Frequently asked questions

A reflective account is a short written piece in which you look back on an experience, work out what you learned and explain how it has changed your practice. It is not a description of events. A good account moves from what happened to why it matters, what you would do differently and how you have put that learning into action. Regulators such as the NMC, GMC, HCPC and GPhC all treat reflection as part of being a safe, up to date professional. Related course: How to Write a Reflective Account (GMC, NMC, HCPC)

You need five written reflective accounts covering the three years since you joined the register or last renewed. Each one must be recorded on the NMC reflective accounts form and must explain how the experience links to the Code. An account can be about a piece of CPD, practice-related feedback you received, an event or experience in your own practice, or a mix of these. You then discuss all five accounts in your reflective discussion with another NMC registrant. Related course: NMC Revalidation for Internationally Educated Nurses

Work through the six stages of the Gibbs cycle in order: description, feelings, evaluation, analysis, conclusion and action plan. Keep the description brief and spend most of your words on analysis, where you explain why things happened and what influenced your decisions. Finish with specific changes you have made or will make, and how you will check they are working. Gibbs is popular, but no UK regulator insists on one model, so Driscoll or Rolfe work just as well. Related course: How to Write a Reflective Account (GMC, NMC, HCPC)

Choose experiences that genuinely taught you something, whether they went well or badly. The NMC accepts reflections on CPD, feedback from patients or colleagues, and events in your own practice. Its guidance says accounts that only cover positive feedback, with no constructive learning, may not meet the requirement. Good topics include a difficult conversation, a near miss, a complaint, a change in guidance or a course that altered how you work. Related course: How to Write a Reflective Account (GMC, NMC, HCPC)

The GMC says it does not ask doctors for their reflective notes when it investigates a concern, and the HCPC says the same about personal written reflections. However, recorded reflections are not legally privileged, so a court can order them to be disclosed if they are relevant. The GMC advises keeping factual details in the clinical record rather than in reflections, and getting legal advice before choosing to share reflective material with a regulator. Related course: Insight and Remediation: Building Your Evidence

No. Leave out anything that could identify a patient, relative or colleague, living or dead. The NMC requires revalidation reflections and discussion summaries to be non-identifiable, and the HCPC asks registrants to anonymise reflections in a CPD profile. Focus on what you learned rather than on clinical facts, which belong in the patient record. Describing a situation in general terms, such as an older patient on a surgical ward, is usually enough. Related course: Confidentiality and Data Protection Breaches

Your reflective discussion must be with another NMC registrant, such as a nurse, midwife or nursing associate. It should take place face to face and be recorded on the NMC reflective discussion form, which your partner signs with their name, NMC PIN and contact details. You do not send the form to the NMC, but you must keep it safe and enter your partner's PIN in your online application. Related course: NMC Revalidation for Internationally Educated Nurses

No. The HCPC says there is no set way to record reflections, so you can use whichever method suits the situation and your learning style. Your employer or professional body may have its own expectations, which you should follow. The HCPC only sees your reflections if you include them in a CPD profile, for example when selected for audit, and it will not ask for your personal reflections if a concern is raised about you. Related course: How to Write a Reflective Account (GMC, NMC, HCPC)

Start by acknowledging what went wrong and its impact on the patient, without blaming others or minimising it. Then explain the factors that contributed, including your own decisions and any system issues, and show what you have changed since. Specific evidence of change, such as new checks you now use or training you completed, carries far more weight than general promises. Keep identifiable details out and seek advice first if the matter is under formal investigation. Related course: Insight and Remediation: Building Your Evidence

Being fit to practise means you have the skills, knowledge, health and character to work safely and effectively in your profession. Regulators such as the NMC, GMC, HCPC and GPhC investigate when there is a concern that a registrant's fitness to practise may be impaired, for example because of misconduct, lack of competence, ill health, a conviction or poor English. The question they ask is whether you pose a current risk, not simply whether something went wrong in the past. Related course: Fitness to Practise Explained: GMC, NMC and HCPC Processes

