Faheem Ahmed on GPhC Fitness to Practise: What Really Happens — and 5 Lessons I Learned

Before we start: this article is educational and reflects my own opinion and experience. It is not legal or professional advice. Processes change, so always check the current General Pharmaceutical Council (GPhC) guidance — or your own regulator’s — and take proper legal advice on your own situation.

A quick, honest word first

Going through fitness to practise can be brutal — and the worst part is rarely the facts of the case. It is the not knowing. You do not understand the process, so your mind fills the gaps. You think about the years of hard work, your finances, your family, your reputation. It can feel like a character assassination, people talk about you, and you start to doubt everything. I have been there, and I want to say this clearly to anyone in it right now: you can get through this, and you are not the first good professional to be sitting where you are.

I am open about my own experience because silence helped no one — it just left the space for other people to write the story. What I can do is take the thing that frightened me most, the not understanding, and remove it for you.

What “fitness to practise” actually means

Fitness to practise is not a criminal court and it is not there to punish you for the sake of it. Its single job is to protect patients and maintain public confidence in the profession. So the central question a regulator asks is not “was this person bad?” but “is this person’s fitness to practise currently impaired, and what — if anything — needs to happen to keep patients safe?”

That framing matters, because it changes how you defend yourself. This is a professional and legal process with its own language and its own tests — it does not run on hearsay, emotion or how unfair it feels. It runs on evidence and on whether your practice today is safe. Understanding that is the difference between feeling helpless and being able to engage with it properly.

How a fitness-to-practise case actually unfolds

It helps enormously to see the whole shape of it before you are inside it. Broadly, a case moves like this.

1. A concern is raised

   Someone — a patient, an employer, a colleague, the police, another body — raises a concern with the regulator. On its own that is just an allegation, not a finding.

2. The regulator investigates

   A team checks whether the concern is genuine, whether it falls within that regulator’s remit, and gathers evidence. They will normally tell you what has been alleged and give you the chance to respond. This stage takes time.

3. Interim measures may be put in place

   Because investigations are slow, a separate interim orders committee can impose interim conditions or an interim suspension while the facts are established — purely to protect the public in the meantime. An interim order is a precaution, not a verdict.

4. An independent committee decides

   If the case proceeds, it goes to a Fitness to Practise Committee that is independent of the regulator’s investigators. This is where the three stages below happen — and where having the right representation counts most.

The three stages of the hearing

The committee works through three stages in order, and — this is the part that gives you something to hold onto — it only moves to the next stage if the previous one is met.

Stage	The question	What it turns on
1 · Facts	What actually happened?	Decided on the balance of probabilities from the evidence. If the facts aren’t made out, the case can stop here.
2 · Impairment	Given those facts, is your fitness to practise currently impaired?	Looks at insight, remediation and risk — not just what happened, but where you are now.
3 · Sanction	If impaired, what is needed to keep patients safe?	The least restrictive measure that protects the public and confidence in the profession.

At the sanction stage the committee is not reaching for the harshest option — it is choosing the lightest one that does the job. The range runs from no further action or a warning, through conditions on your registration, to suspension for a set period, and at the far end removal from the register. Which one applies depends heavily on insight and what you have done to put things right.

5 lessons I wish I’d known at the time

If I could hand my earlier self a short list, this would be it.

1. Understand the process

   Most of the fear is fear of the unknown. Once you can see the stages — investigation, then facts, impairment, sanction — it stops being a black hole and becomes a path with steps you can prepare for. That alone lowers the panic.

2. Get specialist legal advice — early

   Get legal advice, and make sure whoever represents you understands your profession, whether you are a pharmacist, dentist, doctor or nurse. Regulatory law is its own field. If you would like a steer on finding the right kind of representation, get in touch and I will point you in a sensible direction.

3. Be careful what you say

   You have heard “anything you say may be used” — it is true here too. This is a legal process, so it has to be answered with legal framing and evidence, not off-the-cuff explanations or emotional emails. You absolutely have the right to defend yourself — do it properly, with advice, not in the heat of the moment.

4. Diversify your income

   When everything hangs on one income stream and that stream is threatened, the fear multiplies — I had every wild thought about what I’d do instead. Building other income streams is not just good business; it is what lets you face the process from a position of stability rather than desperation.

5. Educate yourself and build a governance structure

   Learn from people who have been through it and from where things go wrong, and put a proper governance structure around your work before any concern ever arises. That is the single best way to protect your registration — more on it below.

Protect yourself before there’s ever a concern

The best fitness-to-practise strategy is the one you put in place years before you need it. If you are setting up a clinic or a pharmacy — ADHD, weight loss, anything — build it so a concern is unlikely in the first place and so that you are protected if one ever comes.

Start from the standards every one of us works to: keep the patient at the centre of everything. There is nothing wrong with revenue — every service earns it — but the focus cannot be sales, sales, sales. With the patient at the centre, the practical safeguards are:

• The right people and training — do the CPD, train properly for the service you’re offering, and have competent staff around you.
• The right processes — not just policies in a folder, but procedures people actually follow, and clear, accurate information for patients.
• Insurance — appropriate, current, and adequate for what you do.
• Access to a multidisciplinary team — people you can pick up the phone to for advice.

The governance committee that protects your registration

The piece I bang on about most is a proper governance committee. Every clinic, pharmacy — honestly any business — should have one. The structure is simple: you have the director on one side, and then three people who are not directors and not shareholders, whose only job is to look after the patient and make sure the company is doing right by them.

Any new service or significant decision goes to that committee. If I want to set up an ADHD clinic, I take the idea to the committee and they approve it or they don’t. That independent check is exactly the kind of safeguard a regulator wants to see — and it is the kind of thing that protects your registration if you also act as a director, where your professional standing can otherwise be exposed by business decisions.

How I can help

Two kinds of people read this far. If you are facing fitness to practise right now: take a breath, get specialist advice, and know it can be survived — reach out if you want to talk it through with someone who has been there. If you are building a clinic or pharmacy and want to do it safely, I help people set these up properly from the start — governance, training, processes and the upskilling that keeps you out of trouble in the first place.

Talk to me

Frequently asked questions

Comments

Going through this yourself, or have a question about the process or building safe governance? Leave a comment below — I read them all, and I reply.