Guidance on health and character - hpc-uk.orghpc-uk.org/assets/documents/10002D1AGuidanceonhealthandcharacter… · Whoisthisdocumentfor? 2 Aboutthestructureofthisdocument 2 Section1–Introduction

How we consider information that applicantsor registrants declare

Guidance onhealth andcharacter

Who is this document for? 2

About the structure of this document 2

Section 1 – Introduction 3

About us (the HCPC) 3

How we are run 3

Approving education programmes 3

Our Register 4

Health and character 4

Section 2 – Information for applicants 5

Other useful publications 5

Applying to be on our Register 5

The health declaration 5

The implications of making a self-declaration 6

Insight and understanding 6

Public protection and the information you give us about your health 7

The character declaration 8

The character reference 8

The registration panel 9

Appeals process 9

Section 3 – Information for registrants 11


Professional self-regulation 11

The standards of conduct, performance and ethics 11

Telling us about changes to your health or character 11

Self-referrals 12

Renewing your registration 15

The registration panel 15

Appeals process 15

Contents

Section 4 – How we consider health information 17

Information we consider 17

Guidance on how we will consider information about health 17

How we consider information supplied to us through self-declaration of health 17

Section 5 – How we consider character information 19

Information that we consider 19

Issues the panel considers 19

Convictions and cautions received when you were young 20

Driving offences 20

Section 6 – Information for education providers 21


The standards of education and training 21

Deciding whether to accept an applicant with a conviction 21

Deciding whether to accept an applicant with a health condition 23

Misconduct during the programme 23

Section 7 – More information 24

Glossary of terms 25

We, the Health and Care Professions Council(HCPC), have written this document to provideguidance on our processes when assessing thehealth and character of people who apply to, orwho are on, our Register.

You may find this document useful if you are:

– applying to us to be registered orconsidering applying to us to be registered(‘an applicant’);

– currently registered with us (a ‘registrant’);

– working in education and makingdecisions about students applying to aprogramme; or

– working in education and advisingstudents on applying for registration.

This is not a full list of possible audiences.However, it should help to give you an idea ofwhether this document will help you.

About the structure ofthis document

To help you get the information you need, we havedivided this document into seven sections. Thereare different sections for applicants, registrantsand education providers. We have done thisbecause the processes are slightly different forapplicants and registrants. Some of theinformation provided for applicants and registrantsmay also be useful to education providers.

Sometimes we have repeated the sameinformation in more than one section to makesure that we provide the relevant information to allthose reading the document. Below is a guide towhat we have included in the following sections.

– Section one, Introduction, containsinformation about us, our standards andwhat we do. This section is for everyone.

– Section two, Information for applicants,is aimed at people who are interested inworking within one of the professions weregulate and applying for registration with

us. It gives information about the applicationprocess, and the information we need toknow about an applicant’s health andcharacter. ‘You’ in this section refers to theperson applying to us.

– Section three, Information forregistrants, is aimed at people whoare already on our Register. This sectionexplains the process of making health andcharacter declarations at different times,and how we consider the information wereceive from these declarations. In thissection ‘you’ refers to the professionalregistered with us.

– Section four, How we considerhealth information, is aimed atapplicants and registrants but may alsobe useful for education providers. Thissection explains how we look atinformation about your health, and theprocesses we use. In this section ‘you’refers to an applicant or registrant.

– Section five, How we considercharacter information, is aimed atapplicants and registrants but may also beuseful for education providers. This sectionexplains how we look at information aboutyour character and conduct and our fitnessto practise processes. In this section ‘you’refers to an applicant or registrant.

– Section six, Information for educationproviders, is aimed at admissions staffand staff on the programme team. Thissection provides guidance to staff whoneed to advise students on health orcharacter requirements when they areapplying to enter a programme, or whenthey are applying to the HCPC Register. Inthis section ‘you’ refers to the educationprovider or staff on the programme team.

– Section seven,More information explainshow to find more information about theHCPC and contains a glossary of some ofthe terms we have used in this document.

Who is this document for?

Guidance on health and character2

About us (the HCPC)

We are the Health and Care ProfessionsCouncil (HCPC). We are a regulator, and wewere set up to protect the public. To do this,we keep a register of professionals who meetour standards for their training, professionalskills, behaviour and health.

Professionals on our Register are called‘registrants’. We currently regulate16 professions.

– Arts therapists

– Biomedical scientists

– Chiropodists / podiatrists

– Clinical scientists

– Dietitians

– Hearing aid dispensers

– Occupational therapists

– Operating department practitioners

– Orthoptists

– Paramedics

– Physiotherapists

– Practitioner psychologists

– Prosthetists / orthotists

– Radiographers

– Social workers in England

– Speech and language therapists

We may regulate other professions in thefuture. For an up-to-date list of the professionswe regulate, please see our website(www.hcpc-uk.org).

Each of these professions has one or more‘protected titles’ (protected titles include titleslike ‘physiotherapist’ and ‘dietitian’). Anyonewho uses one of these titles must be on ourRegister. Anyone who uses a protected title

who is not registered with us is breaking thelaw and could be prosecuted.

You can see our Register on our website.Anyone can search it, so they can check thattheir professional is registered.

Another important part of our role is toconsider any concerns we receive aboutregistrants. We look at every complaint wereceive to decide whether we need to takeaction. We may hold a hearing to get all theinformation we need to decide whethersomeone is ‘fit to practise’.

How we are run

We were created by the Health and Social WorkProfessions Order 2001. This sets out what wemust do and gives us our legal power. We havea Council which is made up of registrants andmembers of the public. The Council sets ourstrategy and policies and makes sure that weare fulfilling our duties under the Health andSocial Work Professions Order 2001.

Health and care professionals must registerwith us before they can use a protected titlefor their profession. This means that evenif you have completed a programme inphysiotherapy for example, you will still notbe able to call yourself a ‘physiotherapist’unless you are registered with us.

Approving education programmes

Part of our role includes approving educationprogrammes. Health and care professionalsmust complete these programmes to becomeregistered with us. However, completing anapproved programme does not guarantee thatsomeone will be able to register with us.Sometimes a student who has completed aneducation programme declares very seriousinformation which may mean that we rejecttheir application for registration. It is importantto stress that this only happens very rarely.

