A notification to your Council or Board starts a process under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act). The responsible authority for your profession reads the notification, decides which of three routes it belongs to, and writes to you. The routes are competence (is your practice at the required standard), health (does a condition affect your ability to practise) and conduct (does the conduct described need a Professional Conduct Committee). The letter tells you which route the authority has in mind and what it wants from you, with a date. Before that date, read the letter twice, speak to your indemnity insurer or professional association, gather the records and write a measured response. This guide sets out what happens on each route, what you can do in the first fourteen days, the outcomes and where remediation fits.
What a notification is and who can make one
The HPCA Act regulates every health practitioner in New Zealand through a responsible authority: the Medical Council, the Nursing Council, the Midwifery Council, the Pharmacy Council, the Dental Council, the Psychologists Board and the others. A notification is any information that reaches your authority and raises a question about your competence, your health or your conduct.
It can come from a patient or a family member, a colleague, an employer, the Health and Disability Commissioner (HDC), ACC, a court or the authority's own recertification checks. Some notifications are required by the Act. An employer must notify the authority when a practitioner resigns or is dismissed for reasons relating to competence (section 34). A practitioner who has reason to believe that a colleague may pose a risk of harm to the public by practising below the required standard must notify the Registrar. Anyone who believes a condition may affect a practitioner's ability to practise can notify the authority under section 45.
A complaint from a health consumer about their care is handled differently. The Act requires the authority to forward it to the HDC, which assesses it under the Health and Disability Commissioner Act 1994 and the Code of Health and Disability Services Consumers' Rights, then tells the authority what it has found. The guide to what happens when a complaint goes to the HDC covers that path.
The three routes and who decides
Each route has its own decision-maker and its own test.
- Competence. The authority itself decides. If it has reason to believe that you may not meet the required standard of competence, it can order a review of your competence under section 36, after giving you notice and considering what you say. Reviewers it appoints look at records, interview you and may observe your practice. The guide to what happens in a competence review sets out the review in detail.
- Health. The authority decides, with medical advice. If it has reason to believe that a mental or physical condition may affect your ability to practise, it can require you to be examined and can place conditions on your practice or accept a voluntary undertaking. The health process under the HPCA Act is separate from a conduct matter and is kept confidential as far as the Act allows.
- Conduct. A Professional Conduct Committee (PCC) investigates. The authority appoints a PCC under Part 4 of the Act where the notification describes conduct, a conviction or a complaint that has come back from the HDC. The PCC hears from you and then recommends an outcome or lays a charge before the Health Practitioners Disciplinary Tribunal (the HPDT). The guides to how a Professional Conduct Committee runs and to what happens at a Tribunal hearing cover those stages.
On any route the authority can make an interim order. Where it believes you may pose a risk of serious harm to the public, it can suspend your practising certificate or place conditions on it while the matter is open, after giving you a chance to be heard. Section 69 provides for this while a PCC investigation or a Tribunal charge is pending, and the competence and health parts of the Act contain equivalents. The guide to interim suspension and interim conditions explains the test and how such orders are lifted.
What happens step by step
- The authority receives the notification and assesses it. The Registrar or a staff committee decides whether it raises a competence, health or conduct question, whether it must go to the HDC first, or whether it needs no action.
- You are told. The authority writes to you with the substance of the concern, in some cases with a copy of the notification, and asks for your response by a stated date. The letter says which route the authority is considering.
- You respond in writing. You set out the facts, refer to the records, explain your reasoning, acknowledge anything that fell short and describe what you have done since. The guide to writing a response to a Council or Board notification gives the structure.
- The authority decides the route. With your response in front of it, the authority takes no further action, orders a competence review, starts the health process or appoints a PCC. It may also decide an interim order is needed while the matter runs.
- The route runs. Reviewers assess your competence and report. A health process involves an examination and a report. A PCC investigates, hears from you and makes its recommendation or lays a charge, which goes to a hearing before the Tribunal.
- The decision and any order. Conditions, a competence programme or a suspension are noted on the register and reviewed later; a Tribunal decision is published.
The first fourteen days: what you can do now
- Read the letter for the exact allegation. Note the route the authority names, the section of the Act it relies on, the date for your response and what it has asked you to provide. Everything you write should answer that allegation and nothing else.
- Tell your insurer and your association today. Doctors call the Medical Protection Society; nurses call NZNO; midwives call NZCOM. The others call the indemnity insurer named on their policy or their professional association.
- Get the records, and leave them as they are. Request copies of the clinical record, the roster, the incident report and any correspondence. Read them before you write your account, so that what you say matches what is documented.
- Write a private timeline. Dates, times, who was present, what you decided and why. It becomes the spine of the response.
