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Alternatives to final panel hearings for fitness to practise cases – the public perspective

15 May 2013 | Professional Standards Authority
  • Research Papers

May 2013 research report

What were the public responses to alternatives to final panel hearings?

We commissioned UK-wide research with members of the public on alternatives to final panel hearings for resolving fitness to practise cases. The research found that there was strong support for these different methods, mainly because hearings are often stressful for the people who have complained about the healthcare professional or social worker. But there were also concerns that these alternatives could lead to less thorough investigations, overly lenient sanctions, a lack of transparency, and the loss of the complainant’s voice in the process.


We commissioned this research in response to the growing interest from the regulators we oversee in alternatives to final panel hearings for dealing with fitness to practise cases. We felt that we could usefully contribute to the debate by exploring the views of members of the public on these alternatives, which until now had not been fully understood. Members of the public are one of the main sources of complaints for regulators, without which many concerns would go unreported. It is therefore important to understand how they feel about these initiatives.


In 2011, we sought to understand people’s experiences of complaining to regulators and acting as witnesses in fitness to practise cases. We had previously set out our views on alternatives to hearings in 2011, when we responded to the GMC consultation on different ways of dealing with cases at the end of an investigation. The GMC was proposing to dispose of all cases where the doctor was willing to accept the proposed sanction by means of a meeting with them. We stated that we were in favour of the principles behind the proposals, namely finding proportionate and cost effective ways of dealing with fitness to practise cases, but voiced our concerns about the transparency of the proposed arrangements. In our response to the NMC consultation on consensual disposal in August 2012, we expressed our concerns about retaining public confidence, the risk of under prosecution, the involvement of complainants, and record keeping and transparency.

Research brief

The research explores the views of members of the public from across the UK on these alternatives, both in principle and in practice, and the extent to which they could achieve the three aims of fitness to practise of:
- protecting the public
- maintaining public confidence in the profession and regulation, and
- upholding professional standards.

Both complainants and non-complainants were involved in the project.


All the complainants had found the hearing process very stressful, much more so than they were expecting, and the expectations of non-complainants mirrored this experience. Alternatives to final panel hearings were therefore well received by both complainants and non-complainants: they were seen as a way of saving time and money, and making the experience less stressful for the complainant.

There were nevertheless concerns that if the panel hearing were removed:

- it would result in a less thorough investigation
- the professional would receive a more lenient sanction
- the complainant would not have the opportunity to put across their side of the story and point out inaccuracies in the professional’s account
- the process would be less transparent, with the complainant being kept out of the loop particularly when came to finding out the sanction.

It was generally believed that if there was any dispute over the events, the case should be taken to a hearing, and a few felt that very serious complaints should always go to a hearing. Some also wanted the complainant to have a say in whether or not a hearing was held.

Next steps

Over the next few months, we will be considering these findings alongside emerging initiatives by the regulators, to inform our views on how they are approaching these alternatives.