The GMC investigates concerns about doctors, while the Medical Practitioners Tribunal Service (MPTS) holds the hearings that decide them. The MPTS is operationally separate from the GMC's investigation role and is accountable to Parliament. Most GMC investigations end with case examiners closing the case, issuing a warning or agreeing undertakings. Only cases referred onwards reach a medical practitioners tribunal, where a panel decides whether fitness to practise is impaired and what sanction, if any, applies. Related course: Fitness to Practise Explained: GMC, NMC and HCPC Processes

It is very unlikely that a single, honest medication error would lead to being struck off. NMC guidance says one clinical incident would not usually show a general lack of competence unless it was exceptionally serious, and that employers can normally manage clinical mistakes locally. Regulatory action may not be needed if there is no ongoing risk and you were open about the error and can show learning. Repeated errors, dishonesty or covering up are treated far more seriously. Related course: Medication Errors: Reflection and Remediation

An NMC Fitness to Practise Committee can take no further action, impose a caution order of one to five years, impose a conditions of practice order for up to three years, suspend registration for up to twelve months or make a striking-off order. Panels are expected to start with the least restrictive option and explain why they rejected less serious sanctions. The full sanctions guidance is published in the NMC's fitness to practise library. Related course: Fitness to Practise Explained: GMC, NMC and HCPC Processes

At the end of a GMC investigation, two case examiners, one medical and one non-medical, decide the outcome. They can close the case with no further action, issue a warning, agree undertakings with the doctor or refer the case to an MPTS tribunal. A GMC warning is published on the register for two years. Undertakings are agreements about future practice, such as retraining or working under supervision. Related course: Fitness to Practise Explained: GMC, NMC and HCPC Processes

An interim order is a temporary restriction, either conditions or suspension, placed on your registration while an investigation continues. It is not a finding that the allegations are true. For doctors, the GMC refers cases to an MPTS interim orders tribunal when the allegations, if proven, could pose a risk to patients or the public. The NMC and HCPC have similar powers. Get advice from your defence organisation or union before any interim hearing. Related course: Fitness to Practise Explained: GMC, NMC and HCPC Processes

Insight means you understand what went wrong, why it mattered and how you would act differently. Strengthened practice is the evidence that you have actually changed, such as targeted training, supervised practice or reflection that shows learning. The NMC asks whether a concern can be addressed, whether it has been addressed and whether repetition is highly unlikely. Evidence of insight and strengthened practice is usually central to deciding whether fitness to practise is currently impaired. Related course: Insight and Remediation: Building Your Evidence

The NMC lists a small number of concerns as more difficult to put right. These include breaching the duty of candour, for example by covering up or falsifying records, discriminatory behaviour, sexual harassment or misconduct, abusing a position of power, specified criminal offences, using false qualifications or employment history, and deliberately exposing people to harm. Most clinical concerns are not in this group, but reflection and insight still matter in every case. Related course: Probity and Dishonesty: Ethics Course for Healthcare Professionals

Dishonesty is always taken seriously, but not every dishonest act amounts to serious misconduct. NMC guidance gives examples, such as a one-off act in private life unconnected to practice, that are unlikely to be misconduct on their own. Panels consider what happened, its effect on public protection and the context. A pattern of dishonesty is more serious, and the NMC says most findings of dishonesty lead to suspension or striking off. Related course: Probity and Dishonesty: Ethics Course for Healthcare Professionals

Yes, in most cases. The NMC expects you to tell it as soon as you can if you are charged with an offence or receive a caution, conditional discharge or conviction, and you must also declare these at renewal unless they are protected. The HCPC asks registrants to self-refer as soon as possible. A conviction does not automatically mean removal, as each case is judged on its facts, but failing to declare is a serious matter in itself. Related course: Criminal Convictions, Cautions and Declaring to Your Regulator

Contact your defence organisation, trade union or a legal representative straight away, before you reply to the regulator. Read every letter carefully, keep to deadlines and stay calm. The GMC notes that legal aid is not available for its investigations, so membership of a defence body or union matters. While you wait, keep practising safely, follow any restrictions exactly, and start reflecting honestly on the concerns with your adviser's guidance. Related course: Fitness to Practise Explained: GMC, NMC and HCPC Processes

