Can your Council or Board suspend you before a decision, and what are interim conditions?

Yes. Under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act), your Council or Board can suspend your practising certificate, or place conditions on it, before any finding is made, while a competence review, a health process, a Professional Conduct Committee (PCC) investigation or a charge before the Health Practitioners Disciplinary Tribunal is open. The authority can do this only where it believes you may pose a risk of serious harm to the public if you keep practising without restriction, and only after it has given you notice of what it proposes and a reasonable opportunity to make written submissions and be heard. An interim order is not a finding against you. It lasts while the matter it was made for is open, it is entered on the public register, and it can be varied or lifted on application with evidence that the risk has been addressed. The way to reduce the chance of an interim suspension is to put a less restrictive alternative in front of the authority before it decides.

What an interim order is

An interim order is a protective measure, not a penalty. It changes what you may do while a question about your practice is answered. There are two kinds: an interim suspension, under which you cannot practise at all, and interim conditions, under which you practise with limits, such as supervision, a narrowed scope, a bar on a particular setting or procedure, or a requirement to report to the authority at intervals.

The Act provides for interim orders on each of the three routes. On the competence route, the authority can suspend or impose conditions while a review of competence is pending or in progress. On the health route, it can do so where it believes a condition affecting your ability to practise makes it unsafe for you to continue without restriction. On the conduct route, section 69 allows the authority to suspend or impose conditions while a PCC investigation or a Tribunal charge is pending. The guide to what happens after a notification to your Council or Board explains the three routes, and the guides to a competence review, the health process and a Professional Conduct Committee cover each in detail.

Who decides and the test they apply

The authority decides: the Council or Board itself, or a committee it has delegated the power to. A PCC cannot make an interim order; it can only ask the authority to consider one. While a charge is before the Tribunal, the power stays with the authority under section 69.

The test is risk, not proof. The authority must have reason to believe that you may pose a risk of serious harm to the public by practising, or by practising below the required standard, while the matter is open. In applying it the authority looks at the following.

• The nature of the allegation. Whether the conduct or the shortfall alleged, if true, puts patients at risk of serious harm: a clinical error with a serious outcome, a boundary with a patient or a colleague, dishonesty in records, prescribing outside safe limits, practising while unwell.
• Whether it could recur. One event under explained pressure, or a pattern; conduct in the past, or a continuing situation.
• What is already in place. Supervision, a changed role, a voluntary undertaking, an employer's own restrictions, treatment under way on the health route, courses completed.
• Your response. Whether you have engaged with the concern, acknowledged what the records show, and proposed a workable alternative.
• The least restrictive order. Whether conditions would protect the public as well as a suspension would. The authority is required to weigh the effect on you against the protection the order gives.

What happens step by step

1. Notice of a proposed order. The authority writes to you with the order it is considering, the reasons and the material it relies on, and gives you a date to respond. The time can be short where the authority considers the risk urgent.
2. Advice, the same day. Contact your indemnity insurer, your professional association or union, or a lawyer. For doctors that is the Medical Protection Society; for nurses NZNO; for midwives NZCOM.
3. Your written submissions and proposal. You respond to the reasons, correct anything wrong with reference to the records, and propose a less restrictive order with the arrangements already made.
4. Being heard. The authority or its committee meets, in person or by video, and hears from you and your representative before it decides.
5. The decision. The authority makes no order, imposes conditions or suspends, and gives written reasons. Any order is entered on the register and noted on your practising certificate.
6. Review and lifting. You can apply to have the order reviewed or varied as the matter progresses, and it ends when the matter it was made for is decided or when the authority revokes it.

Being heard first

The Act requires notice and a reasonable opportunity to make written submissions and to be heard before an interim order is made. That is a right, not a courtesy, and an order made without it can be challenged by review or appeal. Use the opportunity for three things: to correct the facts where the records support you, to show what is already in place, and to propose the order you would accept. Bring your representative. Answer the questions put to you directly. Say what you have changed. The authority is judging, among other things, whether you understand why it is concerned.

How long an order lasts and telling your employer

• Duration. An interim order lasts until the matter it was made for is decided, unless the authority varies or revokes it earlier. On the competence route that is the authority's decision after the review; on the conduct route it is the PCC's decision or the Tribunal's, and the Tribunal's own orders then replace it.
• Review. You can apply to the authority at any time to have the order reviewed, with evidence that the risk has been addressed: supervision reports, an audit, a medical report on the health route, courses completed with dated certificates. Some authorities review interim orders at set intervals as well.
• The register. An interim suspension and interim conditions are entered on the public register while they are in force and are removed when the order ends.
• Your employer. An employment agreement will require you to disclose a change to your practising certificate, and conditions such as supervision cannot be met without the employer's involvement. Tell your employer in writing, with a copy of the order, before they see it on the register. The guide to an employer's mandatory notification covers how the employment and regulatory processes run alongside each other.
• Other registrations and insurers. Check whether your indemnity policy, ACC provider status or any other registration requires you to notify an interim order, and do so on advice.

