When the Nursing Council of New Zealand receives a notification about you, it decides which of three routes under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act) the concern belongs on: competence, health or conduct. It writes to you with the concern, asks for your written response by a date, and then decides whether to close the matter, order a competence review, refer the matter to its health process, or appoint a Professional Conduct Committee. While a matter is open it can suspend your practising certificate or place conditions on it. Call NZNO or your indemnity insurer the same day, obtain the records, do not alter them, do not contact the notifier, and reply before the date with a response written against the record and the Code of Conduct that shows what you have done since.
Where a notification comes from
A notification can come from a patient or their whānau, a colleague, a doctor or pharmacist, a manager, an aged care provider, a hospital, a court or another agency. Two are mandatory under the HPCA Act. An employer must notify the Council when a nurse resigns or is dismissed for reasons relating to competence (section 34), and a practitioner or employer who believes a nurse may be unable to perform the functions required for practice because of a mental or physical condition must notify the Registrar (section 45). An employer notification can arrive while an employment process is still running, and the guide to what a mandatory employer notification means covers how the two run side by side. A complaint made to the Health and Disability Commissioner reaches the Council when the Commissioner refers it.
The Council's letter states the concern, the route it has placed it on, what is enclosed, what it wants from you and the date. Write the concern out in your own words; that is the sentence your response has to answer.
The three routes
Competence. If the concern is that your practice may not meet the competencies for your scope, the Council can order a competence review under section 36 of the HPCA Act. The review measures your practice against the competencies for registered nurse, enrolled nurse or nurse practitioner, as the case is, using records, interviews, observation and a written component. After it, the Council can find that the competencies are met, set a competence programme, or place conditions on your practising certificate. The guide to the Nursing Council competence review and competence programme covers the review, the programme and the recertification programme in detail.
Health. If the concern is that a mental or physical condition may affect your ability to practise, the Council's health process applies. The Council can require an examination, accept voluntary undertakings and recommend conditions, and the matter is handled separately from conduct. The guide to the health process under the HPCA Act explains it.
Conduct. If the concern is about behaviour, the Council can appoint a Professional Conduct Committee under Part 4 of the Act. The Committee investigates, gives you its proposed findings to answer, and recommends an outcome to the Council or lays a charge before the Health Practitioners Disciplinary Tribunal. The guide to how a Professional Conduct Committee process runs covers it.
What the Council measures you against
The Council assesses conduct against its Code of Conduct, and competence against the competencies for your scope of practice. The Code sets out principles on respect for the dignity and individuality of health consumers, respect for cultural needs and values including partnership with Māori and whānau, partnership with health consumers in their care, safe and competent care, privacy and confidentiality, respectful work with colleagues, honesty and integrity, and public trust in the profession, with numbered standards beneath each. The Council's guidelines on professional boundaries and on social media and electronic communication are read with it. The guide to how the Nursing Council's Code of Conduct is used when a concern is raised shows how an allegation is mapped to a principle and how to write a reflection against the Code.
What happens, step by step
- The letter arrives. The Council sends you the concern, the material and a date. Call NZNO or your indemnity insurer that day and ask your employer in writing for the records and any report it has sent.
- You respond in writing. Facts from the record with page references, your reasoning at the time, what fell short, what you have done since with evidence, and what you have understood, in the terms of the Code and the competencies. The guide to how to write a response to a Council notification gives the structure.
- The Council decides the route. On your response, the records and any further enquiries it decides whether to close the matter, write to you with advice, order a competence review, refer the matter to its health process or appoint a Professional Conduct Committee.
- The review or investigation runs. A competence review is carried out by reviewers who report to the Council. A Professional Conduct Committee gathers documents, can interview you and witnesses, and gives you its proposed findings before it decides.
- You are heard before any order. Before the Council sets a competence programme, imposes conditions, or makes an interim order, it tells you what it proposes and gives you the chance to respond in writing or in person.
- The outcome is decided and reviewed. The Council records its decision, tells you what it has told your employer and what appears on the register, and sets when conditions or a programme will be reviewed. A charge laid by a Committee goes to the Tribunal.
Interim suspension and conditions
While a Professional Conduct Committee investigation is open, section 69 of the HPCA Act lets the Council suspend your practising certificate or place conditions on it if it is satisfied that is needed to protect the public, and the Council can make an interim order while a competence or health matter is open. You are entitled to be heard before the order is made, and the Council can vary or revoke it. A nurse who has arranged supervision with a named senior colleague, stepped back from the part of practice the concern relates to, and shown that in writing gives the Council a reason to choose conditions over suspension. The guide to interim suspension and conditions on practice covers the risk test and how an order is lifted.
What you can do now
- Get advice the same day. NZNO, or your indemnity insurer if you hold cover elsewhere. Tell them the route, the date and what the Council has asked for, and ask whether a lawyer should be instructed.