The HCPC first gathers information, then a senior decision maker checks the concern against its threshold policy and standards. If the threshold is not met, the case is closed with no action. If it is met, the concerns become allegations and go to an Investigating Committee Panel, which meets in private and decides whether there is a realistic prospect of proving them. You are sent the papers and given time to respond before that panel meets. Related course: Fitness to Practise Explained: GMC, NMC and HCPC Processes

Not usually. NMC guidance for employers says most concerns should normally be managed locally, often after a local investigation. Employers are expected to refer when they cannot manage the risk themselves, for example if someone disengages from an action plan, keeps making errors after retraining or is dismissed for serious concerns about safe practice. Engaging openly with local processes is often the best way to show the risk is being addressed. Related course: Human Factors and Learning from Incidents

NMC revalidation has eight requirements: practice hours, continuing professional development, practice-related feedback, written reflective accounts, a reflective discussion, a health and character declaration, a professional indemnity arrangement and confirmation. Most must be met over the three years since you joined the register or last renewed. You also need to pay your annual registration fee. Full details and the mandatory forms are on the NMC revalidation website. Related course: NMC Revalidation for Internationally Educated Nurses

Nurses, midwives and nursing associates need 35 hours of CPD relevant to their scope of practice over the three-year revalidation period, and at least 20 of those hours must be participatory. For each activity you should record the method, the topic and how it relates to your practice, the dates, the hours, the most relevant part of the Code and evidence that you completed it. The NMC does not prescribe a particular type of CPD. Related course: NMC Revalidation for Internationally Educated Nurses

Only if it involves interacting with other professionals. The NMC defines participatory learning as activity with one or more other professionals, in person or in a virtual setting such as an online discussion group. Self-paced e-learning that you complete alone still counts towards your 35 CPD hours, but it would not normally count towards the 20 participatory hours unless you discuss or work through it with colleagues. Related course: NMC Revalidation for Internationally Educated Nurses

You need 450 practice hours over three years for a single registration, such as nurse, midwife or nursing associate. Combined nurse and midwife registration needs 900 hours, including 450 in each role, and triple registration needs 1,350 hours. If you cannot meet the hours, you must complete an approved return to practice programme or a Test of Competence before your application date. Related course: NMC Revalidation for Internationally Educated Nurses

You need five pieces of practice-related feedback over the three-year period. Feedback can come from patients, service users, colleagues, managers, team performance reports or your annual appraisal, and it can be written or verbal, formal or informal. You must not record anything that identifies another person. Feedback is also a useful starting point for one or more of your five reflective accounts. Related course: Communication, Attitude and Responding to Complaints

Your revalidation application is due on the first day of the month in which your registration expires. For example, if your renewal date is 30 April, your application is due by 1 April. The NMC sends a renewal notice 60 days before the due date, and you can submit through your NMC online account at any point in that window once you meet the requirements. If you need more time, you can request an extension online. Related course: NMC Revalidation for Internationally Educated Nurses

Where possible, your confirmer should be your line manager, who does not need to be on the NMC register. If you have no line manager, the NMC recommends choosing an NMC-registered nurse, midwife or nursing associate, or failing that another UK-regulated healthcare professional. Family members and close friends cannot act as your confirmer. You should try to meet your confirmer face to face to go through your evidence. Related course: Appraisal and Revalidation Explained

Each year the NMC asks a sample of nurses, midwives and nursing associates for more information about their revalidation. If you are selected, you will be told within 24 hours of submitting your application and paying your fee, and you then have 21 days to provide the information online. Selection does not necessarily mean the NMC has concerns, and you can keep practising while it reviews your evidence. Related course: NMC Revalidation for Internationally Educated Nurses

Doctors with a licence to practise usually revalidate every five years. Your responsible officer makes a recommendation to the GMC based on evidence from your annual appraisals and information from your organisation's governance systems. Appraisals should cover your whole scope of practice, including private, locum and voluntary work. If you do not engage with appraisal and revalidation, your licence to practise can be put at risk. Related course: Appraisal and Revalidation Explained

The GMC does not set a fixed number of CPD hours or points for revalidation. Instead, it expects you to keep up to date across your whole scope of practice and to reflect on your learning at each annual appraisal. Many medical royal colleges and faculties publish their own recommendations, often expressed as credits per year, so check your college's current CPD scheme for the figure that applies to your specialty. Related course: Appraisal and Revalidation Explained

