Respond to a Council or Board Notification: What to Write

Your response to a notification is the document your Council or Board will read beside the notification and the records when it decides what to do next. Write it in this order: read the letter and identify the exact allegation; get the records; get advice from your indemnity insurer, your professional association or union, or a lawyer; then write a response that sets out the facts with reference to the record, your reasoning at the time, what fell short, what you have done since and what you have understood. Keep the tone level, answer every point the letter raises and nothing it does not, attach the evidence, and send it before the date in the letter or ask in writing for more time. A response that meets those requirements can close a matter at the first stage; one that does not can turn a question into an investigation.

What the response is for

Under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act) a responsible authority that receives a notification about you must decide which route it belongs on: competence, health or conduct. Your response is part of the material it decides that on. For a competence question it is read with the records to decide whether a review under section 36 is needed. For a conduct question it is read to decide whether the matter can close, whether you should be counselled, or whether a Professional Conduct Committee should be appointed. For a complaint that came through the Health and Disability Commissioner, the Commissioner has already asked for your account and the authority reads both.

The authority is asking three questions. What happened. Whether what happened fell below the standard. Whether the public is safe now. A response that answers all three with evidence gives the authority what it needs to close the matter or keep it at the lowest stage. The guide to what happens after a notification to your Council or Board describes the routes; this guide is about the document.

Before you write anything

Read the letter twice. Find the exact allegation, the route the authority has put it on, the material enclosed, the date for your response and what the authority has asked you to provide. Write the allegation out in your own words so you can check that your response answers it.
Get advice the same day. Your indemnity insurer, your professional association or union, or a lawyer. For doctors the Medical Protection Society, for nurses NZNO, for midwives NZCOM. Tell them the date in the letter.
Get the records. The clinical record for the patient and the period, your rosters, correspondence, messages, prescriptions and any policy you were working under. Ask your employer or practice for copies in writing. Do not change, add to or annotate any record once a notification has been made.
Ask for what is missing. If the authority refers to a document you have not been given, ask for it in writing before you respond. You are entitled to see the material the authority will rely on.
Write a private first draft. Get the anger and the fear onto a page you will not send. The response you do send is written against the record, not from the feeling of the day the letter arrived.

The structure of a strong response

Set the response out under headings that follow the authority's own questions. Number the paragraphs so the authority can refer to them. Attach the documents and refer to them by page.

The allegation, restated. One paragraph saying what you understand the concern to be, in the authority's words. This shows you have read it and fixes what your response is answering.
The facts, from the record. What happened, in order, with the date and time of each entry and the page it appears on. Where your memory and the record differ, say so and prefer the record. Where the record is silent, say that it is silent rather than filling the gap.
Your reasoning at the time. Why you made the decision you made, with the information you had then. Name the guideline, policy or standard you were applying. This is where an authority sees whether a decision was reasonable even if the outcome was poor.
What fell short. Where the record shows a gap against the standard, say so in one plain sentence each. A missing consent discussion, a late note, a dose not checked, a boundary with a patient or a colleague that was not kept. Your adviser will help you word this without making an admission you should not make.
What you have done since. Supervision arranged with a named supervisor, an audit with results, a change to how your practice is organised, courses completed with dated certificates, a conversation with the patient where that was appropriate and advised. Attach the evidence.
What you have understood. A short reflection: what happened, why, what you understand now and what you have changed. The guide to showing insight and building a remediation plan explains what reads as insight and what does not.
Attachments and offers. A list of the documents attached, and an offer to provide anything further, to meet, or to accept a step the authority may be considering, such as a period of supervision.

Tone

The authority is judging your professionalism from the way you write as well as from what you say. Plain sentences. No adjectives about the notifier. No argument about their motives, their own conduct or the fairness of the process; if the process has been unfair, your adviser raises that separately. Write about the patient with respect, whatever the notification says. Where the notifier has misunderstood what happened, show the misunderstanding from the record and leave it there. A level response reads as the response of a practitioner who can be trusted with a concern; an angry one reads as the opposite, and an authority will remember it when it decides whether the public is safe.