Section 1 – Introduction

Guidance on health and character 3

Our Register

Being on our Register shows that aprofessional meets our standards for theirprofession.

We have a Register to show the public thatprofessionals are fit to practise, and that theyare entitled to use the protected title for theirprofession. It shows that registrants are part ofa profession with nationally recognisedstandards set by law.

When we say that someone is ‘fit to practise’,we mean that they have the skills, knowledge,character and health to do their job safely andeffectively.

Health and character

We must check the health and character ofeveryone who applies to join our Register. Thisis to make sure that applicants will be able topractise safely and effectively within theirprofession. We can also take action to protectthe public if a registrant’s health or characterraises concerns about their ability to practisesafely and effectively.

The relationship between a registrant and theservice user is based on trust, confidence andprofessionalism. By checking an individual’shealth and character, we can help to reducethe risk of harm and support the public’s trustin the professions that we regulate.

When making decisions about character, welook at whether someone is of ‘goodcharacter’ or whether there is any evidence ofpast actions which might suggest that theperson is not of ‘good character’. Evidencethat someone might not be of ‘good character’could include evidence of untrustworthiness,dishonesty, actions which harmed a serviceuser or a member of the public or actionswhich might affect the public’s confidence inthe registered professions.

When we talk about ‘health’ we mean healthconditions which may affect either anapplicant’s or a registrant’s fitness to practise.We are not asking whether an applicant orregistrant is ‘healthy’. This is becausesomeone may be unwell or may have a healthcondition which they manage appropriately butthey may still be able to practise theirprofession safely. We do not need informationabout any health condition unless it affects aperson’s fitness to practise. We recognise thata disability may not be seen as a healthcondition. So, we only need information abouta disability or a health condition if it affects anapplicant’s or registrant’s fitness to practise.

It is rare that any information we receive abouta registrant’s or applicant’s health or characteraffects their registration with us. For example,in 2010 –11, we received information about 334cases related to applicants’ health or character.We only refused registration in seven of thesecases where there were serious concerns.However, it is important that applicants orregistrants tell us this information so we haveit for making decisions about whether theyshould be registered with us.


Section 1 – Introduction

This section provides information on theapplication process and the information that youneed to give us about your health and character.It explains what happens to the information yougive us and also how we use the informationgiven to us by someone else, such as yourcharacter referee. In this section ‘you’ refers tothe person applying to join our Register.

Other useful publications

A number of the topics in this section are alsocovered in other publications we haveproduced. You may want to refer to thefollowing publications for more information.

– Guidance on conduct and ethics forstudents

– Standards of conduct, performanceand ethics

– A disabled person’s guide to becominga health professional

– Standards of proficiency for eachprofession

– Managing fitness to practise

You can download a copy of thesepublications from our website(www.hcpc-uk.org).

Applying to be on our Register

Completing an approved programme does notguarantee that you will become registered. Butit does show us that you meet our professionalstandards and so are eligible to apply forregistration. So that we can register you, weneed more information from you.

To apply for registration you need to send usinformation which includes:

– a character reference;

– a certified document containing yourphotograph; and

– a certified document proving yourcurrent address.

All of the information that we need from youhelps us to make sure that:

– you are who you say you are;

– you meet our standards; and

– we can contact you if we need to.

You can find out more about the applicationprocess on our website (www.hcpc-uk.org).

When you fill in your application we ask youto declare information about your health andcharacter. We work on the principle of‘professional self-regulation’. This means thatyou have a personal responsibility, onceregulated, to maintain and manage your ownfitness to practise. This includes giving us anyinformation about changes to your health orcharacter which might affect your ability topractise safely and effectively.

As an applicant, we expect you to follow thesame principle. Being registered places extraresponsibilities on you to act in a professionalway. This includes declaring any new informationabout either your character or health.

If you do not provide accurate information inyour application, or if you fail to provide all therelevant information, you will be making a ‘falsedeclaration’. Making a false declaration canresult in you being removed from our Register.

The health declaration

Standard 12 of our standards of conduct,performance, and ethics says: ‘You must limityour work or stop practising if your performanceor judgement is affected by your health.’

When you apply to our Register we ask you tosign a declaration to confirm that you do nothave a health condition that would affect yourability to practise your profession. We call thisa self-declaration. You only need to declareinformation about a health condition if you

Section 2 – Information for applicants


believe that your health may affect your abilityto practise safely and effectively. If you tell usyou have a health condition that might affectyour fitness to practise, we will use theinformation you give us to decide whether youshould be registered.

You do not need to tell us about your healthcondition or disability if it does not affect yourability to practise safely and effectively, or youknow you are able to adapt, limit, or stop yourpractise if your condition does affect yourability to practise.

You should tell us about your condition if itaffects your ability to practise safely andeffectively, or if you are not sure whether youwill be able to adapt, limit, or stop practising asneeded if your condition affects your ability topractise.

When we talk about ‘health’ we are not makingjudgements about whether people are ‘healthy’or in ‘good health’. We are also not makingjudgements about disabilities. You may have adisability or long-term health condition whichwould mean that you would not consideryourself to be in ‘good health’. However, aslong as you manage your condition or disabilityappropriately, and have insight andunderstanding, this will not prevent you fromregistering with us.

Having a disability should not be seen as abarrier to becoming a health and careprofessional. We have produced guidance fordisabled applicants called A disabled person’sguide to becoming a health professional, whichyou should refer to for more information on thisissue.

The implications of making aself-declaration

We work on the principle of ‘professional self-regulation’. This means that, when we ask youto declare whether you have a health conditionthat could affect your fitness to practise, we are

trusting you as an autonomous professional(one who is independent enough to makedecisions based on their own judgement) tomake an informed and reasoned judgementabout whether your health will affect your abilityto practise safely and effectively.

You should complete the health declarationhonestly. If we find out later that you did notdeclare a relevant health issue when makingyour application, we will investigate, and thiscould affect your registration. It is important toknow that making a declaration to us about ahealth condition that could affect your ability topractise is a positive action, which shows thatyou have an awareness of the possible effectof your health on your ability to practise safelyand effectively.

