Who does the HCPC regulate, and what does fitness to practise mean?
The Health and Care Professions Council (HCPC) regulates a range of professions across the UK, including physiotherapists, paramedics, occupational therapists, radiographers, speech and language therapists, operating department practitioners, dietitians and others. Social workers in England are regulated separately by Social Work England.
Being fit to practise means you have the skills, knowledge, character and health to practise safely and effectively. A fitness to practise concern is not a finding that you did something wrong. It is a question the HCPC must look into: is there a current risk to the public, or to public confidence in your profession?
Hearings are run by the Health and Care Professions Tribunal Service (HCPTS), which is the HCPC's adjudication arm. The HCPC investigates and presents cases. HCPTS panels decide them.
What are the stages of the HCPC fitness to practise process?
- Triage: The HCPC checks the concern is about an HCPC registrant and falls within its remit. If it does not, the case is closed or redirected.
- Initial investigation and threshold: The HCPC gathers information, which may include contacting your employer. It then tests the concern against its threshold policy: could this amount to an allegation that your fitness to practise is impaired? If not, the case closes with no further action. Some very serious concerns, such as serious violence, sexual offences or serious dishonesty, can skip this step.
- Allegations and your response: If the threshold is met, the HCPC drafts formal allegations and sends them to you with the information gathered. You are invited to respond in writing within 28 days. You can ask for one extension of up to 28 days. Responding is optional but usually helps.
- Investigating Committee Panel: A panel meets in private and looks at the papers. It decides whether there is a realistic prospect of proving the facts, the statutory ground and current impairment at a hearing. Outcomes are case to answer, no case to answer, or sending the case back for more information.
- Final hearing: If there is a case to answer, a panel of the Conduct and Competence Committee or the Health Committee hears the case, usually in public, and decides the outcome.
The HCPC usually tells you when an investigation starts. In rare cases it may delay telling you and will explain why. The person who raised the concern does not receive your written response, but all information goes to the panel.
What does the Investigating Committee Panel decide?
The Investigating Committee Panel (ICP) has three members: a chair, a registrant from your profession, and a lay member who is not from any HCPC-regulated profession. It meets in private and decides on the papers. You do not attend.
The ICP does not decide whether the allegations are true. It applies the realistic prospect test. In plain terms, it asks whether there is a real possibility that the HCPC could prove, at a hearing, that:
- the facts in the allegation happened,
- those facts amount to a statutory ground (such as misconduct or lack of competence), and
- your fitness to practise is impaired now, not only at the time of the events.
Because impairment is judged as at the present, your written response is an early chance to show insight and any steps you have taken. Panels can only weigh what is in front of them. The panel can also amend the allegations. If a change is significant, you can comment and a new panel will look at it.
What happens at an HCPTS final hearing?
Final hearing panels also have three members: a chair, a registrant from your profession and a lay member. A legal assessor advises on the law. The HCPC is represented by a presenting officer. You can be represented by a union or professional body representative, a lawyer, or a lay supporter such as a friend.
The panel works through four questions in order. If the answer to one is no, the hearing ends there.
| Stage | Question the panel asks | What helps you here |
|---|---|---|
| Facts | Are the alleged facts proved on the balance of probabilities (more likely than not)? | Honest admissions where facts are true, and clear evidence where they are disputed. |
| Statutory ground | Do the proved facts amount to a ground such as misconduct, lack of competence, a conviction or caution, a health condition, or a decision by another regulator? | Context about the incident, your workload and the system you worked in. |
| Impairment | Is your fitness to practise impaired today? | Insight, reflection, relevant training, and evidence of safe practice since. |
| Sanction | What outcome is needed to protect the public and public confidence? | Evidence that risk has reduced, and references from people who know the allegations. |
HCPTS final hearings are generally held in public, and hearing details are published in advance. The press can attend and report. Parts can be heard in private, for example where your health is discussed. The hearing can go ahead if you do not attend, so it is usually in your interests to take part.
What sanctions can the HCPC give?
If impairment is found, the panel applies the HCPC Sanctions Policy. It starts with the least restrictive option and works upwards until it finds one that protects the public. The policy was updated in 2026, so check the current version on the HCPC website.
| Outcome | What it means | Length |
|---|---|---|
| No further action or mediation | No sanction on your registration. Unlikely once impairment is found. | Not applicable |
| Caution order | A note on the register. It does not restrict practice. | 1 to 5 years |
| Conditions of practice | Requirements such as supervision, or limits on certain work. | Up to 3 years, reviewed before expiry |
| Suspension | You cannot practise in your profession. | Up to 1 year, reviewed before expiry |
| Striking off | You are removed from the register. | You cannot apply to return for 5 years |
For cases based on lack of competence or health, striking off is only available after you have been under conditions or suspension continuously for at least two years. Sanctions do not take effect until 28 days after the decision, or until any appeal ends. The panel can make an interim order to cover that period.
Disposal by consent
In some cases the HCPC and the registrant can agree an outcome without a contested hearing. This needs a case to answer decision, and you must admit the allegations and that your fitness to practise is impaired. A panel must approve it. One option is voluntary removal from the register, which has the same effect as striking off. Take advice before considering this route.
What is an HCPC interim order?
An interim order restricts or suspends your practice while a case is ongoing. It is not a finding that you did anything wrong. The HCPC can apply for one at any point after a concern is first raised. The panel must be satisfied there is enough evidence supporting the concern and that an order is needed to protect the public, in the wider public interest, or in your own interests.
- Interim conditions of practice should be considered before interim suspension.
- The maximum length is 18 months, but an order should last only as long as necessary.
- The first review must take place within six months, then every three months.
- The HCPC can ask a court to extend an order by up to 12 more months.