What not to write

A general defence of your career. Years of practice, qualifications and testimonials do not answer an allegation about one event. One or two sentences of context is enough; the rest of the response is about the matter.
A contradiction of the record. If your account and the record differ, the authority believes the record. Write against it.
An explanation that reads as excuse. Workload, staffing and a difficult patient can be stated as facts; they cannot carry the response. Follow each with what you did about it and what you have changed.
A promise instead of evidence. "I intend to complete a course" is a promise. A dated certificate is evidence. Complete the step before you send the response where you can.
Blame. A colleague, a system, the patient. Where another person's conduct is relevant, state it as a fact from the record and return to your own part.
Anything your adviser has not read. Including an email sent while the formal response is being prepared.

Where the allegation is about honesty, the response has to be written with greater care still, because the authority is judging whether your account of the event can be trusted at all; the guide to an honesty or probity concern covers that. Where it is about a boundary, the guide to a boundary concern about a patient or a colleague describes what the authority looks for.

Deadlines and extensions

The date in the letter is the deadline. If you cannot meet it because records have not arrived, your adviser needs time, or you are unwell, write to the authority before the date with the reason and a proposed new date. An authority can grant an extension requested in time with a reason. A second extension needs a stronger reason than the first. If the date passes without a response or a request, the authority decides on the material it has, and a Professional Conduct Committee or a competence review can be the result of silence; the guide to how a Professional Conduct Committee process runs shows what that stage involves. Keep a copy of everything you send and a note of the date you sent it.

Where remediation fits

The section of your response that describes what you have done since is the one you control entirely, and it is the one an authority reads to decide whether the public is safe now. Courses completed before the response goes, with dated certificates attached, are evidence; courses promised are not. Dealing with a Complaint or Investigation covers how to engage with a regulatory process and what a response needs to contain. Reflection for Fitness to Practise covers how to write the reflection that goes in the response. Insight for Fitness to Practise covers the difference between regret and insight and how an authority tells them apart.

Each course is NZ$200, takes 2 CPD hours, is self-paced with immediate access, and ends with a dated certificate issued by Healthcare Ethics Courses that you can submit to your Council or Board or put in your remediation plan. The remediation courses for every Council and Board are on the hub page, and the Council and Board investigation process explained shows where your response sits in the stages. Profession guides describe what the Medical Council expects from a doctor's response and what the Nursing Council expects from a nurse's response.

Sources and further reading

Health Practitioners Competence Assurance Act 2003: the competence, health and conduct provisions, including section 36 on competence reviews and Part 4 on Professional Conduct Committees.
Health and Disability Commissioner: how a complaint is assessed, what a provider is asked to supply, and how the outcome reaches a responsible authority.
Health Practitioners Disciplinary Tribunal: published decisions describing how practitioners' responses and remediation were weighed.

Frequently asked questions

How long do I have to respond to a notification?

The letter states the date. The HPCA Act does not fix a single period for every authority, so the date in your letter is the one that applies. If you need more time to obtain records or advice, write to the authority before the date, say why and propose a new date. A request made before the deadline with a reason is a normal step; a response that arrives late without one reads as a failure to engage with the process.

Should I admit anything in my response?

Acknowledge what the records show. Where a note is missing, a step was skipped or a conversation did not happen, say so plainly and say why. A Council or Board reads a response that matches the records as credible and a response that disputes them as the opposite. The line between an acknowledgement of fact and an admission with wider consequences is one your indemnity insurer, your professional association or a lawyer will help you draw, which is why they read the draft before it goes.

Can I contact the person who made the notification?

No. Do not contact the notifier, the patient or a witness about the matter, directly or through someone else, and do not discuss it with colleagues who may be asked for a statement. Contact can be treated as an attempt to influence the process and can become a second concern alongside the first. If you believe the notifier has misunderstood what happened, your response is the place to say so, with reference to the record.

What if the notification is wrong on the facts?

Say so, with the evidence. Set out what the record shows, attach the pages, and explain the difference between the account in the notification and the account in the record without speculating about why the notifier gave it. A Council or Board can close a matter on a response that shows the allegation is not supported, but it does so on documents, not on a denial. Where part of the notification is right and part is wrong, deal with each part separately.

Do I need a lawyer to respond?

Not in every matter, but you need someone with experience of the process to read your draft before it goes. For doctors that is the Medical Protection Society, for nurses NZNO, for midwives NZCOM, and for other professions your indemnity insurer or professional association. Where the notification alleges dishonesty, a boundary breach, or conduct that could reach a Professional Conduct Committee or the Tribunal, ask your insurer whether a lawyer should be instructed now rather than later.