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Witness to harm, holding to account

Improving patient, family and colleague witnesses’ experiences of Fitness to Practise proceedings: A mixed methods study

There are 13 regulators in the UK which ensure over 1.5m health and social care professionals practise safely and act appropriately. If professionals fail to meet the standards, they may face a Fitness to Practise (FtP) investigation and hearing. This is rare compared to the number of professionals and the number of complaints made about professionals. It can be a long and costly process. Regulators’ research has focussed on the registrant and employers. The experience of those who have directly experienced behaviour of the registrant has not been subject to independent research.

Our research aims to understand the experience of people being a witness in this process. We focus on those cases where the witness may themselves or their family member may have been seriously harmed or died. We will examine the impact of being a witness in investigations and hearings at fitness to practise tribunals on the patient or service user, family and colleague witnesses, what support they receive from the regulator and what support they would like. This is important because having to remember traumatic events can be deeply distressing, and even re-traumatising, yet their evidence is often crucial.

Working with the regulators, employers, lawyers and the public, we aim to find out what works and what can be improved.

Expected Outcome

The main beneficiaries of this work will be the public, professional regulators, employers and health and care professionals. We will co-produce recommendations for regulators, resources (including web resources, films and courses) designed for the public, professionals, regulators and employers; For the public we will develop free films of witnesses‘ experiences, a free Open Learn course, and podcasts. For employers and regulators we will develop training materials for professionals who may support their staff, patients and service users through the fitness to practise process. 

Contact us

For more information or to get involved with the Witness to harm, holding to account project, please email Louise Wallace ( or Amy Clow (

Logos: The Open University, Manchester Metropolitan University, Nuffield Department of Primary Care Health Sciences at the University of Oxford, University of Glasgow, The University of Edinburgh Law School