Can you keep working during a fitness to practise investigation?
Usually, yes. Being referred to the NMC, GMC, HCPC or another regulator does not on its own stop you from practising. Your registration stays as it was unless the regulator applies for, and a panel imposes, an interim order.
Most investigations go ahead without any interim order. Regulators reserve them for cases where there may be a real risk to patients or the public, or another strong reason to act before the facts have been tested.
Your employer can still take its own steps, though. An employer may carry out a local investigation, adjust your duties, add supervision, move you to a non-clinical role, or exclude you while it looks into things. Those decisions follow the employer's own policies and are separate from the regulator's process.
What is an interim order?
An interim order is a temporary restriction on your registration while an investigation continues. It is a protective measure, not a punishment and not a finding of fact. The panel does not decide whether the allegations are true. It decides whether, on what it knows so far, some restriction is needed until the case is resolved.
There are two kinds:
| Type | What it means in practice |
|---|---|
| Interim conditions of practice order | You can keep working, but must follow specific conditions. Examples might include working under supervision, not working as the only registrant on shift, not handling controlled drugs, or attending regular meetings with a supervisor. |
| Interim suspension order | You cannot practise as a registered professional while the order is in place. Your registration shows that you are suspended. |
Where an order is needed, panels are expected to consider whether conditions would be enough before turning to suspension. The NMC's own guidance says panels should not impose suspension automatically and should first ask whether conditions would be sufficient and proportionate.
What test does the panel apply?
The wording varies slightly between regulators, but the panel generally asks whether an order is:
- necessary to protect the public,
- otherwise in the public interest, for example to maintain confidence in the profession, or
- in the registrant's own interests, for example where they are seriously unwell.
The panel weighs the seriousness of the concern, the risk of it being repeated while the case is ongoing, and the effect of an order on you. Any order must be proportionate. The panel usually sees the regulator's summary of the allegations and any response you provide. It is not a full hearing of the evidence.
Who imposes interim orders?
The regulator decides whether to apply. An independent panel or tribunal decides whether to make the order.
| Regulator | Who decides | Points to know |
|---|---|---|
| GMC (doctors, physician associates, anaesthesia associates) | An interim orders tribunal run by the Medical Practitioners Tribunal Service (MPTS) | The GMC can refer at any point in an investigation. Hearings are held in private, though the registrant's name appears in MPTS hearing listings. |
| NMC (nurses, midwives, nursing associates) | A panel of the Investigating Committee or the Fitness to Practise Committee | Hearings are generally public, with parts relating only to health heard in private. Only one interim order can be in place at a time. |
| HCPC (allied health professions and others) | A panel of the Health and Care Professions Tribunal Service (HCPTS) | The HCPC applies where a very serious allegation suggests a possible risk to the registrant or others, or for public interest reasons. |
The GPhC and other regulators have similar powers. The detail differs, so check your own regulator's guidance.
How long do interim orders last, and how often are they reviewed?
An interim order can be made for up to 18 months. Regulators often ask for the full period, because investigations can take a long time, but that does not mean the order will last that long. It ends when the case concludes, or earlier if a review panel decides it is no longer needed.
| Regulator | Review interval | Extension |
|---|---|---|
| GMC | Reviewed every six months, or sooner if there is reason to think it may no longer be appropriate | The GMC must apply to the High Court to extend beyond the period set |
| NMC | Reviewed every six months, and sooner if new relevant evidence emerges. You can ask for an early review | The NMC applies to the relevant court in England and Wales, Scotland or Northern Ireland |
| HCPC | First review after six months, then every three months | Check current HCPC guidance for the detail of extensions |
Under the legislation for nurses and midwives, a court can extend an order by up to 12 months at a time, and the regulator can apply more than once. The registrant can also apply to the court to have an order revoked or varied. Your legal representative can advise you whether this is worth considering in your case.
What happens at an interim order hearing?
- Notice: You are told that the regulator is applying for an interim order. Notice can be short, sometimes days rather than weeks.
- Preparation: Contact your defence organisation, union or solicitor at once. You can usually submit a written response and supporting documents, such as testimonials or evidence of training, though you should not comment on the allegations without advice.
- The hearing: Hearings are often held remotely. The regulator's representative explains why it thinks an order is needed. You or your representative can respond and suggest alternatives, such as conditions you would accept.
- The decision: The panel decides whether to make no order, conditions or suspension, and for how long. It must give reasons.
- After the hearing: If an order is made, it takes effect and appears on the register. You must follow it exactly and tell anyone you work for.
