Fitness to Practise

If you are enrolled on a course which leads to professional registration, the University is required to ensure that you are fit to practise for the full duration of your course. It is expected that all students on a programme leading to professional qualification or registration will act with integrity, honesty, with respect for others and their property, and in compliance with the relevant code of professional standards. This requirement is an ongoing responsibility throughout your programme and applies not only to your health and conduct in university and on placement, but in your personal life too.

You must:

• Ensure your behaviour is professional on placement, in University and in your personal life;
• Ensure you remain mentally and physically fit and seek support if your health deteriorates or impacts on your ability to study or engage with placement activities.

Very importantly, you are expected to be open and honest at all times and so must immediately report any circumstances which may adversely impact your (or anyone else's) fitness to practise to your School. These might be health issues, any police involvement resulting from your behaviour or alleged behaviour, other statutory body investigation or other issues of probity or breach of professional body standards. Failure to be open and honest can be seen as a far more serious issue than the original concern.

Failure to be open and honest can be seen as a far more serious issue than the original concern.

Useful Links

• Cardiff University Fitness to Practise Procedure
• Cardiff University Fitness to Practice intranet page
• Office of the Independent Adjudicator (OIA): Good Fitness to Practise Procedures

Professional Standards

• General Dental Council: Standards for the Dental Team
• General Dental Council: Guidance on using social media
• General Medical Council: Achieving Good Medical Practice: guidance for medical students
• General Medical Council: Good Medical Practice
• General Medical Council: Doctor's use of social media
• General Pharmaceutical Council: Developing professionalism as a student
• General Pharmaceutical Council: Standards for pharmacy professionals
• Health and Care Professions Council: Standards
• Health and Care Professions Council: Guidance on the use of social media
• Nursing & Midwifery Council: The Code, Professional standards of practice and behaviour
• Nursing & Midwifery Council: Social Media Guidance
• Social Care Wales: Codes of Practice and Guidance
• Social Care Wales: Social Media Guidance

The following are examples of circumstances that might trigger an investigation:

• Substance, alcohol, or drug misuse;
• A criminal offence including any caution, reprimand, or ongoing investigation by the police or relevant statutory body;
• Failure to inform the University of a criminal offence, reprimand, or investigation by the police or a relevant professional or statutory body;
• Any physical, verbal, racial or sexual abuse, discrimination, harassment or bullying of any other student, member of the public, or member of the University community;
• Falsification of documents or clinical information, personal or academic-related information;
• Publication of inappropriate information, comments, or images, including on social media platforms;
• Repeated unprofessional behaviour which has not been addressed by the student in accordance with the outcome of any informal action;
• Physical or mental health conditions which cause a concern regarding fitness to practise, for example where there has been a failure to follow medical or support service advice, including where reasonable adjustments have been provided;
• Breaching confidentiality;
• Breaching the expected conduct and behaviour specified by the relevant professional body.

Real examples of issues that have been investigated

• Twitter comments regarding placement;
• Screenshots from a Facebook conversation;
• Student signing a mentor sheet on behalf of a mentor;
• Student removing hospital apparatus from hospital;
• Student not providing a DBS certificate;
• Student receiving a caution;
• Student developing a health condition that prevents them from safely practising following reasonable adjustments being put in place;
• Student sending inappropriate emails to staff and students;
• Students publishing photos of themselves in uniform on the ward;
• Student falsely stating that they had undertaken clinical placement hours;
• Student being reported for using cannabis;
• Student being on the ward smelling of alcohol.

Reporting a Health Concern

You may already have a condition that worsens or changes, or you may develop a health condition during your Programme. You must ensure the University is aware of any conditions that may affect your fitness to practise.

If you report a change or a new condition the University will usually refer you to Occupational Health services to ensure all appropriate support and reasonable adjustments can be put in place.

If your condition has an impact on your fitness to practise once appropriate support and reasonable adjustments have been put in place, then this will need to be considered using the Fitness to Practise Procedure. The investigation may include liaising with your doctor or healthcare team to be able to make an accurate and detailed assessment of your health.