- Begin the remediation that fits the concern. A dated certificate from a course completed before your response is sent shows you took the concern seriously from the first week. The guide to showing insight and building a remediation plan explains what to include.
- Check your employment position. If your employer made the notification or is running its own process, the two run in parallel. The guide to an employer's mandatory notification explains how they interact.
The outcomes open to the authority
These are the orders the Act provides for, by route.
- No further action. The authority is satisfied with your response and closes the file, in some cases with a letter noting what it expects of you.
- Counselling. A PCC can recommend that you be counselled, which means a formal meeting or letter about the standard expected.
- Competence orders. After a review the authority can require you to complete a competence programme, place conditions on your scope of practice, require supervision or an examination, or, where it considers you unable to practise safely, suspend your practising certificate.
- Health conditions or an undertaking. On the health route the authority can place conditions on your practice, accept a voluntary undertaking, or suspend your practising certificate while a condition makes practice unsafe.
- A PCC recommendation. The Committee can recommend no further action, counselling, a competence review or conditions, or it can lay a charge before the Tribunal.
- A Tribunal penalty. If a charge is proved, the Health Practitioners Disciplinary Tribunal can cancel your registration, suspend it for up to three years, impose conditions, censure you, impose a fine and order you to pay costs. The decision is published.
On every route the questions are the same: what happened, whether you understand why, and what you have changed. The guide to an HDC breach finding and the Director of Proceedings describes the path a consumer complaint can take to the Tribunal.
How long it takes
The Act does not set a single timetable. Your first deadline is the date in the letter, and it can be extended on request with a reason. A competence review runs in stages: notice, submissions, the review, the reviewers' report, your comments and the decision. A PCC gathers records and statements before it hears from you, and a Tribunal hearing is listed after the charge is laid and evidence exchanged. Use that time: every month with supervision in place, courses completed and an audit done is evidence that the concern has been addressed.
Where remediation fits
Remediation is what you do about the concern before anyone orders you to. It belongs in your first response and in every later submission, as dated evidence rather than a promise. Dealing with a Complaint or Investigation covers the process you are now in. Insight for Fitness to Practise covers the difference between regret and insight. Remediation for Fitness to Practise covers how to build a plan with evidence a Council, Board, PCC or Tribunal 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 full set of remediation courses for every Council and Board is on the hub page, and the Council and Board investigation process explained sets out the stages on one page. Profession guides cover a notification to the Medical Council, a notification to the Nursing Council and a notification to the Midwifery Council.
Sources and further reading
- Health Practitioners Competence Assurance Act 2003: the competence, health and discipline provisions, including sections 34, 36, 45 and 69.
- Health Practitioners Disciplinary Tribunal: published decisions and the Tribunal's procedures.
- Health and Disability Commissioner: the Code of Health and Disability Services Consumers' Rights and how complaints are assessed.
Frequently asked questions
Who can make a notification to my Council or Board?
Any person can tell a responsible authority that they have a concern about a registered practitioner. The HPCA Act also places duties on some people. An employer must notify the authority when a practitioner resigns or is dismissed for reasons relating to competence. A health practitioner who believes a colleague may be practising below the required standard, or may be unable to practise because of a condition, must notify the Registrar. The Health and Disability Commissioner notifies the authority of complaints and findings, and a court notifies certain convictions.
Will my employer be told about the notification?
Not automatically. The authority writes to you, not to your employer, when it assesses a concern. Your employer will know if the notification came from them, if the authority asks them for records or a report, or if an order is made that changes your practising certificate. Interim conditions, conditions on your scope of practice and a suspension are recorded on the public register, which an employer can check. Your employment agreement may also require you to tell your employer about a Council or Board process.
Do I have to respond in writing?
The Act gives you the right to respond, and the authority cannot order a competence review, impose an interim order or refer you to a Professional Conduct Committee without first giving you notice and a chance to make submissions. You are not compelled to write, but silence leaves the authority with only the notifier's account. A measured written response, prepared with your indemnity insurer or professional association, is the one document you control and the one the decision-makers read first.
Can the authority suspend me as soon as a notification arrives?
Only by an interim order, and only where it believes you may pose a risk of serious harm to the public. The Act requires the authority to give you notice of the proposed order and a reasonable opportunity to make written submissions and be heard before it decides, and the order can be challenged and reviewed. An interim order is not a finding against you. It lasts while the competence, health or conduct matter is open and is lifted or replaced when that matter is decided.
Will a notification appear on the public register?
A notification by itself does not. What the public register shows is any condition on your scope of practice, any suspension, whether interim or final, and the annotation that follows a Tribunal finding. Decisions of the Health Practitioners Disciplinary Tribunal are published on its website, with the practitioner's name unless the Tribunal orders suppression. A competence review or a health process that closes without an order on your practising certificate is not published.