Fitness to Practise

This information applies to England and Wales.

Fitness to Practise is a legal process that only applies to certain professions. It applies:

  • while you are studying at university or college
  • and in your career

Some professions require trainees to register with the relevant professional body. There is an initial process at course application or admission stage. This may include:

  • a health questionnaire
  • self-declaration
  • and possibly a medical

Careers include:

  • teaching
  • nursing
  • medicine
  • social work
  • dentistry
  • pharmacy
  • veterinary medicine

Which professions do HCPC regulate? (Health and Care Professions Council)

These professions have a legal requirement to protect the public and to meet legal standards for safety. Everyone who applies to join these courses of study will be asked to complete the same health declaration.

If you are returning to your studies after a break, you may be asked to do the health declaration again. Your health may have changed. This may prompt questions or concerns that were not raised before you took time off.

Return to study at university

The university may ask you to attend a Fitness to Practise assessment. This should only happen if they have serious concerns about:

  • your wellbeing
  • your ability to practise safely in your chosen profession
  • professional standards and safety

They should never ask you to have a Fitness to Practise assessment just because you are disabled or you have taken time off.

Warning Video assessments

The university or the professional body may offer an alternative Fitness to Practise assessment process.

A hearing can only take place by video if everyone, including you, your supporters and any note takers agree to it being held in this way.

The university and professional body must make sure that:

  • the process is accessible
  • you have suitable equipment
  • all necessary reasonable adjustments are in place

Fitness to Practise assessment

All professional bodies and your university should publish their Fitness to Practise procedures online. If you have a Fitness to Practise assessment, they should tell you what will happen and what you need to do.

Cause for concern meeting

This should be a supportive meeting if you are having problems. Your wellbeing should be a priority. It may be with your course tutor.

If you are asked to go to a meeting like this, it’s OK to ask whether it is part of a formal process. Your tutor should:

  • explain why they have asked you to the meeting
  • talk about the university’s concerns
  • consider any reasonable adjustments that the university could make to help you practise safely
  • agree a plan of action

An action plan might include:

  • changes to your workload, if your course involves workplace study, such as a student nurse working in a hospital
  • arrangements for specialist technical or personal support
  • being referred to an occupational health specialist to look at how you could practise safely

If these measures do not address their concerns, the university may refer your case for investigation.


Your university must consider reasonable adjustments

All universities have a legal duty to make reasonable adjustments so that disabled students are not disadvantaged. These adjustments will be different for each student. They could include:

  • changes to your environment, such using accessible classrooms or private study areas
  • personal support, such as notetakers or interpreters
  • assistive technology, such as communication aids or digital recorders
  • changes to your timetable, to give you enough time to rest or extra time to complete exams
  • access to information in different formats
  • lecture capture, including recordings you can review later
  • speech to text for video conferencing

Reasonable adjustments in college and university education

You should discuss your needs with your university's disability service. Do not assume that they will know what they need to do to help you. The university should talk with you about what is possible and what will benefit you. Make your requests in writing and keep a copy of any emails or letters.

If your university refuses to make reasonable adjustments, this could be discrimination.

Disability discrimination in college and university


This could involve:

  • the Head of Department
  • an independent investigator
  • the professional body's Fitness to Practise team

For example, the Nursing and Midwifery Council (NMC) has a specialist team to investigate concerns. They will work with you and your university to resolve issues at an early stage.

The person leading the investigation should talk to you to:

  • make sure you understand the concerns raised
  • allow you to contribute to the investigation
  • allow you to ask questions about the evidence

This procedure could lead to:

  • an action plan
  • further adjustments and support
  • condition management
  • referral to occupational health
  • ongoing monitoring

Once the investigation is complete, you may attend a formal Fitness to Practise hearing.

Fitness to Practise Hearing

This meeting normally takes place at your university when you are ready to return to your studies. If you have had time off for health reasons, you can ask that it takes place once you have had time to recover. A panel will look at evidence and decide if you can continue to study.

The panel may ask you to:

  • answer questions about the evidence
  • explain your situation and respond to concerns
  • make your case for why are you able to return to your studies

Who might be at the hearing

  • A representative of the university
  • A legal adviser who is there to keep the process fair but not there to represent you
  • Someone taking notes
  • A medical adviser
  • The person who carried out the investigation, who will present evidence
  • Solicitors acting for the professional body or the university
  • Your representative
  • A representative of the professional body


Both you and the panel can call witnesses to the hearing.

For example, if there are concerns about your mental health, you might want to bring a mental health professional who knows you well. They can talk about your history and how you are now.

Who to bring with you

You may bring anyone that you feel can help you to:

  • make your case
  • understand the information and decisions

You can also ask for a students' union representative to attend.

You may wish to appoint a legal representative to argue your case and help you to gather and present evidence.

Finding free or affordable legal help (Citizens Advice)


You are entitled to see the evidence in advance of the hearing. You can present any evidence that you believe will support your case. This might include:

  • medical reports
  • psychological assessments
  • academic reports
  • references from family or support professionals
  • correspondence between you and your university about reasonable adjustments
  • your needs assessment for your return to study

Ask for reasonable adjustments

There should be no barriers to you putting your case across. If you need reasonable adjustments so that the hearing is accessible to you, write to ask for these in advance. This could include:

  • allowing a disabled person longer to respond to any allegations or concerns
  • supporting people with mental health difficulties going through the process (which can be quite stressful) to access counselling services
  • changing meeting rooms to a more accessible venue
  • communication support at meetings and hearings, such as a British Sign Language interpreter
  • allowing an advocate or someone to support you to understand the information and make your case
  • providing an ergonomic chair
  • providing documents in an accessible format
  • asking that the hearing takes place in a specific place or at a certain time of day

Asking for reasonable adjustments

Disabled Students Helpline

Disability Rights UK's Disabled Students Helpline can:

  • give you advice about the Fitness to Practise process
  • help you understand what is reasonable and fair
  • give you general advice on how to present your case

Contact Disabled Students Helpline

Help from your university

Ask your university about how to find the Student Welfare Officer. They can:

  • advise you about how to get support for your health and wellbeing
  • attend meetings to make sure you get a fair hearing

The university's Disability Service can:

  • give you specialist advice about reasonable adjustments
  • arrange specialist support in advance to make sure that the process is accessible to you, such as communication aids or interpreters

You can find information about Student Welfare and Disability Services on your university's website.

Your professional body will have a Fitness to Practise team. They can help you to understand the process and try to resolve issues before the hearing.

Last reviewed by Scope on: 20/06/2023

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