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Table 5 Summary of issues and recommendations across analytical themes

From: Living life in limbo: experiences of healthcare professionals during the HCPC fitness to practice investigation process in the UK

Issues (themes one and two) Recommendations (theme three)
Disproportionate, inflexible and punitive nature of the process (theme one) Consider alternative processes that are less legal and take context into account (e.g. mediation); allow registrants a voice and develop a range of processes that depend on the nature of the complaint to address the disproportionate nature of the one size fits all process.
Perceived assumption of guilty before proven innocent (theme one) Hold face to face meetings and opportunity for registrant to be heard and provide insights into the context of incident(s).
Ensure the maxim innocent until proven guilty is felt and experienced by registrants
Time taken by the investigation and the associated uncertainty; Poor communication about the process and timelines (no road map) (theme one) Reduce time taken and keep registrants informed at each step of the process to reduce uncertainty; provide clear timeframes to reduce psychological burden on registrants; provide case specific information as well as advise on worst case outcomes; actively provide more guidance to registrants, including what type of evidence is required, appropriate reflective approaches to take and suggested structures.
Lack of compassion and empathy for registrants (theme one) Ensure HCPC staff themselves feel supported so they in turn they can better support registrants. Increase empathy and staff continuity; train staff to be more responsive, kinder and more compassionate; provide continuity where possible including access to the same case manager/hearing personnel throughout.
Public exposure, shame and associated impact on reputation including impact on employment (theme two) Ensure the process is confidential and the registrant anonymous until after the hearing unless registrants are suspended; with registrant details not being in the public domain when no case has been proven.
Reduce stigma associated with process allowing participants to be more open
High costs and associated financial losses (theme two) Consider access to free legal support and running panels in more regional locations or via online technology.
No voice in the process for registrants to provide context and be heard (theme two) Increase opportunities for registrants to be heard using face to face contact to enable HCPC to hear the registrant’s story and more contextual details, particularly at the beginning information gathering stage.
Lack of support (theme two) Increase support for registrants by signposting and creating support networks including peer support or support line.