Suspension

Depending on how serious the health/conduct issue is, the University may suspend you from placement or the programme during an investigation. The University will usually wait for any outstanding police matters to be resolved before investigating.

You can be suspended at any point in the Fitness to Practise procedure, from the University and/or from your programme. Where the risk is only in relation to patients, clients, or members of the public, you can be suspended from placement or clinical settings only. This is not supposed to be a penalty but a precautionary measure taken to avoid the risk of harm.

Where there is considered to be an immediate risk, the Head of School can suspend you with immediate effect, from a placement or clinical setting, for up to 7 days in order to protect the safety of patients, clients, and members of the public. If this happens, the Vice-Chancellor, or nominee, must review the suspension within 7 days.

The Vice-Chancellor can then suspend you for a period of up to 12 months, which can be extended in exceptional circumstances. The Vice-Chancellor must review any suspension at least every 60 days and inform you in writing of the outcome within 7 days.

You can request a review of the decision to suspend you:

• within 14 days of the decision; or
• where there is a change of circumstances and/or new information relevant to your case.

Investigation into a Fitness to Practise Concern

If, on receipt of a concern, the Head of School decides that an investigation is needed, they will appoint an Investigation Officer. You should be informed within 14 days of this happening.

The Investigating Officer will contact you via email to inform you that a concern has been raised and invite you to attend an investigation meeting. The letter should include:

• the purpose of the meeting;
• the reported concern and any evidence submitted;
• the Fitness to Practise Procedure;
• the details of the staff who will be present;
• the right to be accompanied either by a friend or representative.

You should be given 7 days' notice of the meeting.

The initial investigatory meeting will be to establish the facts of the case. You will also be expected to show an understanding of why the concern has been raised and the professional standard relevant to your programme of study. If you are accepting the allegation or concern it is very important that during the meeting you are able to demonstrate, remorse, reflection, and learning.

If you are unable to attend the meeting it can normally be rearranged with sufficient prior notice. You should be treated fairly and transparently under this procedure.

Understanding the Concern and Preparing for the Meeting

You will normally be expected to demonstrate a full understanding of why any allegation has caused concern, even if you are denying it. We strongly advise, in preparation for the initial investigatory meeting, that you:

• Read the alleged concern and any supporting evidence sent to you;
• Read the University's Fitness to Practise Procedure;
• Read the professional standards/code of conduct for your chosen profession;
• Make notes of which parts of the above procedures/standards/codes the alleged behaviour may have breached;
• Makes notes detailing your understanding of what Fitness to Practise is and why it is important;
• Reflect on your actions if you think you have breached the rules of the University and/or professional body. This should include the above understanding of where you went wrong, why it is important, what you have learnt from this and what you have done to prevent it happening again.
• Think about a sincere apology and how you can put things rights, if you have breached the rules;
• Go through your portfolio and/or any feedback you have received that is positive and relevant. If, for example, the allegation raises concerns about your professionalism, try to find feedback that describes you as being demonstrating professional behaviour;
• Think about any evidence you have to support what you say if you are denying all or part of the allegation and get it in advance. If you are denying an allegation, it is essential that you keep in mind the requirement of honesty and openness. If the School and/or University think that you are not being honest, the consequences can be far worse;
• Think about what was happening at the time of the allegation. Were you experiencing any extenuating circumstances that may have affected your judgment and can you get evidence of these? If something was affecting your judgment and this caused your behaviour to fall short of what was expected, you need to be prepared for questions about whether you reported these issues and got help. if you did not, the School/University may be concerned about your lack of insight and openess about the circumstances but, again, it is usually better to be open and honest as early as possible in any investigation.
• Think about any mitigating factors that may make your actions less serious and/or more explainable. Are you at the beginning of your course and finding things very different to high school? Was your mentor unsupportive and absent a lot of the time? Is the behaviour something you were never told was wrong?