- You can ask for an early review if your circumstances change.
How should you respond to an HCPC investigation?
Your written response goes to the Investigating Committee Panel. It is often the first time the panel hears from you. Write it with your representative. Be factual, honest and focused on the concern.
I have been a paramedic for 12 years and have never had a complaint. The crew was under huge pressure that night and the patient's family were not clear about his history. I do not think I did anything wrong.
I accept that I did not record a full set of observations before deciding not to convey the patient, and that my documentation did not show my reasoning. I understand this left him at risk and made it hard for others to review my decision. Since then I have completed training on non-conveyance decisions, I now use a structured checklist, and my clinical team leader has audited 20 of my records. The audit is attached.
Context matters and you should include it. But the stronger response leads with ownership, names what you would do differently, and shows evidence that someone else has checked your practice.
Priya was referred after a patient fell during a home exercise session she had delegated to a support worker without a clear plan. In her response she accepted the gap in delegation and supervision, explained the staffing at the time without blaming colleagues, and attached a reflection, a delegation course certificate and a signed statement from her manager, who knew the full allegations, about her current practice. The panel then had specific evidence to weigh when considering current impairment. (Fictional example. Every case turns on its own facts.)
Can you appeal an HCPC decision?
Yes. If you think a final hearing panel's decision is wrong or unfair, you can appeal within 28 days. Appeals go to the High Court in England and Wales, the High Court in Northern Ireland, or the Court of Session in Scotland, depending on where you are. You must serve the court papers on the HCPC yourself. Appeals are technical, so take independent legal advice first.
Getting your learning in order
At every stage, the question is whether you are safe to practise now. Clear, honest reflection and relevant evidence help panels answer that question. Start early rather than waiting for a hearing date.
Our Fitness to Practise Explained: GMC, NMC and HCPC Processes course sets out each step in more detail. If your case involves practising beyond your role or delegation, Working Within Your Scope of Practice may help you reflect on it. For paramedics, Paramedic Practice: Assessment and Non-Conveyance Decisions covers one of the most common areas of concern. These courses support your learning. They cannot predict or change the outcome of your case.
Frequently asked questions
How long does an HCPC investigation take?
It varies a great deal. Simple cases closed at the threshold stage can be resolved fairly quickly. Cases that go to an Investigating Committee Panel and then a final hearing can take many months, and sometimes longer. The HCPC publishes performance data on its website. Your case manager can give you an update on your own case.
Do I have to tell my employer about an HCPC investigation?
The HCPC may contact your employer itself, depending on the concern. Whether you must tell an employer also depends on your contract and local policy, and on any interim order. If an interim order or sanction is imposed, you will need to tell employers. Ask your union or representative how to handle this sensibly in your situation.
What does 'no case to answer' mean in an HCPC case?
It means the Investigating Committee Panel decided there is no realistic prospect of the HCPC proving the facts, the statutory ground and current impairment at a final hearing. The case is closed with no further action. However, if a new concern arises within three years, a later panel can look at the earlier allegations again.
Are HCPC hearings public?
Final hearings are generally held in public, and the HCPTS publishes details in advance. The press and public can attend. Parts of a hearing can be held in private, for example when your health is discussed. Investigating Committee Panel meetings are always held in private and decided on the papers, without either side attending.
Is an HCPC caution order the same as a police caution?
No. An HCPC caution order is a regulatory sanction recorded on the HCPC register for between one and five years. It does not restrict your practice and is not a criminal record. A police caution is a criminal justice outcome. If you receive a police caution, you must tell the HCPC, and it may then look at whether your fitness to practise is affected.
Can I keep working during an HCPC investigation?
Usually yes, unless an interim order restricts or suspends your practice. Many registrants continue working throughout. If an interim conditions order is made, you must follow it and tell relevant employers. Continuing to practise safely, with feedback from a manager who knows about the concern, can be useful evidence later.
Related courses
Fitness to Practise Explained: GMC, NMC and HCPC Processes
This course explains, step by step, how fitness to practise concerns are handled by the UK health regulators, from the first referral to a final…
Paramedic Practice: Assessment and Non-Conveyance Decisions
This course teaches a structured approach to assessment and safe decision-making when a paramedic considers discharging a patient on scene or…
Working Within Your Scope of Practice
This course explains what scope of practice means for UK health professionals, how to recognise the limits of your competence, and how to delegate,…
Sources and further reading
- What our investigation would involve. Health and Care Professions Council.
- Investigations and Investigating Committee Panel stage (fact sheet). Health and Care Professions Council.
- Substantive hearings (fact sheet). Health and Care Professions Council.
- Sanctions policy (2026). Health and Care Professions Council.
- Practice note: Interim orders. Health and Care Professions Tribunal Service.
- Disposal by consent (fact sheet). Health and Care Professions Council.
- What happens at a hearing. Health and Care Professions Tribunal Service.
Practitioner Insight is an independent education provider. It is not affiliated with or endorsed by the GMC, MPTS, NMC, HCPC, GPhC or any NHS organisation, and this information is not legal advice. If you have been referred to a regulator, speak to your defence organisation, trade union or legal representative.
More guides
What Does 'Insight' Mean in a Fitness to Practise Case?
What insight means in a fitness to practise case, how the NMC and GMC assess it, how to show it in a reflective statement, and what weakens it. Plain UK guide.
What Happens at an NMC Fitness to Practise Hearing?
What happens at an NMC fitness to practise hearing: who attends, the three stages, possible sanctions, hearings versus meetings, and how to prepare calmly.
MPTS Tribunals Explained: The Process and Possible Outcomes for Doctors
MPTS tribunal process explained for doctors: who decides, the three stages of a hearing, possible outcomes and sanctions, review hearings and appeals.