If after reading this guidance you are stillunsure about whether you should tell us abouta health condition, you should tell us anywayand give us as much information as you can,so we can assess whether your conditioncould affect your ability to practise.

For more information about how we use theinformation you give us about your health,please see the section How we consider healthinformation on page 17.

Insight and understanding

If you declare a health condition to us, we willwant to be sure that you have insight andunderstanding into your health and how thatcould affect your ability to practise safely andeffectively. By insight and understanding wemean that you have a realistic, informed idea ofthe limits of your safe practice. ‘Safe practice’means practice that does not put service usersor you at risk. An applicant or registrant whohas insight or understanding into their conditionwill adapt their practice where necessary tominimise any risk to service users.

The two examples below show how the samehealth condition may (or may not) affect aprofessional’s ability to practise, depending ontheir insight and understanding.



Example

A recent graduate with epilepsy is applying forregistration with us. While the applicant hashad epilepsy since he was a child, he has beentaking the same kind of medication for overtwo years, and has not had a seizure duringthis time. He has made plans for combiningwork with his condition. This includes telling hiscolleagues and keeping a small supply of hismedication somewhere safe at work in case heneeds it. The applicant’s insight andunderstanding of his condition, and the way heis taking responsibility for his continuingtreatment, means that his epilepsy should notaffect his ability to practise his profession. Hesigns the health declaration to confirm that hishealth condition would not affect his fitness topractise.

Example

Someone with epilepsy is applying for HCPCregistration. While this applicant has beenprescribed medication by his doctor to helpmanage his condition, he often avoids takingthe medication because he experiences side-effects. Because of this, he has had seizuresrecently. He is unwilling to discuss with hisdoctor ways of better managing his epilepsy.This applicant cannot sign the healthdeclaration, because he is not managing hishealth condition appropriately and this is likely toaffect his ability to practise safely and effectively.

In a case such as this, it is not the health ordisability of the applicant that means we needto look at the situation. Instead, it is theconcerns about the effect of their healthcondition or disability on their ability to practisesafely and effectively.

Public protection and theinformation you give us aboutyour health

We were set up to protect the public. We dothis by setting the standards our registrants

must meet. This means that we only need toknow information about your health which mayaffect the safety of the service users you comeinto contact with in the course of your work.

If you declare an ongoing health condition ordisability to us, this does not mean that weneed to be told about your full medical history,as we do not want to receive information thatis not relevant to protecting the public. It is rarethat any information you give us about yourhealth will affect your registration. We look atevery case individually and base our decisionon the particular circumstances of each case.As a result, we do not have a list of healthconditions which would or would not preventyou from practising as a registeredprofessional. In any situation, the mostimportant factor is not that you have a healthcondition or disability, but whether the healthcondition or disability affects your ability topractise safely and effectively.

We would suggest that the kind of informationthat may be relevant could include infectiousdiseases, alcoholism, and mental-health issuesthat might affect the safety of service users(including information on whether the conditioncan be or is managed with medication or othertreatment). We are not suggesting that any ofthese health issues necessarily affect aperson’s fitness to practise, but questions ofinsight and understanding are relevant to someof them.

Example

A student has graduated and returned fromtravelling for several months. While away, shewas involved in a serious accident and neededurgent treatment. She was then flown homefor continuing treatment and therapy.

She is still recovering and getting herapplication for registration ready for when sheis able to start work. She considers whetherher health will affect her ability to practisesafely once she has recovered from her injuryenough to enter employment. She takes into



account the fact that, once registered, she willhave to take steps to make sure that she onlypractises in those areas where she is confidentshe can meet our standards. Because she isnot going to enter work until she is sufficientlyrecovered to a point that her health will notaffect her fitness to practise, she signs herhealth declaration, giving no further informationabout her accident.

Example

An applicant to the Register has been receivingtreatment for alcoholism for six months. Whilethe applicant is honest about his alcoholismand his treatment is progressing well, he isaware that he has only relatively recently startedhis treatment programme and he is stillconcerned that his condition might be a factorthat could affect public safety. As a result, hedecides not to sign the health declaration, butinstead gives us information about his conditionand the treatment programme he is on.

More information about how we consider thehealth information you give us, including theissues we look at when deciding if your healthaffects your ability to practise, is on page 17.

The character declaration

We ask you to fill in a self-declaration aboutyour character as part of your application. Inthis declaration you need to tell us if you:

– have ever been convicted of a criminaloffence or received a police caution orconditional discharge for a criminaloffence;

– have ever been disciplined by aprofessional or regulatory organisation oryour employer; or

– have ever had civil proceedings (otherthan a divorce or dissolution of a civilpartnership) brought against you.

We ask you to declare this information as part ofour process of checking that you are of ‘good

character’. We ask about these areas as webelieve that they help us to make a judgementabout whether, on the basis of past behaviour,you are of good character and should beallowed to register. It is rare that any informationwe receive affects registration, but it is importantthat it is declared.

All of the professions that we regulate areexempt from the requirements of theRehabilitation of Offenders Act 1974. Thismeans that when you apply to join theRegister, you must declare any convictions orcautions that you have. This includes anyconvictions or cautions that are considered‘spent’ because they happened some timeago. It also includes convictions or cautionsthat you may have received in countriesoutside the United Kingdom, if the offence isone that could have resulted in a conviction orcaution in the UK.

Civil proceedings are any action in a court otherthan being prosecuted for a crime. They caninclude lawsuits brought to claim compensationor for breaking the terms of a contract.

If you answer ‘yes’ to any of the above on theapplication form, you should provide extradetails on a separate piece of paper. We willlook at the information and decide whether itraises concerns. If it raises concerns, it will bepassed on to a registration panel. Please seethe section called The registration panel formore information on the process for thosecases referred to a panel.

The character reference

As well as the character declaration, you mustalso provide a character reference.

A character reference needs to be provided by‘a person of professional standing in thecommunity’. This can include:

– a registrant;

– a doctor;





– an academic tutor or lecturer;

– a solicitor;

– an accountant;

– a bank manager;

– a justice of the peace;

– a minister of the church;

– a rabbi; or

– an imam.

