacists
The PSI separates a concern, handled outside the statutory process, from a statutory complaint, for issues of a serious nature (PSI). The grounds include professional misconduct, poor professional performance and a pharmacist’s health.
You are invited to submit initial observations, then the PPC may ask for more information, take no further action, refer the complaint to a committee of inquiry, or refer it to mediation (PSI). The PSI says its Professional Conduct Committee and its Health Committee “usually” deal, respectively, with complaints about professional misconduct and about a pharmacist’s health.
An inquiry may be held in public. Sanctions under section 48 are admonishment or censure, conditions, suspension, cancellation and a prohibition on applying for restoration; there is no fine (section 48). In 2024 the PPC considered 50 complaints; 17 respondents were referred to the Professional Conduct Committee and 1 to the Health Committee.
CORU Health and Social Care Professionals Act 2005 · health and social care professionals
A complaint goes to the Council, by or on behalf of any person or by a registration board, on grounds that include professional misconduct, poor professional performance and a relevant medical disability (section 52).
The PPC screens complaints. The Professional Conduct Committee deals with conduct or competence and its hearings are normally held in public; the Health Committee deals with health and its hearings are normally held in private. A committee of inquiry has three members: two registrants and one non-registrant (CORU).
Sanctions under section 66 are admonishment or censure, conditions, suspension, cancellation and a prohibition on applying for restoration, with no fine (section 66). CORU received 73 new fitness to practise complaints in 2025. Psychologists, counsellors and psychotherapists are not yet regulated.
What is considered
What the regulators consider
Where the regulators publish guidance on sanctions, it comes back to the same things. The concern is fixed by the time the letter arrives; the rest is not.
- The concern itself What is said to have happened, in what circumstances, and against which ground and which standard in your regulator’s code.
- Insight The Medical Council’s sanctions guidance says a doctor may show insight by providing evidence of their understanding of the problem, and treats a marked lack of insight as a possible aggravating factor. NMBI’s says that “Mere acknowledgement of the findings does not necessarily demonstrate insight.”
- What you have done since The Medical Council’s guidance allows evidence of how a doctor has addressed the issues; NMBI’s counts remedial action and an apology among the mitigating factors.
- An apology The Medical Council’s guidance refers to an apology to anyone affected at an early stage; NMBI’s lists evidence of an apology among the mitigating factors.
- Admissions In CORU’s trends report, one committee found that early admissions had shown some limited insight.
- Where the file is silent The Dental Council and the PSI have not published sanctions guidance on insight that we can point to. Ask your adviser how evidence of remediation is best presented to them.
Where we come in
Where a course fits
Of the things above, only the first is settled by the time the letter reaches you. Your insight, what you have done since, and how you account for it are not.
That is the whole of the claim we make. No course from us or from anyone else determines what a regulator, a Preliminary Proceedings Committee or an inquiry committee decides, and we say so on every page. What a course can do is help you think an event through properly and put something dated on paper that shows it. Whether that helps is for the committee to judge.
- Insight for Fitness to Practise What insight means to a regulator, and how it is evidenced in writing.
- Reflection for Fitness to Practise Structured reflection on an event, rather than an assertion that you have reflected.
- Remediation for Fitness to Practise The steps that reduce the chance of a repeat, and how to record them.
- Ensuring No Repeat of Misconduct or Mistake in Future Practice Turning a single event into a change in practice.
- Fitness to Practise for Healthcare Professionals The process you are in, from the first letter to an inquiry and the High Court.
- Dealing with a Complaint or Investigation Professionally Your own conduct during the process, which is also noticed.
- Rebuilding Trust of Patients, Colleagues, the Public and the Regulator Where the process ends, and what comes after it.
Those seven run alongside a pair written for your own profession: ethics and professionalism, set against your own regulator’s code rather than a general one. Together they are the Core Set on your profession’s page. Each course is self-paced, opens as soon as payment clears, and carries 2 CPD hours on a certificate issued by Healthcare Ethics Courses, for your response and for your CPD record. €100 each (€70 with Bulk Buy 10), or less as a Bulk Buy of 2 or more through the Bulk Buy Offer.
How it can end
The outcomes
From no further action to cancellation of registration. The names and the limits differ by regulator.
- No further action The PPC, or the Dental Council’s Fitness to Practise Committee, finds there is not enough to go further. At the Medical Council in 2023, 225 of 286 PPC decisions were no further action.
- Mediation or informal resolution Offered by the Medical Council, NMBI, the PSI and CORU where appropriate; at NMBI and CORU both sides must consent.
- Undertakings and consents At the Medical Council the PPC can ask for an undertaking or a consent, and if you agree the investigation is treated as completed. At NMBI undertakings and consents agreed during an inquiry must be agreed by the Board. CORU describes undertakings as agreed commitments to address identified concerns.
- Advice, admonishment or censure The lightest sanctions: advice, admonishment or censure at the Medical Council, NMBI and the Dental Council; admonishment or censure at the PSI and CORU. They take effect on High Court confirmation or when the appeal window passes: 21 days or 30 days, depending on the regulator.