You do not need to write a script for this meeting but detailed notes are a very good idea because you will likely be nervous and need to ensure that you cover all the relevant points. Student Advice can accompany you to this meeting but you will need to give us enough notice to make sure someone can be free.

After the Meeting

The Investigator will use notes of the meeting to produce a report called a Case Record. You should be provided with this record within 14 days of the meeting taking place. The Fitness to Practise Procedure says that you can submit a statement if you believe that the meeting record is inaccurate but we normally advise to do so even if it isn't.

Further meetings may be required if more information becomes available.

Preparing your Statement

Your statement is important because it is your opportunity to tell the Head of School what you want to say in your own words. The Head will take this into consideration when deciding whether or not your fitness to practise is a concern and, if so, what to do next. We recommend that you wait until after you have attended the investigatory meeting and received a written record of it.

What you include in your statement will depend on your circumstances and whether you are admitting or denying any allegations. As a general structure we advise that you look at including the points suggested for the meeting preparation above and cover:

• Reflection. If your actions may have breached the rules and/or fallen short of the required standards, it is important to reflect on that. Explain your understanding of why fitness to practise is important and exactly how your conduct or health may be cause for concern. Have you potentially undermined public confidence in the profession? Have you potentially shown a lack of insight into your own health? Have you posted something that if shared would bring the profession into disrepute? Why is important for others to have confidence in you and the profession? Why do you need to be aware of how well you are? If you can demonstrate that you fully understand the issue, you can show the Head of School that you are taking the matter seriously and doing everything to make sure it does not happen again.
• Apology. If you have breached rules, even if unintentionally, it is important to show remorse. Everyone makes mistakes but being sorry shows the right attitude moving forward and can reassure the Head of School that it will not happen again.
• Intent. Did you intend to breach the rules or cause concern? If you did intend your actions it is best not to address this in your statement. If you had no intention, what happened?
• Context. If there is some context to what happened that may help to explain your actions, be sure to include it but be careful with your tone. Do not try to excuse any breaches but say that you would like to explain what was happening at the time to give some context to the allegations.
• Mitigation. Are there any mitigating factors that, like context, may help to explain what happened or make it less serious? If, for example, you had reached out for help, or you had reported yourself for the concern at issue.
• Extenuating Circumstances. Explain if anything was impacting you that may have affected your judgment/thinking. You need to be honest but careful with how you say what you say here. If something was happening that meant your judgment was impaired, that can itself be an issue if you did not show the appropriate insight at the time. If, for example, you were suffering with insomnia and made a mistake on the ward, you will need to address why you attended placement that day when you were not fit to do so.
• Conclusion. Finish with an explanation of what you have done/are going to do to prevent this from happening again and how you feel about your course and profession. A final reiterated apology and demonstration of commitment to the profession can help to end your statement in the right tone.

The Head of School Decision

Once you have confirmed the record as being an accurate account of the meeting (or not as the case may be) and sent your statement and any supporting evidence, it will all be sent to the Head of School, who can:

• Dismiss the concern/issue, or
• Refer the concern/issue for consideration at a School Fitness to Practise Committee, or
• Refer the concern/issue for consideration at a University Committee if the concern is very serious or if there are other factors which require consideration by the University.

You should receive the Head of School’s decision within 14 days.

Attending a Fitness to Practise Committee

If the Head of School has decided that your case does need to be considered further, they will refer it to a Fitness to Practise Committee. This can be either a School Committee or University Commitee

The purpose of the Committee is to provide an independent panel to consider the evidence and to provide you with the opportunity to respond. A Fitness to Practise Committee is not something to be scared of but should be taken very seriously and well prepared for. Student Advice can help you prepare for and attend the hearing with you but please be sure to give us as much notice as possible.

A Fitness to Practise Committee is not something to be scared of but should be taken very seriously and well prepared for.

Before the hearing, you will be sent “committee papers”, which should include:

• The Investigating Officer’s report and evidence gathered;
• Occupational health report, if applicable;
• Relevant professional body codes and regulations;
• The Fitness to Practise Procedure;
• Your statement, if you submitted one.

