Find your support
Find your support

Need help now? Urgent help.

An independent directory. Not a charity, care provider or helpline.

Workplace pressure

Professional investigations: what to do first

Build a support team early

By , Editor Updated How we check sources

Short answer

Healthcare staff face two kinds of investigation: an employer process, such as a disciplinary or capability case, and a regulator fitness to practise case run by the GMC, NMC, GPhC, GDC, HCPC or PSNI. Get advice from your union or defence body before you reply to either, meet every deadline, and arrange separate emotional support. The GMC funds a free Doctor Support Service, and the NMC runs a 24-hour Careline on 0800 587 7396.

Key facts

Right to be accompanied
At a formal disciplinary or grievance hearing, you can bring a work colleague or a trade union representative (Employment Relations Act 1999, section 10). The legal right does not cover investigation meetings, but many NHS policies allow a companion.
Doctor Support Service
Commissioned by the GMC and run by the BMA. Up to 6 hours of confidential emotional support from a trained doctor. BMA membership is not needed. Phone 020 7383 6707.
NMC Careline
Free, confidential emotional support for nurses, midwives and nursing associates in a fitness to practise case. Open 24 hours a day on 0800 587 7396.
Doctors and dentists in England
NHS employers follow the Maintaining High Professional Standards in the modern NHS (MHPS) framework when handling concerns.

Employer investigation or regulator investigation

An employer investigation looks at conduct, capability or a specific incident under your employer's policy. The outcome can range from no action to a warning or dismissal. The Acas Code of Practice on disciplinary procedures sets the basic standard of fairness in Great Britain.

A regulator investigation asks if your fitness to practise is impaired. The outcome can range from closing the case to conditions, suspension or removal from the register. Regulators for each group:

  • Doctors: General Medical Council (GMC).
  • Nurses, midwives and nursing associates: Nursing and Midwifery Council (NMC).
  • Pharmacists and pharmacy technicians in Great Britain: General Pharmaceutical Council (GPhC). Pharmacists in Northern Ireland: Pharmaceutical Society of Northern Ireland (PSNI).
  • Dentists and dental care professionals: General Dental Council (GDC).
  • Allied health professionals: Health and Care Professions Council (HCPC).

Both processes can run at the same time. An employer can also refer a case to the regulator.

What to do in the first week

  1. Read the letter and note every date. Write down the allegation, the deadline and the name of the investigating officer or case examiner.
  2. Call your adviser. Doctors and dentists contact their defence organisation and the BMA or BDA. Pharmacists contact the PDA. Nurses contact the RCN or their union. Do not send a written response before you get advice.
  3. Start one folder. Keep every letter, email and note in date order, with a timeline of events. Our guide to keeping safe records explains what to store.
  4. Follow any restrictions. If you are suspended, excluded or under interim conditions, follow them exactly and ask for them in writing.
  5. Do not contact witnesses about the case unless your adviser agrees.
  6. Tell someone you trust. You do not need to share details to get support.

Fairness checks to ask about

NHS England publishes a guide to help managers decide if action against an individual is appropriate, or if the cause sits in the system. In England, NHS Resolution's Practitioner Performance Advice service advises employers on concerns about doctors, dentists and pharmacists. Exclusion or suspension should be a last resort and reviewed at set intervals. Ask your adviser if these steps were followed in your case.

Reflection and insight

Regulators look for insight: an understanding of what went wrong, what you have learned and what you have changed. Your adviser may suggest a reflective statement, relevant training and testimonials. Prepare these with advice, because anything you write can become evidence.

Protecting your health while the case runs

Investigations often take months. Sleep problems, anxiety and low mood are common. See your GP and tell occupational health if work is affecting your health. Use the support services in this guide for the emotional side, and keep your adviser for the procedural side. Peer services and charities do not represent you in the case. If you feel unsafe, use our urgent help page.

Support organisations

Related guides

Common questions

Can I bring someone to an investigation meeting?

The legal right to a companion applies to formal disciplinary and grievance hearings. Many NHS policies also allow a colleague or union rep at investigation meetings, so check your employer's policy.

Is there free support for doctors under GMC investigation?

Yes. The Doctor Support Service, run by the BMA for the GMC, offers up to 6 hours of confidential emotional support from a trained doctor. You do not need to be a BMA member.

Is there support for nurses in an NMC case?

Yes. The NMC Fitness to Practise Careline offers free, confidential emotional support 24 hours a day on 0800 587 7396.

Should I write a reflective statement?

Regulators look for insight, and a reflective statement is one way to show insight. Write the statement with advice from your union or defence body, because the document can be used as evidence.

How long does a fitness to practise investigation take?

Times vary by regulator and case, and many cases take months. Ask the case officer for an expected timescale and for updates.