Evidence of a registrant’s behaviour and attitude during and after an incident and during fitness to practise proceedings is vitally important.

We have represented healthcare professionals facing fitness to practise proceedings for many years.  In our experience of doing this, a healthcare professionals’ attitude and behaviour throughout the entire process have often been an important determinative factor in the outcome of fitness to practise proceedings.

Whilst different healthcare regulators will have their own fitness to practise guidance and procedures, there are common views held on the conduct of healthcare professionals in fitness to practise.

When things go wrong, consideration will be given to, among other things:

• Cooperation – Regulatory bodies would expect healthcare professionals to fully cooperate with the investigation or being candid with patients and the public when things go wrong.

For example, the General Pharmaceutical Council’s guidance states: “Evidence of the registrant’s behaviour and attitude before, during and after the incident in question and before and during proceedings, is also important –for example, co-operation with the investigation or being candid with patients and the public when things go wrong.”

• Honesty – Regulatory bodies would expect that all healthcare professionals have a responsibility to be open and honest with patients when something goes wrong with their treatment or care.
  

For example, the General Dental Council’s guidance states: “One of the most important factors in the cases we see is how professionals respond, or how candid they are with patients, when things don’t go to plan.  All healthcare professionals have a responsibility to be open and honest with patients when something goes wrong with their treatment or care. This is the professional duty of candour. Quick acknowledgement of a problem, an appropriate apology, and/or the offer of a remedy are important to patients and can prevent an issue from escalating.” 

• Engagement – Research recently published has shown that decisions in fitness to practise proceedings was consistently linked to engagement with hearings rather than their personal characteristics.

Whilst the research undertaken in the context of doctors and MPTS hearings, the principle remains the same for other healthcare regulators.  It is important for healthcare professionals to attend hearings, respond to correspondence and seek legal advice.  The GMC’s research has shown a proactive approach to engagement is an important factor in the outcome of fitness to practise proceedings.

• Reflection – Regulatory bodies want to see that healthcare professionals have learnt from mistakes, reflected on the reasons and circumstances that caused the mistake and took action to address and rectify this.

Reflective practice has become an important part of healthcare practise.

For example, the General Pharmaceutical Council’s guidance states: “The GPhC believes that insight is a key factor for committees to consider during fitness to practise proceedings. The expectation that a registrant can accept and understand that they should have behaved differently, and that they will take steps to prevent a reoccurrence, is an important factor for a committee to consider. 

When assessing insight the committee will need to take into account factors such as whether the registrant has genuinely demonstrated insight –not only consistently throughout the hearing but also through their actions after the incident took place -and also has demonstrated understanding and insight after the committee finding.” 

We have drawn on a range of healthcare regulators’ guidance and advice to provide examples of the importance of behaviour and attitude when facing fitness to practise proceedings.  Whilst each regulatory body will have its own set of rules and guidance, there is also commonalities that exist.

Healthcare professionals must engage in fitness to practise proceedings, be honest and show genuine insight.  Doing so will place them in a much better position when questions of impaired fitness to practise are raised and subsequent sanctions.