Healthcare Ethics New Zealand
Council and Board investigations · New Zealand · The process, explained
A letter has arrived
The Council or Board investigation process in New Zealand, explained
what happens between the letter and the decision at your Council or Board: the routes, the committees, the Tribunal, what is being weighed — and where remediation courses fit
- A notification is not a finding
- Three routes: competence, health, conduct
- One Tribunal for every profession
- Cancellation is the Tribunal’s alone
In one line
Every regulatory statement on this page is drawn from the Health Practitioners Competence Assurance Act 2003 and the authorities’ own published processes, linked at the foot of the page. This is general information about the process, not advice on your matter. For that, speak to your indemnity insurer, your union or a lawyer.
The short version
What happens after a notification
A notification is a concern raised with your Council or Board — your responsible authority under the Health Practitioners Competence Assurance Act 2003 — about your competence, your health or your conduct. Colleagues and employers are required to raise some of them; a complaint about your care can be referred to the authority too. Raising one is not a finding that anything went wrong.
The Registrar decides which of three routes the concern takes. A competence review looks at your practice against the standard for your scope. The health process looks at whether a condition affects your ability to practise. A Professional Conduct Committee investigates conduct, and it alone can lay a charge before the Health Practitioners Disciplinary Tribunal, the one tribunal for all 18 professions. Only the Tribunal can cancel registration as a penalty.
At every stage you are told what is alleged and given the chance to respond. Many notifications end with no further action, an educational letter or a competence programme; a minority reach a Committee; fewer still reach the Tribunal.
Step by step
The stages, in order
Not every notification passes through every stage. Most stop at the fourth or fifth.
- A concern is raised A notification reaches your Council or Board from a colleague or an employer — the Act requires them to notify where they believe a practitioner poses a risk of harm by practising below the required standard (s 34) or cannot perform the functions of the profession because of a health condition (s 45) — or a complaint is referred to it, or a matter arrives from another agency, the Police or ACC. Raising a concern is not a finding that anything went wrong.
- The Registrar triages it The Registrar and a small team decide two things first: whether anything urgent is needed to protect the public while the matter is looked at, and which route the concern belongs to — competence, health or conduct. Most authorities publish how they make that choice; the Medical Council calls its team the Notifications Triage Team.
- You are told, and asked for your response You receive the concern in writing and are invited to respond. This is the first, and usually the best, opportunity to put your account, your reflection and any steps you have already taken in front of the people deciding. Take advice before you write — and write.
- The route runs A competence review (s 36) assesses your practice against the required standard for your scope, by practitioners from your own profession, and may lead to a competence programme, supervision, an examination or conditions. A health concern goes to the authority’s health process (from s 45), with a medical assessment the authority arranges and pays for. A conduct concern goes to a Professional Conduct Committee (s 71) — two from your profession and one layperson — which investigates with its own investigator and legal adviser and hears from you.
- The Committee, or the Council, decides A Professional Conduct Committee (s 80) may recommend that no further steps be taken, that the authority review your competence, your fitness or your scope of practice, that you be counselled, or that the matter be referred to the Police — or it may lay a charge before the Tribunal. A competence or health route ends in the Council’s or Board’s own orders. Many notifications end here, and most end without a charge.
- The Tribunal, in the most serious matters The Health Practitioners Disciplinary Tribunal hears a charge (s 91): a lawyer chair, three members of your profession and one layperson. It decides whether a ground under s 100 is made out and, if so, the penalty under s 101. Its decisions are published. Cancellation of registration as a penalty is the Tribunal’s alone.
Three doors, one Act
The three routes
The first thing worth establishing, because it decides who writes to you, what they are asking, and how it can end.
Competence Section 36 · educative
A review of your practice against the required standard for your scope, carried out by practitioners from your own profession. It may end in a competence programme, supervision, an examination or conditions (s 38). Where there is a risk of serious harm, interim suspension or conditions may run while it happens (s 39).
