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Fitness to Practice

Fitness to practice refers to the ability of an individual to perform their professional duties competently and safely within their chosen field. In the context of healthcare, fitness to practice encompasses a healthcare professional's physical and mental capability to provide safe and effective care to patients. Assessing fitness to practice is crucial for safeguarding the public and maintaining the integrity of clinical professions.

At Bush & Co, we understand the serious consequences that can arise from fitness to practice concerns. Concerns regarding an individual’s professional conduct and competence can be raised for a variety of reasons, including health issues, suspected breach of duty, alleged misconduct, or doubts over capability and performance, allegations which require in-depth analysis by an appropriate and experienced health care professional who understands professional regulatory frameworks, ethics and relevant codes of conduct.

Our team of expert witnesses are all experienced healthcare professionals and deliver comprehensive fitness to practice assessments and support services, guiding instructing parties through every step of the process with expertise, objectivity, and discretion.

Trusted Expertise

Fitness to practice expert witnesses from Bush & Co operate under instruction from solicitors or professional bodies, such as the Nursing and Midwifery Council (NMC) and the Health and Care Professions Council (HCPC).

By adhering to rigorous standards, Bush & Co’s expert witnesses follow a thorough, unbiased process to determine if an allegation of impaired fitness to practice is substantiated and our role is to provide an authoritative, third-party expert opinion to assist fitness to practice panels in reaching a fair and just resolution for all those concerned.

Kessi Donnelly


Our Established Process

  • Case Background Review and Evidence Evaluation

    We collect comprehensive details on the background and context of the case from our instructing party. This includes a meticulous review of the initial complaint, findings from any internal investigations, relevant clinical records, and witness testimony.

  • Professional Competency

    Our experts also carefully evaluate any evidence provided surrounding the competency, training and professional development of the health care individual concerned alongside applicable and expected professional standards of practice, codes of conduct and specific competency frameworks pertinent to the clinical role in question.

  • Expert Report

    With a comprehensive understanding of the facts, our experts author a detailed report setting out their reasoned opinion on whether the evidence supports that expected and appropriate standards of professional practice were met or whether conduct fell below that which is expected by the individual’s professional regulatory body. The report cites applicable professional guidelines supporting expected standards of practice and competency to support our conclusion.

The objectivity of our associate expert witnesses gives all parties confidence our opinions are impartial, consistent and rooted in verifiable evidence and clinical best practice - not compromised by conflicts of interest or external pressure.

Whether engaged by the practitioner or regulator, Bush & Co's fitness to practice reports provide reliable guidance for regulatory hearings, disciplinary committees and appeals processes.

Katherine Rothwell


Bush & Co Expert Witnesses

Bush & Co's expert witnesses operate across various medical and healthcare professions, with each providing exceptional knowledge and expertise and possessing:

  • Experience in navigating complex fitness to practice cases and providing valuable insights on professional competency.
  • Quality assurance principles and abilities in examining evidence, adhering to legal/professional regulatory protocols, and upholding ethical standards in delivering high-quality expert opinions.
  • Expertise in providing tailored reports with detailed and technical insights that can shape outcomes in complex investigations while maintaining objectivity.
  • Knowledge through specific training on relevant legal processes and frameworks, how to write clear reports, and be responsive to the needs and timescales of instructing parties.

Find An Associate

Finding the right medico-legal expert to support your fitness to practice case may be complex and we encourage you to contact us to discuss the right expert witnesses for the case.

Not only can we help you choose the right clinician, we can also discuss Court experience, the individual’s skills and knowledge and the small details you may be looking to address in such complex and sensitive cases.

Contact Cathy Preston, Head of Medico-Legal at to discuss your needs further.

Cathy Preston

Head of Medico-Legal