This is not a full list. The person who gives thecharacter reference must also have known youfor at least three years and must not be relatedto you. We will accept a character referencefrom your academic tutor or course leader ifthey have known you for three calendar years.

When the person completes your reference,we ask them to declare the number of yearsthey have known you. They must also confirmthat they know of no reason why you wouldnot practise your profession with honesty.

You can find more information about how weconsider character in the section How weconsider character information on page 19.

The registration panel

If information about your health or characterneeds to be considered by a registration panel,we will write to you to let you know. This isbecause it may delay your registration by ashort time. We normally hold at least oneregistration panel a month for each professionwe regulate to try to reduce any delays inbecoming registered.

We will write and tell you about the date of thepanel at least 14 days before it takes place. Atthis time, we will write and ask you to send usany more information that you would like thepanel to look at.

The panel will include at least one person fromthe profession you want to be registered in and

at least one lay member (someone who is notregistered with us).

The panel make their decision based entirelyon the documents you have provided. Theymay also consider other information that wemay have collected. The panel meets in privateso you cannot go to the meeting. We will sendyou a copy of all the information that the panellooks at and you will have 14 days to respondto anything that you have not seen before.

The panel will decide whether the informationyou have declared affects your ability topractise safely and effectively or will affectpublic confidence in your profession. It is rarethat information on health and characteraffects an application for registration.

Appeals process

We will write to you and let you know the panel’sdecision. If we refuse your application, we willalso provide detailed information about makingan appeal. You will have 28 days from the dateof our letter to make your appeal to us in writing.

The appeal will be heard by a registrationappeal panel. The panel will include one of ourCouncil members, at least one person from theprofession you want to be registered in and alay person.

You can ask to have your appeal decided onthe basis of documents only, or you can go tothe hearing yourself. You can also provideextra information for the panel to look at. Theextra information could include more characterreferences or extra information from yourdoctor, if this is appropriate. Whichever wayyou ask to have your appeal considered, wecan make the hearing accessible for you. Wejust need to know your needs beforehand sowe can meet them for you. For example, wecan provide documents in other formats, holdthe hearing in an accessible building, provide ahearing loop for people with hearing difficulties,or provide a British Sign Language interpreter,or an assistant, as appropriate.

As well as any assistant or interpreter youneed, you can bring someone with you to theappeal. This could be a solicitor, unionrepresentative, colleague, or friend, who cansupport or represent you.

If your appeal is not successful, you canappeal that decision in the county court (orsheriff court in Scotland).



This section explains the process of makinghealth and character declarations either as a‘self-referral’ or as part of renewing yourregistration. It also explains what happens tothe information you tell us. In this section,‘you’ refers to registrants.


In this section, we cover a number of thetopics that are also covered in otherpublications we have written. You may want torefer to the following publications for moreinformation.

– Standards of conduct, performanceand ethics

– Managing fitness to practise

– What happens if a concern is raisedabout me?

You can download these publications from ourwebsite (www.hcpc-uk.org).

Professional self-regulation

We work on the principle of ‘professionalself-regulation’. This means that you have apersonal responsibility to maintain and manageyour own fitness to practise. You also have tomake decisions about whether you are fit topractise your profession. This includesdeciding whether changes to your health affectyour fitness to practise.

As a registrant, you are expected to meetcertain extra responsibilities linked to yourprofessionalism. This includes the professionalresponsibility to declare information to usabout any changes to your health or character.

The standards of conduct,performance and ethics

Our standards of conduct, performance andethics explain the ethical behaviour that weexpect you to meet and keep to. Thestandards play an important role in helping us

make decisions about whether someone is fitto practise.

The standards of conduct, performance andethics say that:

“You must tell us (and any other relevantregulators) if you have important informationabout your conduct or competence, orabout other registrants and health and careprofessionals you work with. In particular, youmust let us know straight away if you are:

– convicted of a criminal offence, receive aconditional discharge for an offence, or ifyou accept a police caution;

– disciplined by any organisationresponsible for regulating or licensing ahealth or social care profession; or

– suspended or placed under a practicerestriction by an employer or similarorganisation because of concerns aboutyour conduct or competence.”

Telling us this information is called a‘self-referral’.

Telling us about changes to yourhealth or character

As we have said above, you have aresponsibility to maintain and manage yourfitness to practise. This includes giving usimportant information about your characteror health.

There are two different ways in which you cangive us this information. You can either tell usat any point during your two-year registrationcycle, which is called a ‘self-referral’. Or, youcan give us the information when you come torenew your registration.

You only need to declare changes to yourhealth that affect your ability to practise whenyou renew your registration. However, you canchoose to tell us about changes to your healthat any other time if you want to. Please see

Section 3 – Information for registrants


page 19 of this guidance for more informationabout these requirements.

However, you must let us know straight away ifyou are:

– convicted of a criminal offence, receive aconditional discharge for an offence oraccept a police caution;

– disciplined by any organisationresponsible for regulating or licensing ahealth or care profession; or

– suspended or placed under a practicerestriction by an employer or similarorganisation because of concerns aboutyour conduct or competence.

The requirement to tell us straight away aboutcharacter issues means that you would usuallygive us this information through a self-referralrather than waiting until you next renew yourregistration. This means that almost all theself-referrals we receive are about characterissues. The following guidance on self-referralsonly applies to character. However, if aregistrant chose to make a self-referral abouttheir health, we would consider the informationin the same way.

Information supplied as a self-referral follows aslightly different process to information which issupplied when renewing registration. In caseswhere you are renewing registration, we passinformation to a registration panel if this isnecessary. If serious information about you isprovided when you are renewing yourregistration, the panel can recommend thatyou should not be allowed to renew yourregistration.

A self-referral takes place outside theregistration renewal process. When we receivea self-referral, we will consider the informationto decide whether we should take any furtheraction. We will pass the information received tothe Fitness to Practise Department. If afterassessing the information they decide that itraises concerns about your fitness to practise,

they may decide that the matter should beinvestigated further.

Self-referrals

We understand that you may be worried aboutthe effect on your registration if you tell usabout changes to your character. Declaringthis information is part of your professionalresponsibility as a registrant and we believethat it shows insight and understanding. Wehope that this section will explain the processwe use and also reassure you.