You will be given the opportunity to submit additional evidence and call witnesses. It is very important to attend the committee so you can put forward your response to the allegations. You may be able to attend the committee via Skype, Zoom or Teams if you cannot attend in person.

The School and University Committees have different people in attendance but both follow the same format:

• Everyone will introduce themselves and the Chair of the Committee will explain the formalities; that you are there because of a fitness to practise concern and it is being considered under the Fitness to Practise procedure.
• Someone from the University will present the concerns and evidence. In a School Committee, this is usually the Investigating Officer that met with you at the beginning. In an University Committee, it may be someone more senior in the School. Everyone in the room at this point should have been given a copy of the Committee papers in advance of the meeting, so should be fully aware of the concerns. The person presenting them will normally provide a summary of the key points and make reference to pages in the papers they deem of particular importance.
• You and your representative, if you have one, can ask questions of the person presenting the concerns.
• The Committee panel can ask questions of the person presenting the concerns.
• The Chair of the panel will then say that it is over to you and/or your representative, if you have one, to say what you would like to say. As above, everyone should be fully aware of the concerns and should have read your statement, if you submitted one. We normally advise that you do the same as the person presenting the concerns and provide a summary of the key points you want the panel to understand. It is a good idea to make a note of these points in advance and tick them off as you go, so you know that you have covered everything, You can write bullet points to guide you or write in full and read if you feel very nervous.
• The Committee panel can then ask you questions. This part can feel quite intense but try to keep calm and think about what you want to say. You may find that you are asked questions that you feel you have already answered or have a question repeated in a way that feels you have not answered in a way the panel want. Do not be afraid to ask for clarification of what a panel member means by their question, or to say that you cannot answer any more than you already have. Your representative from Student Advice can help with this, if you choose to take one.
• The person presenting the concerns can ask you questions.
• You will be asked if there is anything else you want to add. Although you will have already had your chance to speak, it is a good idea to say something at this stage as it will be the last thing the panel hear before they make their decision. What you say should ideally be brief, heartfelt and impactful; perhaps a few sentences reiterating an apology, dedication to your course, how hard you have worked and what you have done to ensure any breaches will not happen again.
• You, your representative, and the person presenting the concerns will then be asked to leave the room while the panel make their decision. The panel do normally try to reach a decision on the day but, if they feel unable to do so, they should inform you in writing within 7 days.
• If they do reach the decision on the day, you, your representative and the person presenting the concerns, will be called back in and the decision will be explained. If the panel have found that your fitness to practise has been called into question, they will also explain what you are required to do next.

School Committee Actions

A School Committee may take 1 or more of the following decisions:

• Dismiss the concern;
• Issue an informal warning;
• Issue a formal warning for a specified length of time to be kept on your file and to be taken into account in any future proceedings;
• Require you to attend internal or external support sessions;
• Require you to write a reflective account supported by a member of staff;
• Require you to develop and complete an action plan supported by a member of staff;
• Require you to be monitored by the Occupational Health Service and continue on the programme with support;
• Require you to take an interruption of study for a specified period of time;
• Refer to the University Committee

University Committee Actions

A case will be referred to a University Committee if the concern is very serious or if there has been a previous Fitness to Practise decision. A University Committee can decide any of the above and:

• Suspend you for a specified period of time;
• Require you to resit part(s) of your programme of study, where this is possible within the regulations;
• Require you to engage with specified supportive measures for the remainder of your programme of study;
• Any action which the Committee considers to be appropriate to give you an opportunity to successfully complete the programme;
• Withdraw you from your programme of study and allow a transfer to a non-professional programme of study (subject to the admission requirements of that alternative programme of study);
• Exclude you from the programme and the University.

If a Committee has decided that a breach of fitness to practise conduct has occurred, you may request a review of the decision in accordance with the University Review Procedure. Time limits apply to this procedure.

Contact Student Advice

Advice@cardiff.ac.uk
+44 (0)2920 781410