- Get the records and keep them as they are. The clinical record, medication charts, care plans, handover notes, rosters, messages and the incident report. Ask in writing.
- Write the response against the record and the Code. Facts with page references, reasoning at the time, what fell short, what you have done since, what you have understood.
- Start remediation before you reply. Supervision, a medication or documentation audit with results, a change to how your shift or your handover is organised, and courses completed with dated certificates. Completed steps are evidence; intended steps are promises.
The outcomes
At the first stage the Council can take no further action, write to you with advice, or send the matter down one of the three routes. After a competence review it can find that the competencies are met, set a competence programme, or place conditions on your practising certificate. On the health route it can accept undertakings or impose conditions. A Professional Conduct Committee can recommend no further action, counselling, a competence review or conditions, or lay a charge before the Health Practitioners Disciplinary Tribunal. The Tribunal can cancel or suspend registration (suspension for up to three years), impose conditions, censure, fine and award costs, and its decisions are published. The guide to a Health Practitioners Disciplinary Tribunal hearing describes what it weighs.
Conditions on a practising certificate can appear on the public register. At every stage the Council asks whether the public is safe now, and what you have done since the letter arrived is the evidence it reads to answer that.
Where remediation fits
The part of a Council matter you control is what you have done since the concern was raised. Courses completed before your response goes, with dated certificates attached, are evidence that you have engaged with the Code and the competencies. Ethics for Nurses and Professionalism for Nurses are written against the Nursing Council's Code of Conduct and its guidelines, so a certificate from either answers a concern framed in the Council's terms. Dealing with a Complaint or Investigation covers how to engage with the Council's process and what a response needs to contain, and Remediation for Fitness to Practise covers how to build the plan the Council reads when it decides whether a programme or conditions are needed.
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 the Council or put in your remediation plan. The remediation courses for nurses facing a Nursing Council investigation are listed on one page, and the Council and Board investigation process explained shows where each course sits in the stages. The guide to showing insight and building a remediation plan explains how to present the certificates with the rest of your evidence, and the guide to what happens after a notification to any Council or Board gives the whole HPCA Act process.
Sources and further reading
- Nursing Council of New Zealand: the Code of Conduct, the competencies for each scope, the guidelines on professional boundaries and on social media, and the Council's pages on concerns, competence and health.
- Health Practitioners Competence Assurance Act 2003: sections 34, 36, 45 and 69 and Part 4 on Professional Conduct Committees and the Tribunal.
- Health Practitioners Disciplinary Tribunal: published decisions involving nurses, with the penalties imposed and the weight given to insight and remediation.
- Health and Disability Commissioner: how a complaint about a nurse is assessed and how it reaches the Council.
Frequently asked questions
My employer has reported me to the Nursing Council. What have they sent?
Under section 34 of the HPCA Act an employer must notify the Council when a nurse resigns or is dismissed for reasons relating to competence, and the notification states the reasons. The Council sends you a copy and asks for your response. Ask the Council in writing for every document it holds, including anything your employer sent after the notification. An employment process and a Council process run separately, so advice from NZNO or your indemnity insurer before you write to either is the first step.
What is a competence programme?
It is a programme the Council sets after a competence review, under section 36 of the HPCA Act, to bring a nurse's practice back to the competencies for their scope. It can include supervised practice, assessment against the competencies, a Competence Assessment Programme and a written component, within a timeframe. Conditions on your practising certificate can run alongside it. When the Council is satisfied the competencies are met, the programme closes and the conditions are lifted.
Can the Nursing Council suspend me before it decides anything?
Yes. While a Professional Conduct Committee investigation is open, section 69 of the HPCA Act lets the Council suspend your practising certificate or place conditions on it if it is satisfied that is needed to protect the public, and the Council can make an interim order while a competence or health matter is open. You are entitled to be told what is proposed and to be heard first. A nurse who has already arranged supervision and restricted the part of practice concerned gives the Council a reason to prefer conditions.
What does the Nursing Council expect in my written response?
An account of the facts from the record with page references, your reasoning at the time, a plain acknowledgement of anything that fell short, what you have done since with evidence, and what you have understood, written in the terms of the Code of Conduct and the competencies for your scope. A level tone, no comment about the notifier, and nothing your adviser has not read. The Council reads the response beside the records; where the two differ it believes the record.
Who do I call first: NZNO or a lawyer?
NZNO, or your indemnity insurer if you hold cover elsewhere, the day the letter arrives. NZNO has professional and legal advisers who deal with Nursing Council matters and employment matters and who will tell you whether a lawyer should be instructed. Where the notification alleges dishonesty, a boundary breach with a patient or a colleague, or conduct that could reach a Professional Conduct Committee or the Tribunal, ask that question in the first call rather than later.