All of the professions we regulate are ‘notifiableoccupations’. This means that the police shouldtell us automatically if you are cautioned orconvicted of an offence.

However, you should still tell us as soon aspossible if you are convicted of an offence,receive a caution, are disciplined by youremployer or placed under any practiserestriction because of concerns about yourconduct or competence. You must do this bywriting to our Fitness to Practise Department.You can find the address on page 24 in Moreinformation.

When you give us information about yourcharacter at any time other than through theregistration application or renewal process, youare making what we call a ‘self-referral’. If youmake a self-referral and give us informationabout your character, we will consider thatinformation and decide whether the issuescould affect your fitness to practise. If theinformation suggests that your ability topractise safely and effectively is affected, wewill investigate the matters in more detail. Youcan find out more about the fitness to practiseprocess on our website (www.hcpc-uk.org).

If we do not think that the issues raised willaffect your fitness to practise, we will write toyou and let you know. We will not take anyfurther action.



If we refer the case to our fitness to practiseprocess, we will let you know. An InvestigatingCommittee panel will meet to consider the issue.This panel will decide whether there is a ‘case toanswer’ and, if so, whether the case should beconsidered at a full hearing by a panel of theConduct and Competence Committee or HealthCommittee. Before the Investigating Committeeconsiders the case, you will have the chance togive this panel extra information if you want to.

The panel at a final hearing can make thefollowing decisions. They can decide to:

– take no further action;

– send the case for mediation;

– caution you;

– place a conditions of practice orderon you;

– suspend you; or

– in very serious circumstances, strike youoff the Register.

You have the right to appeal the decision tothe High Court or, in Scotland, the Court ofSession.

You only need to tell us about changes to yourhealth when you renew your registration. Weset this requirement because we expect you tomanage your health appropriately during thecourse of your registration, which includesadjusting or stopping your practice if you needto (see ‘Renewing your registration’ for moreinformation). However, if you do decide to tellus, we will look at that information and carefullyconsider whether we might need to take anyaction.

You must still keep to the standards ofconduct, performance and ethics.

Standard 12 says:

“You have a duty to take action if your physicalor mental health could be harming your fitnessto practise. You should get advice from aconsultant in occupational health or anothersuitably qualified practitioner and act on it. Thisadvice should consider whether, and in whatways, you should change your practice,including stopping practising if this isnecessary.”

On page 14 we have added a diagram whichoutlines the process for self-referrals.



NoNo action taken

Yes



We investigate the information

We present information tothe Investigating Committee panel

Final hearing

Does theinformation suggestthat your ability topractise safely andeffectively maybe affected

Panel decideswhether there is acase to answer

You refer information to us

No action taken

Yes

No

Self-referrals

Renewing your registration

Each time you renew your registration, youmust make a ‘professional declaration’. Thisprofessional declaration confirms that:

– you have continued to meet ourstandards of proficiency for the safe andeffective practice of your profession; and

– there have been no changes to yourhealth or your ‘good character’ whichyou have not told us about, and whichwould affect your ability to practise safelyand effectively.

Changes to your good character could include:

– being convicted or cautioned for anoffence or receiving a conditionaldischarge;

– disciplinary action taken by youremployer or professional body orrestrictions placed on your practice byyour employer because of concernsabout your conduct or competence; and

– civil proceedings.

If the information you provide about your healthor character is serious enough, we will pass it toa registration panel. You can find out more aboutthe registration panel in the section below.

The registration panel

If we send information about you to aregistration panel, we will write to you to letyou know. This is because this may delay therenewal of your registration by a short time. Wenormally hold at least one registration panel amonth for each profession we regulate to try toreduce any delay in renewing registration.

If you have to make a declaration about yourhealth or character when you renew yourregistration, you will stay on the Register whilewe process your declaration.

You may want to refer to the sections How weconsider information about health on page 17and How we consider information aboutcharacter on page 19 for some of the issues thatwe consider when looking at health andcharacter information.

At least 14 days beforehand, we will write andtell you the date when the panel will meet. Wewill ask you to send us any more informationthat you would like the panel to consider. Wewill send you a copy of all the information thatthe panel looks at and you will have 14 days torespond to anything that you have notpreviously seen.

The panel will include at least one person fromyour profession and at least one lay member.

The panel make their decision based entirelyon the documents you have provided. Theymay also consider other information that wemay have collected. The panel meet in private,so you cannot go to the meeting.

The panel will decide whether the informationyou have declared affects your ability topractise safely and effectively or underminespublic confidence in your profession. It is rarethat health and character information affectsyour ability to renew your registration.

Appeals process

We will write to you and tell you if we refuse torenew your registration. You can appeal thisdecision by writing to us within 28 days of thedate of our letter.

The appeal will be heard by a registration appealpanel. The panel will include one of our Councilmembers, at least one person from theprofession you are registered in and a lay person.

You can ask to have your appeal decided onthe basis of documents only, or you can go tothe hearing yourself. You can also provideextra information for the panel to look at. Theextra information could include more characterreferences or extra information from your



doctor, if this is appropriate. Whichever wayyou ask to have your appeal considered, wecan make the hearing accessible for you. Wejust need to know your needs beforehand sowe can meet them for you. For example, wecan provide documents in other formats, holdthe hearing in an accessible building, provide ahearing loop for people with hearing difficulties,or provide a British Sign Language interpreter,or an assistant, as appropriate.

As well as any assistant or interpreter that youneed, you can bring someone with you to theappeal. This could be a solicitor, unionrepresentative, colleague, or friend, who cansupport or represent you.

If your appeal is not successful, you canappeal that decision in the county court (orsheriff court in Scotland).

If we write to you to say that your registrationrenewal has not been successful, we will giveyou detailed information about making aregistration appeal.



This section explains how we considerinformation that you declare about your health.In this section we use ‘you’ to refer to bothapplicants and registrants. When we look atinformation about your health, we considerwhether the health condition affects your abilityto practise safely and effectively.

Information we consider

A panel may look at an applicant’s healthdeclaration and any other relevant informationwhen making decisions about their health.

When we make decisions about a registrant’shealth, we look at any information that theregistrant has declared when they renewedtheir registration.