Health From section 45 · protective
A concern that a mental or physical condition may affect your ability to practise. The authority arranges and pays for a medical assessment, and may impose conditions, or suspend pending assessment where it is urgent (s 48). It is protective, not disciplinary, and it is confidential.
Conduct Sections 71–80 · may lead to a charge
A Professional Conduct Committee — two from your profession and one layperson — investigates and hears from you. It may recommend no further steps, a review of your competence, fitness or scope, counselling or referral to the Police, or lay a charge before the Tribunal (ss 80, 91). Interim orders may run while it investigates (s 69).
What is being weighed
What your Council or Board is actually weighing
The authorities publish their processes rather than a single list, but the same six things run through all of them. Five are fixed by the time the letter arrives — and one is not.
- The events described What is said to have happened, in what circumstances, and against which standard for your scope of practice.
- The risk to the public Whether the concern points to a continuing risk, or to something already contained — the question that decides whether interim orders are even considered.
- Your scope and your practice setting The standards and guidance that cover your scope; whether you practise alone or in a team; who your patients are.
- What the authority already holds Earlier notifications, conditions, competence programmes and their outcomes.
- Your response, your insight and what you have done since Every authority’s own process documents come back to this: whether you understand what went wrong and why it mattered, and what you have changed. It is the one item on this list that is still open after the letter arrives.
- Your workplace The support, supervision and safeguards already around you, and whether your employer has acted.
Where we come in
Where a course actually fits
Of the six things above, five are settled by the time the letter reaches you. The sixth — your response, your insight and what you have done since — is not, and it is the one every authority’s own process names.
That is the whole of the claim we make. No course from us or from anyone else determines or influences what a Council, a Board, a Professional Conduct Committee or the Tribunal decides, and we say so on every page. What a course can do is help you think an event through properly and put something dated on paper that shows it. Whether that helps is for your authority to judge.
- Insight for Fitness to Practise What insight means to a Council or Board, and how it is evidenced in writing.
- Reflection for Fitness to Practise Structured reflection on an event, rather than an assertion that you have reflected.
- Remediation for Fitness to Practise The steps that reduce the chance of a repeat, and how to record them.
- Ensuring No Repeat of Misconduct or Mistake in Future Practice Turning a single event into a change in practice.
- Fitness to Practise for Healthcare Professionals What the phrase means, and what a Council or Board is deciding when it uses it.
- Dealing with a Complaint or Investigation Professionally Conduct during the process itself, which is also observed.
- Rebuilding Trust of Patients, Colleagues, the Public and the Regulator Where the process ends, and what comes after it.
Those seven run alongside a pair written for your own profession — ethics and professionalism, set against your own Council’s or Board’s code and standards rather than a general one. Together they are that authority’s Core Remediation Set. Each course is self-paced, opens as soon as payment clears, and carries 2 CPD hours on a certificate issued by Healthcare Ethics Courses. No New Zealand Council or Board accredits any provider’s courses, and we do not claim otherwise.
How it can end
The outcomes
From the authority’s own orders to the Tribunal’s penalties. Before any order is made against you, you are told what is proposed and given the chance to be heard.
- No further action Either no continuing risk was identified, or what you and your workplace have already done is enough to manage it. A common end to a notification.
- An educational letter, or counselling The authority, or a Professional Conduct Committee, sets out what it expects of you in future. Not a disciplinary finding.
- A competence programme, supervision or an examination The orders a competence review can lead to (s 38): a programme of education and assessment, a period of supervised practice, or an examination, against the standard for your scope.
- Conditions on your scope of practice Restrictions on what you may do, or how, or with whom, entered on the public register while they run.
- Recertification requirements Additional requirements under the authority’s recertification programme, monitored through your practising certificate.
- A charge before the Tribunal Laid by a Professional Conduct Committee where the conduct may amount to professional misconduct or another ground under s 100.
- Tribunal penalties (s 101) Censure; conditions for up to three years; suspension for up to three years; a fine of up to NZ$30,000; costs; and, in the most serious cases, cancellation of registration.
