Being notified that you are the subject of an Nursing and Midwifery Council (NMC) investigation raises immediate questions about your professional standing and your ability to continue to practise. In the vast majority of cases, a nurse can continue working while under NMC investigation, as a pending investigation does not automatically mean a nurse, midwife or nursing associate is guilty of any wrongdoing. It also does not mean that your registration is immediately restricted.

However, this depends heavily on the specific circumstances of your case. If the NMC believes that there may be a risk to patient health or safety if you continue to practise, it may take steps to restrict your ability to continue your employment. The NMC recognises that healthcare professionals need to maintain their livelihood, but aims to balance this against patient safety and public confidence.

In some cases, this means that the regulator pursues restrictions in cases where they are not necessary, by applying for an interim conditions of practice order or interim suspension order. Under the former, you can continue working, but with specific restrictions, while under the latter you will be temporarily suspended and unable to practise until the investigation concludes.

It is vital to involve a solicitor at your earliest if you become aware that an investigation has been launched. Early involvement by the regulatory discipline team at JMW will enable you to mount a defence and present a strong case at any interim orders hearings that could otherwise restrict your ability to work. Our involvement may encourage the regulator to discontinue or limit the scope of its investigation at an early stage. Here, we outline the fitness to practise process and when interim orders or other restrictions are likely to apply.

When Could a Regulator Seek an Interim Order?

At any stage during an ongoing fitness to practise investigation, the Nursing and Midwifery Council can apply for interim orders. These orders manage immediate risks before the final outcome of the investigation is reached. When an individual decides to raise concerns about a nurse, midwife, nursing associate or other registered professional, the regulatory body has a legal duty to investigate the matter, and may seek interim orders at any stage.

The main function of an interim order is to protect the public while an investigation is ongoing. If you are subject to concerns about clinical errors, allegations regarding professional conduct, criminal charges involving the police or severe ill health, the panel conducting the investigation may pursue an interim order, although this does not apply in all cases. If the panel determines that the risk to the public is low, you will normally face no restrictions. In these cases, you maintain your full professional practice and can provide your standard services to the public without interruption.

Alternatively, the panel may request an interim orders hearing to seek restrictions on your practise, particularly in cases involving allegations of serious errors or misconduct, where your actions could pose a risk to patients or threaten public confidence in the process. Either of the following may apply if your defence is unsuccessful:

An interim conditions of practice order

An interim conditions of practice order allows you to work, but imposes specific restrictions on your practice. For example, it might demand direct supervision when you administer controlled medication, or you might be barred from working night shifts. This practice order aims to address any perceived immediate risk while maintaining your employment. You must disclose these interim conditions to your employer and any other organisations you provide services for.

An interim suspension

An interim suspension order is the most severe temporary measure. It prevents a nurse, midwife or nursing associate from working entirely for up to 18 months while the investigation continues. Panels can use this measure when allegations are exceptionally serious. This includes when investigating incidents involving significant patient harm, or when it is fundamentally in the public interest to suspend the individual immediately.

What Do I Have to Tell My Employer?

In cases where the NMC launches an investigation or imposes any interim orders, you have strict duties to disclose your situation to your employer, prospective employers and other organisations you interact with professionally. You must inform employers at the first reasonable opportunity if your fitness to practise is called into question, and if you receive an interim conditions of practice order or an interim suspension, you must tell any employers straight away.

Failing to disclose this information to an organisation you work with constitutes a serious breach of professional standards that could impact the findings of an investigation and the outcomes you can expect, and lead to separate dishonesty charges in some cases that could do further damage to your career.

This applies for as long as the investigation continues. If you apply for a new job, you must answer honestly if the application specifically asks about current investigations or restrictions.

Will My Employer Be a Part of an NMC Fitness to Practise Investigation?

Even if the regulator does not impose an interim order, your employer may be involved or carry out their own internal risk assessment to decide whether you can safely continue in your current job, or if they need to move you to a non-clinical role while the investigation proceeds.

Employers will usually attempt to manage the risk locally at first, particularly if they were the person who originally reported the concerns to the regulator. Employers frequently use advisory services to discuss suitable approaches, although if the concern poses a serious risk that local supervision cannot effectively manage, they refer the matter to the regulatory body.

If you intend to leave your job, your employer must still conclude their local investigation. They may also share details of the ongoing investigation in future employment references.

When Will I Be Able to Return to Practise?

An investigation may conclude with no further action, or the NMC may make a referral to a fitness to practise committee to determine the outcome and possible sanctions in serious cases. In some cases, if you admit the charges in full, your solicitor can negotiate a consensual panel determination. This involves agreeing on the facts and the proposed appropriate sanction in writing, avoiding the public exposure of a full hearing.

Otherwise, the outcomes vary significantly, but in many of the following cases you may be able to return to work immediately following the conclusion of any proceedings. These outcomes include:

Taking no further action

A panel may take no further action if it finds no impairment or deems the risk of repetition extremely low.

A caution order

The panel may issue a caution order, which stays on your public record for one to five years but allows you to continue your employment without restriction.

A final conditions of practice order

A final conditions of practice order lasts for up to three years. It requires you to work under specified restrictions that are legally binding, or complete targeted training, and you must provide evidence of your compliance to the NMC and your employer.

A suspension or striking off order

A suspension order prevents you from working for a period of up to 12 months, while a striking off order is the most severe outcome possible. It permanently removes your name from the register, and prevents you from applying to rejoin the register for at least five years. You will not be able to legally practise during this time.

Can Legal Representation Prevent an Interim Order?

An NMC fitness to practise investigation is a complex legal process, but the right solicitor can help to minimise any impact on your career at all stages. For example, early written responses often dictate the progress of the entire case, and JMW specialises in drafting representations that persuade case examiners to close cases early, with no need for public hearings and further action.

In making its decision, a regulatory body places immense weight on whether your fitness to practise is currently impaired. If you can present concrete, documented evidence that you have learned from the incident and taken steps to fix the underlying issues, this can prevent an outcome that would see you struck off or even reduce the risk of interim orders.

If an interim orders hearing is held, we will represent your interests and work to prevent a complete suspension by negotiating interim conditions instead, where possible. Our aim is to allow you to keep your job, maintain your income and continue offering your services.

During a full fitness to practise committee hearing, we will challenge the evidence presented by the NMC and develop a bespoke legal strategy to respond to fitness to practise concerns. Our support and guidance can be vital in high-stakes cases involving clinical errors or those tied to police investigations, and we will tailor our approach to your exact circumstances.