Guidance on how we willconsider information about health

We look at each case individually and makeour decision based on the particularcircumstances of the case. As a result, we donot have a list of health conditions whichwould prevent you from practising as aregistered professional.

The panel look at various issues when makinga decision about whether your health wouldaffect your ability to practise safely andeffectively. They may look at:

– how you currently manage your condition;

– whether you have shown insight andunderstanding into your condition;

– whether you have got medical or othersupport;

– whether you have made reasonableadjustments to your placementconditions or employment conditions; or

– whether you have agreed reasonableadjustments with your placementproviders or employers.

In most cases where registration panels havelooked at information about an applicant’shealth, we have not refused their application forregistration. This may be because the applicanthas shown insight and understanding into theircondition or perhaps because their conditiondoes not actually affect their ability to practisesafely and effectively. It is also rare that aregistrant’s health condition affects theirregistration, often for similar reasons.

An example of a health condition which mightaffect registration is an alcohol dependencyproblem which the person is not managingappropriately and which is affecting their abilityto practice. However, it is still important that wetreat every case individually and that we avoidstereotypes and misinformed judgements.

How we consider informationsupplied to us throughself-declaration of health

When you apply for registration with us, weask you to sign the health self-declaration toconfirm that you do not have a health conditionthat could affect your ability to practise yourprofession safely and effectively. Once you areregistered, when you renew your registrationevery two years you are asked to confirm thatyour health does not affect your ability topractise. In both these situations we trust youas an autonomous professional to make aninformed and reasoned judgement aboutwhether your health will affect your ability topractise.

You only need to declare changes to yourhealth that affect your ability to practise whenyou apply for or renew your registration.However, you can choose to tell us aboutchanges to your health at any other timeduring your registration if you want to. We setthis requirement because we expect you tomanage your health appropriately during thecourse of your registration, which includesadjusting or stopping your practice if you needto. Please see the section on self-referral on

Section 4 – How we considerhealth information


pages 12 to 13 of this guidance for moreinformation about these requirements.

Most of the time, when you tell us about ahealth condition (if you are applying to theRegister), or if you tell us about a change inyour health (if you are a registrant), you areshowing insight and understanding andmanaging your fitness to practise. By insightand understanding we mean that you have arealistic, informed idea of the limits of your safepractice. ‘Safe practice’ means practice thatdoes not put your service users or you at risk.

In serious circumstances, we may pass theinformation to a registration panel who willconsider whether your fitness to practise isaffected by your health. The panel meets inprivate to consider, on a case-by-case basis,all the information they receive.

The panel will make decisions based onlooking at the factors outlined on the previouspage. You may have already made or identifiedamendments you can make to your practice inresponse to your health. If so, we do not needto take action to protect the public. At thispoint, if you are applying to the Register, thepanel will agree that you should be registered.However, if the registration panel is concernedthat the way you manage your health conditionor disability could affect your ability to practise,they may recommend that you should not beallowed to register.

Making amendments to your practice, whenthey are necessary, is part of managing yourfitness to practise. We have produced adocument on this topic which you candownload from our website (www.hcpc-uk.org).

If you are a registrant and can demonstratethat you have adapted your practise inresponse to your health, we would not need totake action to protect the public. Theregistration panel would not pass the case onto the Fitness to Practise Department and wewould not take any further action. However, invery serious circumstances, the panel can

pass the case on to our fitness to practiseprocess for a hearing. In every case referred fora hearing, we will ask whether you will giveyour permission to be examined by a doctorso that the panel can make an informeddecision.

The cases we consider under our fitness topractise process are usually those where aregistrant has continued to practise while unfitto do so, and this has directly led to harm, orthe risk of harm, to the service user or to theregistrant. In these cases, it is not the health ordisability of the registrant that means we haveto take action, but the poor conduct orpractice that it has contributed to.


Section 4 – How we consider health information

This section explains how we consider informationthat applicants and registrants declare about theircharacter. In this section we use ‘you’ to refer toboth applicants and registrants.

Information that we consider

We look at a number of pieces of informationwhen making decisions about an applicant’scharacter. These include:

– the information provided on thecharacter reference;

– whether the applicant has declared anyconvictions or cautions;

– whether another regulator or professionalbody has made a decision about theapplicant; and

– any other information which might berelevant such as disciplinary action takenby an employer.

When we make decisions about a registrant’scharacter, we look at:

– any information that the registrant hasdeclared on their registration renewalform; or

– any information that the registrant haspassed to us through self-referral.

Issues the panel considers

When making decisions about character, weare considering whether your behaviour in thepast means you can practise in a way whichdoes not put the public at risk or affect publicconfidence in you or your profession.

The information you give us about yourcharacter when you are applying for orrenewing your registration will be consideredby a registration panel. Please see the sectionon page 9 for more information aboutregistration panels.

When you give us information about yourcharacter at any time other than through the

registration application or renewal process wewill consider the information. If it is serious, wewill refer it to our Fitness to PractiseDepartment for them to consider. Giving usinformation in this way is called a ‘self-referral’.We consider self-referrals in this way to makesure that the management, investigation anddecisions made about self-referral cases areconsistent with the other decisions our panelsmake through our fitness to practise process.Please see the section on page 12 forinformation about the self-referral process.

When someone declares a conviction orcaution, we do not re-examine the nature ofthe evidence or retry the case. If you are anapplicant, the registration panel considers theeffect it will have on your application forregistration. If you are a registrant, our panelswill consider the effect it will have on yourregistration. They may look at whether theconviction or caution affects public confidencein your profession.

Whether information about your character isconsidered by a registration panel, or throughour fitness to practise process if you havemade a self-referral, the panel will consideronly the factors relevant to your case. Thepanels will consider on a case-by-case basisall the information we receive, looking at theparticular circumstances around the event.This means that we can only provide guidanceon how we will consider the information andwe cannot provide answers about what theoutcome of the case will be.

When looking at issues around your character,the panel may consider:

– the number and nature of offences orevents;

– the seriousness of the offences orevents;

– when and where the offences or eventstook place;

– any information you have given to help

Section 5 – How we considercharacter information


explain the circumstances; and

– your character and conduct since theoffence or event.

