Free Fitness to Practise Course: What to Do When You Face a Complaint or Fitness to Practise Inquiry

Lesson 13 minutes

Read the letter

Start with what the letter says. It tells you which regulator wrote to you, under which Act, what the concern is, what you are asked to do and by when.

• Who wrote to you. One of the five Irish health regulators, each under its own Act: the Medical Council (Medical Practitioners Act 2007), the Nursing and Midwifery Board of Ireland, NMBI (Nurses and Midwives Act 2011), the Dental Council (Dentists Act 1985), the Pharmaceutical Society of Ireland, PSI (Pharmacy Act 2007), or CORU for the health and social care professions (Health and Social Care Professionals Act 2005).
• What it is about. Each Act sets out the grounds for a complaint. Professional misconduct and poor professional performance are grounds at the Medical Council, NMBI, the PSI and CORU. The Medical Council, NMBI and CORU also list a relevant medical disability, NMBI lists non-compliance with a code of professional conduct, and the PSI has a health ground of its own. At the Dental Council the main grounds are alleged professional misconduct or alleged unfitness to practise by reason of physical or mental disability. Keep a copy of the exact words your letter uses.
• Which route it is on. The PSI deals with some matters as a “concern” rather than through the statutory complaint process, which is for issues of a “serious nature”. At the Dental Council the process starts with an application to its Fitness to Practise Committee for an inquiry.
• What you are asked to do and by when. A response, information or records, and a date. Note every date in your calendar. If you need more time, ask in writing before the date passes.

Our page on the fitness to practise process in Ireland sets out each regulator's stages from the first letter to an inquiry.

Lesson 23 minutes

Your first calls

Before you discuss the detail of the complaint with the regulator, or write anything, call the people whose job is to help you.

• Your indemnifier, your union or professional body, or a solicitor. They can advise on what to say and in what order, and can read your response before you send it. NMBI advises nurses and midwives to “contact your representative body and / or obtain legal advice” (NMBI).
• If you are a doctor. The Clinical Indemnity Scheme “does not provide representation at disciplinary proceedings or before professional regulatory bodies” (HSE). Medical Protection (MPS) offers legal advice and representation for Medical Council fitness to practise proceedings (MPS), and the MDU says it can support doctors on issues the Scheme does not cover (MDU).
• If the regulator phones you first, you can say that you would like to take advice before you answer in detail.
• Your employer. If the complaint came from your employer, or you need to tell them about it, take advice on what to say and when. In 2024, 45% of complaints to NMBI came from employers (NMBI State of Complaints 2024).
• Support for you. A complaint is stressful. Use the support your union or professional body, your colleagues outside the matter or your own GP can give you, early.

Do not contact the person who made the complaint about it, directly or through anyone else. Contact about the complaint can harm your own response.

Lesson 33 minutes

Protect the record

What you do with your records in the first days can matter as much as anything you write later. This is good practice whichever regulator wrote to you.

• Do not change existing clinical notes, and take advice before adding anything to a record. At the Medical Council, the Authorised Officer investigating a complaint can obtain records and expert opinion (Medical Council).
• Write your own account now, dated and private, of what happened and why you acted as you did. It is for you and your adviser, not for sending.
• Gather what you will need: the relevant records, policies, messages and rosters, through the proper channels at your workplace.
• Keep it private. Do not discuss the detail with colleagues who may be asked for information, and do not post about it online.

Lesson 44 minutes

What the Preliminary Proceedings Committee looks at

At the Medical Council, NMBI, the PSI and CORU, the first committee to consider a complaint is the Preliminary Proceedings Committee (PPC). At the Dental Council, the Fitness to Practise Committee considers the application first. Here is what each regulator says the first stage decides.

What your response can show

Whichever regulator wrote to you, three things in your response speak to the concern and to whether it could happen again.

• Insight: you understand what went wrong, why it matters, and how it looked to the patient or colleague involved. NMBI's guidance on sanctions puts it plainly: “Mere acknowledgement of the findings does not necessarily demonstrate insight.” (NMBI)
• Reflection: you have thought it through in writing, linked to your regulator's code: the Guide to Professional Conduct and Ethics (9th edition), NMBI's Code of Professional Conduct and Ethics (2025), the Dental Council's Code of Practice regarding Professional Behaviour and Ethical Conduct (2022), the PSI Code of Conduct (2019) or your CORU board's Code of Professional Conduct and Ethics. CORU's trends report says “Every complaint represents an opportunity for learning and reflection” (CORU).
• Remediation: what you have done since, with evidence: a course on the subject of the concern, an audit of your records, supervision or mentoring, a change to how you work. The Medical Council's guidance describes undertakings as a mechanism “for the remediation and development of a Practitioner” (guidance).

The Dental Council and the PSI publish no guidance on insight that we can point to. Your adviser will help you decide what to include. No course decides the outcome of a complaint or a fitness to practise inquiry.

Self-check2 minutes

Five questions

Choose an answer to see the explanation.