A responsible officer is a senior licensed doctor, usually the medical director of your organisation or their deputy, who makes revalidation recommendations to the GMC. Your designated body, the organisation that supports your appraisal and revalidation, appoints them, so you cannot choose your own. The connection is with the designated body rather than the individual, so it stays the same unless you move to a different organisation. Related course: Appraisal and Revalidation Explained

Pharmacists and pharmacy technicians submit six records to the GPhC every year as part of renewing their registration. These are four CPD entries, at least two of which must be planned learning, plus one peer discussion and one reflective account. Records must be submitted through the GPhC online portal by your renewal deadline, and paper submissions are not usually accepted. Check the GPhC website for the latest framework. Related course: Dispensing Errors in Community Pharmacy

HCPC registrants renew every two years in a fixed window for their profession, making a professional declaration and paying a fee. There are five CPD standards: keep an up to date record of your CPD, do a mix of learning types relevant to your practice, aim to improve the quality of your practice, aim to benefit service users, and provide a CPD profile with evidence if selected for audit. Related course: HCPC Registration for International Allied Health Professionals

At each renewal the HCPC randomly selects 2.5 per cent of each profession for CPD audit. You can only be selected if you have been registered for at least two years, and you could be picked more than once. If selected, you submit a CPD profile showing how you meet the five CPD standards, backed by evidence. If your profile is not accepted, you can appeal, and you can ask to defer in unavoidable circumstances. Related course: Building Your Professional Portfolio from Day One

For IELTS Academic, the NMC requires 7 in reading, listening and speaking and 6.5 in writing. For OET, it requires grade B in reading, listening and speaking and C+ in writing. These are the only tests the NMC accepts. You can combine two sittings of the same test taken within 12 months, subject to minimum scores in each, and results must be no more than two years old when your application is assessed. Related course: NMC Registration for Internationally Educated Nurses

The Test of Competence is how the NMC assesses the knowledge and skills of nurses and midwives trained outside the UK, and of some people returning after a long break. It has two parts. Part one is a computer-based test (CBT) taken at Pearson VUE centres in many countries. Part two is a practical OSCE taken at an approved test centre in the UK. You must pass both to complete registration. Related course: NMC CBT Preparation (Test of Competence Part 1)

NHS Employers guidance states that candidates have up to three OSCE attempts per application, with at least 10 working days between attempts, and only failed stations need to be resat. It also says the first attempt should fall within 12 weeks of the employment start date on your Certificate of Sponsorship. Rules and fees can change, so always confirm the current position with the NMC and your employer before booking. Related course: NMC OSCE Preparation: APIE Stations

You cannot work as a registered nurse until the NMC has added you to its register and issued your PIN. NHS Employers guidance explains that internationally educated nurses can be employed in a pre-registration role while waiting for their first OSCE attempt, working within the limits that role allows. After you pass the OSCE, the NMC processes your registration, and your employer then moves you into a registered nurse post. Related course: Adapting to UK Nursing Practice and Culture

PLAB is the GMC's test for doctors who qualified outside the UK, the EEA or Switzerland, checking they meet the standard of a doctor starting the second year of the UK Foundation Programme. PLAB 1 is a three-hour paper of 180 single best answer questions, available in the UK and several other countries. PLAB 2 is a practical exam of 16 scenarios at the GMC's clinical assessment centre. You must apply for registration within two years of passing PLAB 2. Related course: GMC Registration Routes for International Doctors

Yes, there are other routes. The GMC accepts certain postgraduate medical qualifications as evidence of your knowledge and skills, usually if awarded within the last three years. Another route is sponsorship, where an approved sponsor, such as some royal colleges and NHS organisations, issues a Sponsorship Registration Certificate. Whatever route you use, you still need to meet the GMC's English language requirements. The GMC's online application finder shows which route fits you. Related course: GMC Registration Routes for International Doctors

Yes. On 30 November 2023 the GMC replaced the CESR and CEGPR routes with the Portfolio Pathway. It lets doctors who have not completed a UK training programme apply for specialist or GP registration by showing, through a portfolio of evidence, that their training and experience meet the required standard. Requirements are set out in specialty-specific guidance on the GMC website, and preparing evidence usually takes considerable planning. Related course: Portfolio Pathway (CESR) Planning

