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When health is a fitness to practise issue – adverse health

This is part of our series of briefings on the Fitness to Practise investigations process.

Relevant legislation allows for the possibility that a healthcare professional’s fitness to practise may be impaired by reason of a health condition afflicting that individual, often referred to as the Registrant’s “Adverse health”. That is not to say that any illness provides a sufficient platform for regulatory action. Healthcare professionals, like the population at large can suffer from the full gamut of health conditions. Some health conditions will mean that a Registrant needs to take time off work, either because that is in their own interests or because they are unable to safely and effectively perform their professional role. In the normal course, such matters are left to the good judgment of the Registrant and do not merit the involvement of their Regulator.

It is little surprise then that the vast majority of health cases that lead to fitness to practise investigations relate to conditions which themselves impair the Registrant’s judgment, in many instances because a lack of insight is a feature of the particular condition. Depression, and drug or alcohol problems are among the most frequent examples. Of course, there are cases where individuals with these conditions do have insight, recognise their illness and take appropriate steps to absent themselves from work until sufficiently recovered.

The greatest concern relates to Registrants who, despite not being well enough to work safely, continue to care for patients. This may be because either they do not recognise they are unwell or sometimes because of a misguided sense of duty to their patients or because they feel unable to stop working for financial reasons. It is in cases of this sort that the Regulator is likely to intervene.

There has been a welcome evolution in the approach which the Regulators take to such cases over the last decade. Registrants can now expect that the Regulator’s approach will be compassionate and considerate, whilst respecting their obligation to protect patients. Most health cases are capable of being dealt with without the need for a full hearing, through conditions or undertakings on the practitioner’s registration. These typically involve obligations to engage with appropriate medical treatments and to modify work commitments in accordance with the recommendations of the treating doctor. On rare occasions, a Registrant may be suspended from the register but that will usually be limited to situations where the Registrant is in the acute phase of an illness which has significantly impaired their insight and reasoning. It is relatively common for interim restrictions to be put in place whilst a Regulator is investigating more significant health concerns associated with a lack of insight and associated clinical risk.

Normally restrictions on registration will be lifted when the condition has stabilised and the Registrant has returned to work for a reasonable period without incident. This allows the registrant to demonstrate that they have developed insight and an appropriate network of professional support and coping mechanisms so that they can take appropriate action at the first signs of recurrence.





This briefing is for guidance purposes only. RadcliffesLeBrasseur LLP accepts no responsibility or liability whatsoever for any action taken or not taken in relation to this note and recommends that appropriate legal advice be taken having regard to a client's own particular circumstances.

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