What is... a Fitness to Practise Report?
- Apex Experts
- Dec 31, 2025
- 4 min read
When concerns arise about a nurse’s conduct, competence, or decision-making, one of the most important tools regulators rely on is the Fitness to Practise Report.
These expert reports play a crucial role in maintaining professional accountability, public confidence, and fairness within healthcare regulation. They provide an objective, evidence-based assessment of whether a professional’s actions meet the standards expected by the Nursing and Midwifery Council (NMC), and whether they remain safe to practise.
At Apex Experts, our nursing expert witnesses regularly prepare Fitness to Practise Reports for use in regulatory proceedings, tribunals, and legal cases. This article explores what these reports are, when they’re needed, and why independence and accuracy are vital in every assessment.
What Is a Fitness to Practise Report?
These reports go beyond reviewing an incident in isolation. They analyse the nurse’s actions against the NMC Code of Professional Standards, assessing clinical judgement, communication, documentation, and ethical decision-making in context.
When Are Fitness to Practise Reports Required?
Fitness to practise reports are used across a range of regulatory and legal scenarios where a nurse’s professional performance is under scrutiny. Common examples include:
NMC Investigations – When complaints are raised by patients, employers, or colleagues about standards of care, communication, or professional behaviour.
Fitness to Practise Tribunals – Where allegations of misconduct, impairment, or incompetence require an expert to contextualise practice standards.
Internal Employer Reviews – For example, NHS Trusts or private providers seeking independent evaluation following an incident.
Coroner’s Inquests and Civil Claims – Where questions about nursing care arise as part of a wider investigation into cause of death or alleged negligence.
Cases can involve a wide spectrum of issues, including:
Medication administration errors
Incomplete or inaccurate documentation
Failures in communication, escalation, or safeguarding
Inadequate patient consent processes
Unsafe delegation or clinical decision-making
Each case requires careful examination against both the NMC Code and applicable national or local policies.
What Does a Nursing Fitness to Practise Report Include?
A well-prepared Fitness to Practise Report follows a structured, methodical approach to ensure transparency and clarity. At Apex Experts, our nursing expert witnesses follow a consistent format designed to meet both regulatory and legal standards.
1. Case Background and Chronology: The expert begins with a concise, factual overview of events, setting out key dates, actions, and decisions. This helps regulators and tribunals understand the sequence of care in context.
2. Evidence Review: All relevant documentation is reviewed in detail, including: clinical records, charts, and patient notes; statements from involved staff and witnesses; relevant Trust or organisational policies and applicable professional and national guidance.
3. Standards and Comparison: The nurse’s actions are compared against professional standards such as, the NMC Code (2018); Royal Pharmaceutical Society or RCN guidance; specialist frameworks, such as Joint Council for Cosmetic Practitioners (JCCP) guidance for aesthetic practice, and local protocols and care policies.
4. Expert Opinion: The expert provides a structured opinion on whether the care or conduct met or fell below accepted standards, the degree and significance of any deviation and whether such a deviation constitutes a breach of professional duty.
5. Conclusions: The report concludes with a clear, impartial summary - addressing both strengths and weaknesses in the
practitioner’s care and the impact on patient safety or professional integrity.
Why Independence Is Essential
A Fitness to Practise Report is not an argument for one side; it is a neutral professional opinion.
Independence is critical because these reports can directly affect a nurse’s career, reputation, and registration status. A credible expert must therefore:
Remain impartial, regardless of who commissions the report
Base all opinions on evidence and contemporary standards
Avoid language suggesting bias or advocacy
Acknowledge both mitigating and aggravating factors
Adhere to Civil Procedure Rule (CPR) Part 35, which enshrines an expert’s duty to the court or tribunal, not the instructing party
At Apex Experts, all our nursing experts undergo structured training to ensure their reports are compliant, balanced, and transparent. As one of our senior nurse witnesses explains:
The Role of Apex Experts
At Apex Experts, we provide specialist Fitness to Practise Reports for regulators, solicitors, and healthcare organisations nationwide.
Our panel includes senior nurses and nurse consultants from a range of clinical backgrounds, each experienced in applying professional standards in legal and regulatory contexts.
We offer:
Independent expert opinions for NMC and internal investigations
Fast-track reporting for urgent or time-sensitive hearings
Expert evidence on breach, causation, and governance
Compliant documentation handling under GDPR and ICO standards
End-to-end administrative support, from instruction to report submission
Each report is reviewed internally for accuracy, consistency, and legal defensibility -ensuring that the final document stands up to scrutiny.
Why These Reports Matter
Fitness to Practise Reports are vital for both accountability and fairness. They protect the public from unsafe practice, but they also protect professionals by ensuring that allegations are tested against objective, evidence-based standards.
They promote:
Public confidence in the nursing profession
Fair hearings based on facts, not assumptions
Continuous improvement, by identifying training or system issues
Transparency and learning across healthcare settings
Ultimately, these reports safeguard patients while supporting professional growth and rehabilitation where appropriate.
Conclusion
A Fitness to Practise Report is one of the most important tools in healthcare regulation. It ensures that decisions about a nurse’s competence or conduct are informed by evidence, professional knowledge, and fairness.
At Apex Experts, our team combines clinical expertise with medico-legal precision - ensuring every report we produce is clear, compliant, and credible. Whether for the NMC, an inquest, or a legal team, our experts deliver independent, court-ready opinions that support fair outcomes and uphold trust in nursing practice.