- A fine With censure, up to €5,000 at the Medical Council and up to €2,000 at NMBI. The Dental Council, the PSI and CORU have no fine.
- Conditions, suspension, cancellation or erasure Conditions on your registration, suspension for a specified period, or cancellation, which the Dental Council calls erasure. These need confirmation by the High Court.
Definitions
The words the letters use
Regulatory letters use these terms precisely. Reading them loosely can cause needless alarm, or lead you to miss something that matters.
- Complaint. A concern about a registered professional raised with their regulator. The PSI separates a concern from a statutory complaint, and the Dental Council receives an application for an inquiry. A complaint is not a finding.
- Preliminary Proceedings Committee (PPC). The committee at the Medical Council, NMBI, the PSI and CORU that decides whether a complaint goes further. At the Dental Council, the Fitness to Practise Committee considers whether there is a prima facie case.
- Authorised Officer. At the Medical Council, the person the chief executive officer may assign to investigate a complaint, gather records and expert opinion, and hear from you.
- Fitness to Practise Committee. The inquiry committee at the Medical Council, NMBI and the Dental Council. At the Dental Council it also decides whether there is a prima facie case.
- Professional Conduct Committee and Health Committee. The inquiry committees at the PSI and CORU: the first for conduct or competence, the second for a professional’s health.
- Inquiry. The hearing at which a committee decides whether the allegations are proven. At NMBI they must be proven beyond reasonable doubt.
- Professional misconduct. A ground of complaint under the Medical Practitioners, Nurses and Midwives, Pharmacy and Health and Social Care Professionals Acts and, under the Dentists Act 1985, a ground for an application for an inquiry. The Dental Council describes it as a serious falling short in the standards expected of a dentist; the PSI as behaviour that goes against its Code of Conduct; CORU as any act, omission or pattern of conduct that breaches the code.
- Poor professional performance. A ground at the Medical Council, NMBI, the PSI and CORU. The PSI and CORU describe it as a failure to meet the standards of competence expected of a registrant.
- Relevant medical disability. The health ground at the Medical Council, NMBI and CORU. The Dental Council’s equivalent is unfitness to practise by reason of physical or mental disability.
- Undertakings and consents. Commitments the professional agrees to, such as not to repeat the conduct or to be referred to a professional competence scheme, which can bring a complaint to an end before or during an inquiry.
- Censure. A formal expression of disapproval in writing, one of the lightest sanctions. At the Medical Council and NMBI it can come with a fine.
- High Court confirmation. The step by which the regulator asks the High Court to confirm a heavier sanction before it takes effect.
- Insight. Understanding what went wrong, why it mattered and what you would do differently, shown by evidence rather than asserted.
- Remediation. The steps taken so that the same thing does not happen again, such as further study, supervision or changes to how you work, and the dated record of them.
Before anything else
Where to get help
Before you write anything.
- Your indemnifier For doctors, Medical Protection (MPS) offers advice and representation for Medical Council fitness to practise proceedings, and the MDU can provide support for issues the Clinical Indemnity Scheme does not cover. The Clinical Indemnity Scheme does not provide representation before professional regulatory bodies. For other professions, check what your own indemnity covers.
- Your union or professional body NMBI advises nurses and midwives to contact their representative body or obtain legal advice.
- Your regulator’s own guidance Each regulator publishes how it handles a complaint, in its own words; the page for your profession links to it.
- A solicitor Particularly where an inquiry has been called or a suspension is proposed. At CORU you may bring a legal or other representative to a hearing at your own expense.
Written and last reviewed by Dr Shehzad Iqbal, MBBS, MRCS, MRCGP, Postgraduate Certificate in Healthcare Law and Ethics, University of Dundee. Last reviewed . This page is general information about the complaint and fitness to practise process in Ireland, not advice on any individual matter. How we handle anything you send us is set out in our privacy policy, and our terms and conditions apply to any course bought on this site.
Questions professionals ask
Frequently asked questions
Short answers, with the regulator where the answer differs.
Does a complaint mean I have done something wrong?
No. A complaint is a concern raised, not a finding. Anyone can make one, and the regulator looks into it. At the Medical Council in 2023, 225 of 286 Preliminary Proceedings Committee decisions were no further action.
It is reasonable to find it distressing all the same. Speak to your indemnifier, your union or professional body, or a solicitor early.
How long does the process take?
None of the five regulators publishes a fixed timetable for the whole process. The Medical Council gives you at least two weeks to respond to an Investigation Report; NMBI says you may ask for an extension of time to respond; CORU says it will try to deal with a complaint as quickly as it can. Ask the regulator for the expected timetable at each stage.
What should I do in the first week?
Read the letter carefully and note any date you are asked to respond by. Contact your indemnifier, your union or professional body, or a solicitor before you write anything. NMBI itself advises registrants to contact their representative body or obtain legal advice.
We are not solicitors and this is not advice on your matter. The written response is your first chance to put your account, your reflection and any steps you have taken in front of the people deciding.
Do I have to respond?
You are invited to. Not responding does not stop the process; it means the committee decides without your account of what happened, your reflection on it, or any steps you have already taken.