This is not a full list of factors which can help todecide the seriousness or significance of theissues we consider.

A panel may consider the circumstancessurrounding the case and whether you showthat you understand what made you behave inthe way you did. A panel may also consider thepunishment that was given, but they recognisethat the sentence given does not necessarilyreflect the seriousness of the offence. When thepanel makes a decision, they look at a numberof factors, including whether the conviction orcaution might undermine public confidence inthe particular profession.

The types of convictions which might result ina registrant being struck off the Registerusually relate to offences of a sexual nature,violence or dishonesty. It is likely that similarconvictions would also prevent you frombecoming registered with us.

We have produced standards of conduct,performance and ethics which give youinformation on ethical behaviour for bothregistrants and applicants. These say:

“...we will consider rejecting an application forregistration, or removing you from the Registerif you are already registered, if you areconvicted of a criminal offence or accept apolice caution that involves one of the followingtypes of behaviour:

– Violence

– Abuse

– Sexual misconduct

– Supplying drugs illegally

– Child pornography

– Offences involving dishonesty

– Offences for which you received aprison sentence”.

This is not a full list of the types of convictions orcautions that could lead to us rejecting yourapplication for registration or removing you fromthe Register. If you have a criminal conviction, wewill decide on your case by considering theparticular circumstances of the case.

More information and guidance about how weconsider fitness to practise concerns isavailable on the fitness to practise section ofour website.

Convictions and cautionsreceived when you were young

All of the professions that we regulate areexempt from the requirements of theRehabilitation of Offenders Act 1974. This meansthat you must declare any convictions orcautions that you may have, even if you receivedthem when you were under the age of 18.

Unless the offence is very serious, it is unlikelythat these types of convictions or cautionswould normally affect your application forregistration. However, you should stilldeclare them.

Driving offences

You may have received a conviction or cautionfor a driving offence. When making a decisionabout the offence, the panel may consider thesentence you were given. If it was a drink-drivingoffence, they may also consider whether thealcohol level was significantly higher than thelegal limit, or if someone was injured as a result.

It is rare for driving offences to affect anapplication for registration, but you should stilldeclare them as we need to make ourdecisions on a case-by-case basis.

However, you do not need to declarefixed-penalty motoring offences such asspeeding offences.


Section 5 – How we consider character information

In this section, we cover three areas of interestto those working in education and training. Thissection provides guidance if you are advisingapplicants who have declared convictions,cautions or a health condition and are makingdecisions about their entry on to an approvedprogramme. We also provide information foryou if you are advising students about theprocess for applying to join the Register.

This section is also useful if you are advisingstudents and making decisions about howissues of student misconduct or changes intheir health will be dealt with while they arestudying. You can use this guidance as part ofyour decision-making, but we cannot coverevery circumstance in the advice we offer.

In this section ‘you’ refers to the educationprovider or staff on the programme team.


In this section, we cover a number of the topicsthat are also covered in other publications wehave produced. You may want to refer to thefollowing publications for more information.

– A disabled person’s guide to becoming ahealth professional

– Standards of conduct, performance andethics

– Standards of education and training

– Standards of education andtraining guidance

– Guidance on ethics and conduct forstudents

You can download these publications from ourwebsite (www.hcpc-uk.org).

The standards of educationand training

We set the standards of education and training(SETs) which programmes are approved andmonitored against.

SET 2 is about the admissions procedures to aprogramme. SET 2.3 says that you, as aneducation provider, must apply selection andentry criteria, including criminal convictionschecks. SET 2.4 says ‘you must also complywith any health requirements which areappropriate to the programme concerned’.This means that the requirements you set maydepend on the nature of the profession andthe programme you are providing.

SET 3.16 says that ‘you must have a processin place throughout the programme fordealing with concerns about students’profession-related conduct’. We believe thatthis will help you to identify students whomay not be fit to practise and help them tomanage any concerns about their conduct inrelation to their profession.

Deciding whether to accept anapplicant with a conviction

Someone with a criminal conviction or cautionmay apply to your programme. Or you maybecome aware of a conviction or caution oncethey are on the programme. You may beconcerned about whether you should allow theapplicant on to your programme or to continueon your programme. This may be perhapsbecause you are worried that they may not beable to register with us after they havecompleted their programme.

We consider the information we receive aboutapplicants on a case-by-case basis. As aresult, we cannot provide a list of convictionsand cautions that would definitely lead to usrejecting an application for registration. Wealso cannot provide a list of convictions or

Section 6 – Information foreducation providers


cautions that should definitely lead to yourejecting an application.

However, there are certain types of offenceswhich we believe are usually incompatible withbeing registered within one of the professionswe regulate. The types of convictions whichmight result in us removing a registrant fromthe Register usually relate to offences of asexual nature or dishonesty. These types ofconvictions might prevent an applicantregistering with us.

We also provide some general guidance in ourstandards of conduct, performance and ethics.These standards apply to both registrants andprospective registrants. By ‘prospectiveregistrants’ we mean people who are applyingto join the Register, which includes students onapproved programmes.

The standards say:

“However, we will consider rejecting anapplication for registration, or removing youfrom the Register if you are already registered,if you are convicted of a criminal offence oraccept a police caution that involves one of thefollowing types of behaviour:

– Violence

– Abuse

– Sexual misconduct

– Supplying drugs illegally

– Child pornography

– Offences involving dishonesty

– Offences for which you received aprison sentence”.

You can find more guidance about how welook more broadly at convictions and cautionsand character on page 19 in the section Howwe consider character information.

When you make admissions decisions, youmay want to consider the standards of

conduct, performance and ethics. You mayalso want to consider whether the individual’sconviction or caution might affect theirsuitability for registration or affect the public’sconfidence in their profession.

When making a decision, you may wantto consider:

– the number and nature of offencesor misconduct;

– the seriousness of the offences ormisconduct;

– when the offences or misconducttook place;

– any information provided by theapplicant to help explain thecircumstances of the offences; and

– the applicant’s character and behavioursince the offences.

However, this is not a full list to help youdecide the seriousness or significance of theissues you will need to consider. Anunderstanding of the offence or misconduct isextremely important. Someone may have agreater understanding of the importance of‘good character’ as a result of a previousminor offence.