Separate from the outcome
Interim orders, and why they are separate
An authority can suspend your practising certificate, or place conditions on it, while a matter is still open — but only where the Act allows it: pending a competence review where there is a risk of serious harm (s 39), pending a health assessment (s 48), or pending a Professional Conduct Committee’s investigation or a prosecution (s 69). The Tribunal may also suspend a practitioner pending a hearing (s 93).
Two things follow. An interim order is a risk decision, not a finding against you; and it is not the outcome of your notification — the substantive matter continues underneath it. You must be given the opportunity to be heard before an interim order is made or continued, and it is reviewed as the matter proceeds. Many notifications never involve one.
Definitions
The words the letters use
Regulatory correspondence uses the Act’s terms precisely. Reading them loosely is how practitioners frighten themselves unnecessarily, or miss something that mattered.
- Notification. The word most Councils and Boards use for a concern raised about a registered practitioner, by anyone. The Act uses it for the mandatory reports at ss 34 and 45. It is not a finding.
- Complaint. A concern about your care referred to your Council or Board. On this site it is treated together with a notification: the authority’s routes are the same whichever way the concern arrived.
- Investigation. The general term this site uses for whatever the authority does with a concern — competence, health or conduct — between receiving it and deciding. Practitioners often call the whole thing “fitness to practise”, the UK regulators’ umbrella word; in the Act it is narrower (below).
- Fitness to practise. In the Act, the health route: a notice under s 45 that a mental or physical condition may be affecting your ability to practise, dealt with by medical examination, conditions on your scope or interim suspension (ss 45–51), and the test for registration and a practising certificate (s 16). The Medical Council groups its conduct and competence pages under the same heading; most authorities use it for the health route.
- Competence review. The Act’s own name (s 36) for a review of your practice against the required standard for your scope, by practitioners from your own profession. Educative in purpose; it can still end in orders.
- Competence programme. The programme of education, supervision and assessment an authority may order (s 38) where a review finds the standard is not met.
- Health process. The authority’s process for a concern that a mental or physical condition may affect your ability to practise (from s 45). Protective, not disciplinary; it can lead to conditions or to interim suspension pending assessment (s 48).
- Professional Conduct Committee. The Committee an authority appoints to investigate a conduct concern (s 71): two from your profession and one layperson, with an investigator and a legal adviser. It decides under s 80, and it alone lays a charge.
- Interim suspension, interim conditions. Orders the authority may make while a matter is open — pending a competence review where there is a risk of serious harm (s 39), pending a health assessment (s 48), or pending a Committee’s investigation or a prosecution (s 69). The Tribunal may also suspend pending a hearing (s 93). None is a finding.
- Charge. The document by which a Professional Conduct Committee brings a matter before the Tribunal (s 91), setting out the ground under s 100 alleged.
- Professional misconduct. The main ground under s 100: malpractice or negligence in relation to your scope of practice, or conduct that has brought or was likely to bring discredit to the profession.
- Censure. A formal expression of the Tribunal’s disapproval (s 101). Published with the decision.
- Scope of practice. The area of practice your registration covers, as your authority describes it. Conditions attach to it; a competence review is measured against its standard.
- Practising certificate. The annual certificate every practitioner needs to practise. Conditions and recertification requirements are carried on it.
- Insight. The authorities’ shorthand for whether you understand what went wrong, why it mattered and what you would do differently. Assessed from what you write and do, not from what you say you feel.
- Remediation. The steps taken to reduce the chance of the same thing happening again — education, supervision, changes to systems or scope — and the dated record of them.
Before anything else
Where to get help
In roughly this order, and before you write anything.
- Your indemnity insurer or medical protection organisation This is what the cover exists for. Contact them before you draft a response.
- Your union or professional association Most run a member advice line and have seen the process many times.
- Your Council’s or Board’s own guidance Every authority publishes what happens after a concern is raised, in its own words; the page for your profession links to it.
- A lawyer, where the matter is serious Particularly where interim orders have been proposed, or a Professional Conduct Committee has been appointed.