Professionals trained outside the UK apply through the HCPC international route, showing that their training, skills and experience meet its standards of proficiency. Since January 2025, applicants whose qualification was not delivered in a qualifying country must provide a recognised English test score. The HCPC has added checks to reduce fraud and is changing parts of its assessment, so applications may take longer. Check the HCPC website for current scores and fees. Related course: HCPC Registration for International Allied Health Professionals

Yes. Once you are on the NMC register, you revalidate in the same way as UK-trained colleagues, every three years from the date you joined. That means 450 practice hours, 35 hours of CPD with 20 participatory, five pieces of feedback, five reflective accounts, a reflective discussion, declarations, indemnity and confirmation. Starting a simple portfolio in your first month makes your first revalidation much easier. Related course: NMC Revalidation for Internationally Educated Nurses

Good Medical Practice is the GMC's core statement of the professional standards expected of every doctor on its register. The current version, known as Good Medical Practice 2024, came into effect on 30 January 2024 for doctors, and later applied to physician associates and anaesthesia associates from 13 December 2024. Key updates cover respectful workplaces, patient-centred care, tackling discrimination, inclusive leadership and continuity of care. Related course: Good Medical Practice: Professional Standards for Doctors

Yes. Every Practitioner Insight course is free to study. You can work through the learning content and the knowledge check at no cost. You only pay if you choose to obtain a verified certificate for a course, which you might want as evidence for appraisal, revalidation or your portfolio. Studying a course without buying a certificate is entirely up to you.

A verified certificate costs £49 per course. You pay by card through Stripe, a secure online payment service, once you have passed the knowledge check and completed your reflection. Each payment covers the certificate for one course, so if you take several courses you would buy a separate certificate for each one you want certified.

To earn a certificate you need to score at least 80 per cent in the course knowledge check and complete a structured reflection on what you have learned. The reflection asks you to think about how the topic applies to your own practice and what you will do differently. Once both are complete and payment is made, your certificate is issued with your name, the course title and the completion date. Related course: How to Write a Reflective Account (GMC, NMC, HCPC)

Every Practitioner Insight certificate has a unique ID and a QR code. Anyone, such as an employer, appraiser or confirmer, can scan the QR code or enter the certificate details on our /verify page to confirm that it was genuinely issued and matches the name, course and date shown. This makes it quick for others to check your evidence without needing to contact us.

Each course shows its estimated study time, which is usually about 40 to 55 minutes. Courses are recorded as 0.75 to 1 CPD hour, and the exact figure is shown on each course page. You can study at your own pace. If your regulator or college asks for CPD hours, record the time you actually spent alongside what you learned.

You can include a course in your CPD record if it is relevant to your practice, but it is your responsibility to decide that and record it properly. The NMC does not prescribe types of CPD, and self-study counts towards your 35 hours, though not normally towards participatory hours. Doctors discuss CPD at appraisal, and HCPC registrants need a mix of learning types. Your certificate and reflection can support the record. Related course: Appraisal and Revalidation Explained

No. Practitioner Insight is an independent provider and is not endorsed by any regulator or NHS body, including the NMC, GMC, HCPC, GPhC or MPTS. Always check the detail of any requirement against the official guidance published by your own regulator. Whether a course is suitable evidence for your purpose is a matter for you and the people reviewing it.

Completing a course does not guarantee any outcome in a fitness to practise case, an employer investigation or any other process. Regulators look at whether you have genuine insight and have changed your practice, not simply at certificates. A relevant course and an honest reflection may form part of that wider evidence, but our courses are not legal advice. Anyone referred to a regulator should contact their defence organisation, union or legal representative. Related course: Insight and Remediation: Building Your Evidence

Speak to your defence organisation, union or legal representative first, as they can advise what evidence is appropriate for your case. Many people then start with Fitness to Practise Explained, to understand the process, and Insight and Remediation: Building Your Evidence, which covers how regulators view reflection and change. After that, choose the course that matches the specific concern, such as medication errors, record keeping or professional boundaries. Related course: Insight and Remediation: Building Your Evidence