What does the Preliminary Proceedings Committee do?
At the Medical Council, NMBI, the PSI and CORU it decides whether there is enough to take a complaint further. It can take no further action, suggest mediation or informal resolution, ask for more information, or refer the complaint to an inquiry. At the Medical Council it can also ask you for an undertaking or a consent. At the Dental Council, the Fitness to Practise Committee considers whether there is a prima facie case.
What happens at a fitness to practise inquiry?
A committee hears the evidence and decides whether the allegations are proven: the Fitness to Practise Committee at the Medical Council, NMBI and the Dental Council, or the Professional Conduct Committee or Health Committee at the PSI and CORU. At CORU you may bring a legal or other representative at your own expense. If allegations are proven, the regulator decides the sanction.
Can I be suspended before anything is decided?
In some cases. The Medical Council can seek interim suspension under section 60 of the Medical Practitioners Act 2007. The PSI can seek a suspension from the High Court where there is a serious and immediate risk. The Dental Council can apply to the High Court for suspension under section 44 of the Dentists Act 1985. For NMBI and CORU, ask the regulator or your adviser.
What sanctions can be imposed, and does the High Court have to confirm them?
From advice, admonishment or censure up to conditions, suspension and cancellation (erasure at the Dental Council), with a fine alongside censure at the Medical Council (up to €5,000) and NMBI (up to €2,000). The heavier sanctions need confirmation by the High Court. Advice, admonishment or censure takes effect on confirmation or when the appeal window passes: 21 days for doctors, nurses and midwives, and dentists, and 30 days for pharmacists and CORU registrants.
Will the inquiry be in public?
It depends on the regulator. Medical Council and NMBI inquiries are heard in public unless the Council or the committee decides otherwise. CORU’s Professional Conduct Committee hearings are normally public and its Health Committee hearings normally private. A PSI inquiry may be held in public. Dental Council findings are not published without the dentist’s consent, except findings of misconduct or unfitness.
Will completing courses resolve my complaint?
No. No course from us or from anyone else determines what a regulator or its committees decide. Be wary of anyone who says otherwise.
What the regulators’ published guidance does consider is insight and what you have done since. Structured remediation is one way of evidencing those. It is not a shortcut, and it is not a defence.
Will my employer be involved?
Employers are among those who make complaints: in 2024, 49 of the complaints NMBI received (45 per cent) came from employers. Whatever the source, we never tell an employer, a regulator or a committee that you have taken a course with us.
My registration is suspended or has conditions. Can I still do a course?
Yes. Nothing about taking an online course depends on your registration status, and nothing you do with us is reported to anyone.
Written for your regulator
Find the page for your profession
Each profession has its own page: how its regulator handles a complaint, its committees by their own names, the Core Set with the ethics and professionalism pair written for that profession, and the topic courses that match the kind of concern. Start with yours; the vocabulary and the code differ.
- Doctors Medical Council of Ireland · Ethics and Ethical Standards for Doctors and Professionalism and Professional Standards for Doctors, with the rest of the Core Set and the topic courses
- Nurses and Midwives Nursing and Midwifery Board of Ireland · Ethics and Ethical Standards for Nurses and Midwives and Professionalism and Professional Standards for Nurses and Midwives, with the rest of the Core Set and the topic courses
- Dentists and Dental Professionals Dental Council of Ireland · Ethics and Ethical Standards for Dentists and Dental Professionals and Professionalism and Professional Standards for Dentists and Dental Professionals, with the rest of the Core Set and the topic courses
- Pharmacists Pharmaceutical Society of Ireland · Ethics and Ethical Standards for Pharmacists and Professionalism and Professional Standards for Pharmacists, with the rest of the Core Set and the topic courses
- All Other Healthcare Professionals CORU, and professions not yet regulated · Ethics for Healthcare Professionals and Professionalism for Healthcare Professionals, with the rest of the Core Set and the topic courses
Primary sources
Read the regulators’ own pages
Everything above is drawn from these and from the Acts linked in each regulator’s section. Where this page and your regulator differ, your regulator is right: guidance changes.
Regulated Professions (Health and Social Care) (Amendment) Act 2020
The Act that amended all five regulators’ Acts, including how sanctions are confirmed.
Medical Council: how a complaint is handled
The chief executive officer, the Authorised Officer and the PPC, for complaints made from 6 May 2025.
Medical Council: fitness to practise inquiries
Public and private hearings, and the application to the High Court.
NMBI: the complaints process
From the complaint to the High Court, with the case officer and the PPC.
NMBI: inquiries
How inquiries are heard, and the standard of proof.
Dental Council: Fitness to Practice
The Council’s fitness to practise process and published outcomes.
PSI: disciplinary committees
The Professional Conduct Committee and the Health Committee.
CORU: what happens when CORU receives a complaint
The PPC, the two inquiry committees and mediation.
When you are ready
When you are ready to respond
Insight and remediation are not things you can assert. They are things you evidence. If a course would help you do that, the courses are written to each regulator’s code, and none of them changes what your regulator decides.