Written and last reviewed by Dr Shehzad Iqbal, MBBS, MRCS, MRCGP, Postgraduate Certificate in Healthcare Law and Ethics, University of Dundee. Last reviewed . This page is general information about the process under the Health Practitioners Competence Assurance Act 2003, not advice on any individual matter. How we handle anything you send us is set out in our privacy policy, and our terms and conditions apply to any course bought on this site.
Questions practitioners ask
Frequently asked questions
Short answers, with the section of the Act where one applies.
Does a notification mean I have done something wrong?
No. A notification is a concern raised, not a finding. Anyone can raise one, and the Act requires colleagues and employers to raise some. Your Council or Board looks into it, and many notifications end without any disciplinary step.
It is reasonable to find it distressing all the same. Every authority acknowledges that, and most point practitioners to support.
How long does the process take?
The Act sets almost no clock times, so it depends on the route. A competence review is usually a matter of months; a Professional Conduct Committee’s investigation commonly runs for many months; a matter that goes to the Tribunal takes longer again, and the decision follows the hearing. Ask the Registrar for the expected timetable at each stage — you are entitled to know.
Where an authority publishes its own timeframes, the page for your profession quotes them.
What should I do in the first week?
Read the letter properly and note any date you are asked to respond by. Contact your indemnity insurer or medical protection organisation before you write anything — that is what the cover is for. Speak to your union or professional association.
We are not lawyers and this is not advice on your matter. What we can say is that the written response is usually the practitioner’s main opportunity to be heard, and that it is worth taking seriously.
Do I have to respond?
You are invited to, and a Professional Conduct Committee must give you the chance. Not responding does not stop the process; it means the authority decides without your account of what happened, your reflection on it, or any steps you have already taken.
What is the difference between a competence review, a health process and a Professional Conduct Committee?
They answer three different questions. A competence review (s 36) asks whether your practice meets the required standard for your scope, and is educative in purpose. A health process (from s 45) asks whether a condition affects your ability to practise, and is protective. A Professional Conduct Committee (s 71) asks whether your conduct fell below what the profession expects, and is the only route that can end in a charge before the Tribunal.
The Registrar decides the route at the start. A concern can move between routes if the picture changes.
What happens at a Professional Conduct Committee?
The Committee — two practitioners from your profession and one layperson — appoints an investigator and a legal adviser, gathers documents, and gives you the concern in writing with the chance to respond. Most Committees then meet, hear from the complainant and from you separately, and decide under s 80: no further steps, a recommendation to the authority about your competence, fitness or scope, counselling, referral to the Police, or a charge.
Take advice before the meeting. What you say and write to a Committee is weighed as carefully as the original events.
Can my practising certificate be suspended before anything is decided?
Yes, but only as a protective step, and only where the Act allows it: pending a competence review where there is a risk of serious harm (s 39), pending a health assessment (s 48), or pending a Committee’s investigation or a prosecution (s 69). The Tribunal may also suspend pending a hearing (s 93).
An interim order is a risk decision, not a finding against you. You must be given the chance to be heard on it, and the substantive matter continues underneath it.
What can the Tribunal order?
Under s 101: censure; conditions on your practice for up to three years; suspension for up to three years; a fine of up to NZ$30,000; costs; and cancellation of registration. Its decisions, and their summaries, are published on the Tribunal’s website, with names suppressed only where the Tribunal orders it.
The grounds it decides against are in s 100 — chiefly professional misconduct: malpractice or negligence within your scope, or conduct bringing discredit to the profession.
Will completing courses resolve my notification?
No. No course from us or from anyone else determines or influences what a Council, a Board, a Professional Conduct Committee or the Tribunal decides. Anyone who tells you otherwise is selling you something.
What every authority’s process does weigh is your insight, your reflection and what you have done since. Structured remediation is one way of evidencing those. It is not a shortcut, and it is not a defence.
Will my employer be told?