How practitioners reduce the risk of an interim suspension

The authority chooses between no order, conditions and suspension. Practitioners who avoid suspension are the ones who give the authority a workable set of conditions before it has to design its own. In writing, with the documents attached, offer the following where they fit the concern.

• Supervision. A named senior colleague who has agreed in writing to supervise, with a stated frequency, a method and a written log that can be sent to the authority.
• A narrowed scope. An undertaking not to perform the procedure, prescribe the class of medicine, or work in the setting the concern relates to, until the matter is decided.
• A voluntary undertaking. Some authorities accept a written undertaking in place of a formal order. It has the same effect on your practice but is treated differently on the register; ask your adviser.
• Treatment and monitoring on the health route. A treating practitioner's report, agreed monitoring and an undertaking to comply with it.
• Remediation already completed. Courses with dated certificates that match the concern, an audit of your records, a written reflection. These show the authority that the risk is being managed by you, not only by the order.

The guide to showing insight and building a remediation plan explains what the authority reads as insight, and the guide to what happens at a Tribunal hearing explains how compliance with interim conditions is weighed later on penalty.

How an interim order is lifted

An order ends in one of three ways: the matter it was made for is decided and the order lapses or is replaced; the authority revokes it on your application; or it is set aside on review or appeal. The application that succeeds is the one that shows the risk has changed: supervision reports over a period with no concern, an audit with results, a report from a treating practitioner, courses completed, and a reflection that engages with the concern. Keep every document, because the same bundle serves the review of the order, the competence review or PCC, and any Tribunal hearing on penalty.

Where remediation fits

Remediation completed before the authority decides on an interim order gives it a reason to choose conditions over suspension; remediation completed while an order is in force is the evidence for lifting it. Dealing with a Complaint or Investigation covers the process you are in and how to engage with it. Fitness to Practise for Healthcare Professionals covers what a regulator means by fitness to practise and what it needs to see. Remediation for Fitness to Practise covers how to build a plan with evidence the authority can check.

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 an interim order sits among the stages.

Sources and further reading

• Health Practitioners Competence Assurance Act 2003: the interim suspension and conditions provisions on the competence, health and conduct routes, including section 69.
• Health Practitioners Disciplinary Tribunal: published decisions that record how compliance with interim conditions was weighed on penalty.
• Medical Council of New Zealand: one authority's published description of its interim order process.

Frequently asked questions

Is an interim suspension a finding that I did something wrong?

No. An interim order is a protective step while a competence, health or conduct matter is open, and the authority makes it without deciding the facts. The test is whether the authority believes you may pose a risk of serious harm to the public if you keep practising without restriction while the matter runs. The finding, if there is one, comes later from the authority after a review, or from the Tribunal after a hearing. An interim order does, however, appear on the public register while it is in force.

Can the authority suspend me without hearing from me first?

The Act requires the authority to give you notice of the order it proposes, with its reasons, and a reasonable opportunity to make written submissions and to be heard before it decides. The time allowed can be short where the authority considers the risk urgent, and you may have days rather than weeks. Use them to get advice and to put a less restrictive alternative, with evidence, in front of the authority. An order made without that opportunity can be challenged.

How long does an interim order last?

Until the matter it was made for is decided, unless the authority revokes or varies it earlier. An order made while a competence review is pending lasts until the review concludes and the authority makes its decision. An order under section 69 lasts while the PCC investigation and any Tribunal charge are pending. You can apply to the authority at any time to have the order reviewed, varied or lifted, with evidence that the risk it was made to meet has been addressed.

Do I have to tell my employer about interim conditions?

Interim conditions and an interim suspension are entered on the public register, and your employer can see them there. A condition requiring supervision or a limit on your scope cannot be met without your employer knowing, and an employment agreement will require you to disclose a change to your practising certificate. Tell your employer yourself, in writing, with a copy of the order, before they learn of it from the register. Your union or association can help you with that letter.

What can I offer instead of an interim suspension?

A less restrictive order that meets the same risk. Supervision by a named colleague with a written log, a narrowed scope that excludes the area of concern, a voluntary undertaking not to practise in a setting, a requirement to report to the authority, or an audit of your records. Put the proposal in writing with the arrangements already made and the evidence of remediation already completed. The authority has to consider the least restrictive order that protects the public, and a proposal gives it one.