Fitness to practise and sexual misconduct
Key takeaways from our Section 29 Conference | 21 May 2026
We recently hosted a Section 29 conference at 39 Essex Chambers, bringing together senior leaders from the 10 health and social care professional regulators. The event focused on strengthening cross‑regulator approaches to sexual misconduct cases, with particular attention to supporting witnesses and improving consistency in decision‑making.
Across the day, speakers shared practical insights and emerging approaches from across jurisdictions, alongside reflections on how fitness to practise (FtP) processes can better recognise and respond to harm.
Learning from international approaches
Dr Jamie Orchard, Australian Health Practitioner Regulation Agency (AHPRA), highlighted some notable differences in the Australian system. AHPRA has the power to prevent sanctioned practitioners from moving into related but unregulated roles – for example, stopping a physiotherapist from setting up as a massage therapist. This goes beyond current UK arrangements and prompted discussion about the potential benefits of a more holistic approach to public protection.
AHPRA has also strengthened transparency in how sexual misconduct cases are recorded by making changes to the Health Practitioner Regulation National Law. Findings are now explicitly labelled as sexual misconduct on the public register, linked directly to tribunal decisions, and retained indefinitely. This approach aims to improve clarity for the public and reinforce confidence in regulatory processes.
Another key feature of the Australian model is the routine use of Victim Impact Statements, allowing complainants’ voices to be more fully reflected in proceedings, and use of specialist teams to investigate and present cases.
Supporting witnesses and recognising harm
A consistent theme throughout the day was the need to better support complainants and witnesses in FtP cases. Several speakers emphasised the concept of situational vulnerability – recognising that vulnerability is not limited to predefined categories, but can arise from the circumstances of a case.
Dr Nina Burrowes, Psychologist and founder of The Consent Collective spoke about the science behind impact of trauma on witnesses, with witnesses entering ‘survival mode’, which can impact on memory and result in inconsistencies in evidence. Nina also discussed the impact of myths and misconceptions and the importance of supporting witnesses through the process, ensuring the professionals working on these cases have the necessary skills to navigate the evidence in a way which supports justice.
There was discussion of how some regulatory frameworks still rely on fixed lists of “vulnerable” witnesses, which may not capture the realities of those giving evidence in sensitive cases. Speakers from the Nursing and Midwifery Council (NMC) shared how it has moved beyond this approach in practice through guidance that enables tailored support for all witnesses, alongside planned rule changes to remove restrictive definitions altogether. These changes, expected later this year, aim to ensure that anyone who needs support can access appropriate measures during hearings.
Dr Catherine O’Neill from Intermediaries for Justice discussed the role of intermediaries and how they can support effective participation of vulnerable and/or traumatised witnesses during the investigation and hearing process, with regular use in the criminal justice system and by other courts and tribunals.
The importance of minimising re‑traumatisation during hearings was also highlighted. Professor Louise Wallace and Ros Foster, Capsticks, both encouraged panel members to take a more active role in managing proceedings – for example, intervening to prevent repeated or unnecessary questioning that could cause distress. Training resources, including a video developed as part of the Witness to Harm project, are helping to support panel members to do this effectively.
Judge Fiona Monk, Chair of the MPTS, and speakers from the GMC discussed the benefit of enhanced sexual misconduct training which is provided to all staff including on using a trauma-informed approach and practice towards witnesses and evidence, with all case presenters/Counsel being RASSO trained.
We also heard from Her Honour Justice Anu Thompson about the approach of the criminal courts. We were reminded that the focus should be on enabling witnesses to participate effectively and give their best evidence, and in doing so, whether this requires a deliberate move away from aggressive adversarial hearings and greater judge/panel intervention.
Developing better support services
The NMC’s Public Support Service and GMC’s support service were highlighted as examples of emerging good practice. These services offer end‑to‑end support for people raising concerns, including early needs assessments, tailored assistance, and a dedicated support line. Both regulators have also introduced specialist roles to support individuals with mental health needs and those affected by sexual misconduct and also use intermediaries. While access currently depends on referral, these models demonstrate how regulators can take a more proactive and supportive approach to those navigating complaints processes.
Looking ahead
Across the conference, there was a clear consensus on the need to continue evolving regulatory approaches to sexual misconduct. Key areas for development include improving transparency, strengthening safeguards to prevent practitioners from moving between roles, and embedding more consistent, trauma‑informed support for witnesses and complainants.
The discussions highlighted the value of collaboration across regulators in addressing shared challenges. By learning from international practice and from each other, regulators can continue to build systems that are both robust in protecting the public and responsive to the experiences of those affected by harm.