We know that deciding whether to accept anapplicant with a criminal conviction or cautioncan be difficult. It is important to rememberthat even if you make your own decision aboutan applicant and allow them to join yourprogramme, they will still have to go throughour character process when they apply to jointhe Register. However, it is rare for us to refusean applicant from an approved programme.You can find out more about this on page 8 in‘Information for applicants’.


Section 6 – Information for education providers

Deciding whether to accept anapplicant with a health condition

You may receive an application from someonewith a health condition or you may becomeaware of a health condition once the student ison your programme. When we talk about ‘health’we do not mean people who are ‘healthy’ or in‘good health’. Instead, we consider the effectthat a health condition may have on someone’sability to practise safely and effectively.

We look at each case and make our decisionbased on the particular circumstances of thecase. As a result, we do not have a list ofconditions which would prevent someone frompractising in any of the professions we regulate.

This also means that we cannot provide a listof the health conditions which would preventsomeone from completing an approvedprogramme.

You have certain responsibilities in dealing withadmissions to a programme we haveapproved. You may have specific legal dutiesunder equality and non-discrimination lawsand, because we have approved yourprogramme, you have the responsibility tomake sure that individuals who complete yourprogramme meet our standards of proficiency.

How you meet these duties is up to you.However, we suggest that when assessingapplications you should first consider thereasonable adjustments that you could make forthe applicant.

Having considered this, you might then want toconsider separately whether having made theseadjustments the applicant would, at the end of theprogramme, meet our standards of proficiency.

We have produced a guide for prospectiveregistrants and admissions staff called Adisabled person’s guide to becoming a healthprofessional. You can download a copy of thisguide from our website (www.hcpc-uk.org).

When making a decision about an applicant ora student with a health condition, there are a

number of other factors that you may want tolook at. These are:

– how they currently manage their condition;

– whether they have shown insight intoand understanding of their condition; or

– whether they have got medical orother support.

Most applicants who declare health conditionsfind that their declaration does not affect theirapplication for registration. This is becauseoften the applicant shows insight into andunderstanding of their condition. Or, the healthcondition concerned does not affect theirability to practise safely and effectively.

When you make admissions decisions aboutapplicants, you may want to set up an advisorypanel to help you make the decision. You mayalso want to refer to the section How weconsider information about health on page 17.

Misconduct during the programme

You will have your own procedures for handlingmisconduct which happens while a student ison a programme. These procedures are oftenseparate from those which may look atconcerns about academic performance.

When looking at misconduct, you may want torefer to the standards of conduct, performanceand ethics. You may also want to look at theguidance we have produced called Guidanceon conduct and ethics for students. Anydecision you make about a student’smisconduct will not affect whether that personcould join the Register. The student would stillneed to go through our health and characterprocess and provide any relevant information.

If you remove a student from your programmebecause of misconduct, you should tell us. Ifwe believe the misconduct is serious enough,we can keep the information and look at it ifthe person ever applies to us for registration inthe future.


Section 6 – Information for education providers

You can find out more information aboutus and our processes on our website(www.hcpc-uk.org). Here we publishinformation about how we work, including thestandards that we produce, our registrationand fitness to practise processes, all of ourforms, news releases and much more.

If the information that you need is not on ourwebsite, you can also contact us at:

The Health and Care Professions CouncilPark House184 Kennington Park RoadLondonSE11 4BU

Phone: +44 (0)845 300 4472Fax: +44 (0)20 7820 9684

Section 7 – More information


Autonomous As an autonomousprofessional, you make yourown decisions based on yourown judgement.

Certified When you apply forregistration, we ask you tosupply ‘certified’ documents.This means that they areconfirmed as a true copy ofthe original document by aperson of professionalstanding in the community.This is a professional personsuch as a doctor, solicitor,Justice of the Peace, orminister of religion. Theperson you ask to certify yourdocuments must write onthem ‘I certify that this is atrue copy of the originaldocument’ and must sign itand print their name andprofessional title.

Civil An action in a court whichproceedings does not involve a crime or

criminal proceedings. Civilproceedings can includelawsuits to get compensationor deal with a contract termwhich has been broken.

Criminal A check to see if someoneconviction has been convicted of acheck criminal offence or has

received a police caution.

Disabled The Equality Act 2010person defines a disabled person as

‘someone with a physical ormental impairment and theimpairment has a substantialand long-term adverse effecton their ability to carry outnormal day-to-day activities’.‘Long-term’ is defined aslasting at least twelve months.

Education The place where aprovider programme is delivered

or where a qualificationis awarded.

Fit to practise When someone has theskills, knowledge, characterand health to do their jobsafely and effectively.

Lay member A panel member who is nota registrant or eligible to beregistered by us.

Professional These organisations carrybody out work which may include

promoting a profession,representing members,producing curriculumframeworks, overseeingpost-registration educationand training, and runningcontinuing professionaldevelopment programmes.

Register A published list ofprofessionals who meetour standards. The Registeris available online(www.hcpc-uk.org).

Registrant A professional who appearson our Register.

Regulator An organisation that protectsthe public by making surepeople keep to certain lawsor requirements.

Self- The declarations ofdeclaration health and character that

applicants or registrantsmust sign to confirm thattheir health and characterdoes not affect their ability topractice safely andeffectively.

Glossary of terms



Self- When a registrant givesreferral us information about their

health, character or conductat any time outside of theregistration application orrenewal process.

Service user Anyone who uses or isaffected by the services ofregistrants.

Standards of Standards that weconduct, expect from health andperformance care professionals whoand ethics are registered with us.

Standards of Standards whicheducation education providersand training must meet to make sure

that all those students whocomplete an approvedprogramme meet thestandardsof proficiency.

Glossary of terms


Notes

Notes


This document is available in alternativeformats and Welsh on request.Call +44 (0)20 7840 9806or email [email protected]

Park House184 Kennington Park RoadLondon SE11 4BU

tel+44 (0)845 300 6184fax +44 (0)20 7820 9684www.hcpc-uk.org

© Health and Care Professions Council 2012Publication code 20120316POLPUB(reprinted with amends due to organisational name change in August 2012)This publication is produced using trees from sustainable forests and recycled fibre.

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