Worked example: working under interim conditions
Grace was referred to the NMC after concerns about medication errors on night shifts. An interim conditions of practice order was made for 18 months. Her conditions included not administering controlled drugs unless directly supervised, not working as the sole registered nurse on shift, and meeting her line manager monthly to discuss her practice. Grace stayed on her ward with an adjusted rota. She kept a log of supervised administrations, completed medicines management training, and wrote reflections on what she had learned. At the six month review, the panel had clear evidence of compliance and progress.
Taking agency shifts at another hospital without telling the agency about the conditions, on the basis that nobody would check.
Telling every employer and agency about the order before accepting shifts, sharing the conditions in writing, and only taking work where they could be met.
Breaching an interim order is treated very seriously and can lead to the order being reviewed, conditions being replaced with suspension, and further allegations. Honest compliance, with a record to show it, protects both patients and you.
Do you have to tell your employer?
Yes. If an interim order is made, you must tell your employer and anyone else you work for, including agencies and private clinics. For doctors, Good medical practice says that if you are suspended or have restrictions placed on your practice, you must tell the organisations you work for, and any patients you see independently, without delay. The NMC and HCPC have similar expectations.
Many employers also expect you to tell them about a referral itself, before any order is made. Check your contract and local policy. Be honest on job applications that ask about investigations or restrictions. Failing to disclose can create a separate honesty concern that may be more damaging than the original one.
Looking after yourself while under investigation
Investigations are stressful and can take a long time. Feeling anxious, ashamed or low is common. Look after your health, use your GP and occupational health, and consider confidential support services for health professionals. If you are unwell, tell your representative, as it may be relevant to the process.
- Keep copies of every letter and decision in one place.
- Diarise review dates so they do not take you by surprise.
- Collect evidence of reflection, training and safe practice as you go.
- Keep working within any conditions and record how you meet them.
- Do not discuss the case on social media.
It can also help to remember that an investigation is not the same as a finding. Many referrals close without any action, and many people who work under interim conditions return to unrestricted practice. Using the time to reflect and build evidence of safe practice is constructive, whatever the eventual outcome.
Related courses
Fitness to Practise Explained: GMC, NMC and HCPC Processes walks through each stage of an investigation, including interim orders, in plain language. Insight and Remediation: Building Your Evidence helps you gather the reflection and training evidence that review panels look for. If ill health or fatigue is part of your situation, Practising Safely When Unwell or Fatigued covers how to manage your practice safely and when to step back.
Frequently asked questions
Does an interim order mean I have been found guilty?
No. An interim order is a temporary protective measure, not a finding of fact. The panel does not decide whether the allegations are true. It decides whether some restriction is needed while the investigation continues. The case is decided later, through the regulator's normal fitness to practise process, which may end with no further action.
How long does an NMC interim order last?
An NMC interim order can be made for up to 18 months and is reviewed every six months, or sooner if new evidence emerges. You can ask for an early review. If the case is not finished before the order expires, the NMC can apply to a court to extend it. The order ends when the case concludes or a panel revokes it.
Can I work as a healthcare assistant while suspended by the NMC?
An interim suspension stops you practising as a registered nurse, midwife or nursing associate. Whether you can take an unregistered role depends on the circumstances, your employer's policies and how you describe yourself. Get advice from your union or defence organisation first, be fully open with any employer, and never imply that you are registered.
Is a GMC interim orders tribunal hearing public?
GMC interim orders tribunal hearings are held in private, according to GMC guidance. The doctor's name appears in the MPTS listing of hearings, but details of the allegations are not published. If an order is made, the restriction is shown on the medical register. Check current MPTS guidance for your case.
Can I appeal against an interim order?
There is no ordinary appeal in the same way as against a final decision, but there are routes to challenge an order. You can ask for an early review if circumstances change, and under the relevant legislation you can apply to the court to have an order revoked or varied. A solicitor or defence organisation can advise whether this is realistic in your case.
Will my interim order be on the register?
Yes. Interim suspension and conditions are generally shown on the public register while they are in place. Some details, particularly about health, may not be published. Employers and agencies routinely check the register, which is another reason to tell them yourself before they find out.
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…
Insight and Remediation: Building Your Evidence
This course explains what UK healthcare regulators mean by insight and remediation, how they are assessed at each stage of a fitness to practise…
Practising Safely When Unwell or Fatigued
This course explains how physical illness, mental health problems and fatigue can affect your clinical performance, and what your regulator expects…
Sources and further reading
- Interim orders tribunals (information for responsible officers). General Medical Council.
- Interim orders and multiple referrals (fitness to practise library). Nursing and Midwifery Council.
- Interim order hearings. Health and Care Professions Tribunal Service.
- The Nursing and Midwifery Order 2001, article 31. legislation.gov.uk.
- Good medical practice (2024). General Medical Council.
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.