Your Council or Board may contact your workplace as part of gathering information, and an employer who dismissed you or accepted your resignation for competence reasons was required to notify in the first place (s 34). That is separate from anything we do — we never tell an employer, a Council or Board, a Committee or the Tribunal that you have taken a course.
Will it show on the public register?
It depends on the outcome. Conditions on your scope of practice appear on the register while they run, and Tribunal decisions are published. A notification that ends in no further action, an educational letter or a competence programme is not published.
My practising certificate is suspended or has conditions. Can I still do a course?
Yes. Nothing about taking an online course depends on your registration status, and nothing you do with us is reported to anyone.
Written for your Council or Board
Find the page written for your Council or Board
Each profession has its own page: the concerns that authority often raises, its own committees by their own names, the Core Set with the ethics and professionalism pair written for that profession, and the topic courses that match the kind of concern. Start with yours rather than a general page — the vocabulary, the code and the recertification programme differ.
- Doctors Medical Council of New Zealand · Ethics and Ethical Standards for Doctors and Professionalism and Professional Standards for Doctors, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Nurses Nursing Council of New Zealand · Ethics and Ethical Standards for Nurses and Professionalism and Professional Standards for Nurses, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Midwives Midwifery Council · Ethics and Ethical Standards for Midwives and Professionalism and Professional Standards for Midwives, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Dentists Dental Council · Ethics and Ethical Standards for Dentists and Professionalism and Professional Standards for Dentists, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Pharmacists Pharmacy Council of New Zealand · Ethics and Ethical Standards for Pharmacists and Professionalism and Professional Standards for Pharmacists, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Psychologists New Zealand Psychologists Board · Ethics and Ethical Standards for Psychologists and Professionalism and Professional Standards for Psychologists, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Physiotherapists Physiotherapy Board of New Zealand · Ethics and Ethical Standards for Physiotherapists and Professionalism and Professional Standards for Physiotherapists, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Chiropractors Chiropractic Board · Ethics and Ethical Standards for Chiropractors and Professionalism and Professional Standards for Chiropractors, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Osteopaths Osteopathic Council of New Zealand · Ethics and Ethical Standards for Osteopaths and Professionalism and Professional Standards for Osteopaths, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Optometrists and dispensing opticians Optometrists and Dispensing Opticians Board · Ethics and Ethical Standards for Optometrists and Dispensing Opticians and Professionalism and Professional Standards for Optometrists and Dispensing Opticians, with the rest of the Core Set and the topic courses for the concerns that authority sees most
- Every other registered practitioner All 18 responsible authorities · Ethics for Healthcare Professionals and Professionalism for Healthcare Professionals, with the rest of the Core Set and the topic courses
Primary sources
Read the Act and the Tribunal
Everything above is drawn from these. Where this page and the Act or your authority differ, they are right — guidance changes, and conduct is assessed against the standard in force when it occurred.
Health Practitioners Competence Assurance Act 2003
The Act itself: notifications (ss 34, 45), competence review (s 36), interim orders (ss 39, 48, 69), Professional Conduct Committees (ss 71–80), the charge (s 91), the grounds (s 100) and the penalties (s 101).
Health Practitioners Disciplinary Tribunal
The Tribunal’s own site: how a hearing runs, its practice notes, and the hearings listed.
Tribunal decisions
Every decision and its summary, searchable by profession. The best guide to how the grounds and penalties are applied in practice.
Medical Council — conduct and competence concerns
How the Council’s Notifications Triage Team decides between the competence, health and conduct routes.
Nursing Council — concerns about a nurse
The Council’s competence review, health and complaint investigation processes, in its own words.
Dental Council — complaints and notifications
What the Council does with a notification, and what a Professional Conduct Committee is.
Pharmacy Council — competence and conduct committees
The Council’s committees and what each can decide.
Physiotherapy Board — complaints and notifications
The Board’s process from notification to outcome.
When you are ready
When you are ready to respond
Insight and remediation are not things you can assert. They are things you evidence. If a course would help you do that, the courses are written to each Council’s and Board’s standards — and none of them changes what your authority decides.