Fitness to practise investigations are, by their nature, highly stressful. They place practitioners, patients, and witnesses under significant pressure, often in emotionally charged situations. While regulators have a duty to protect the public and maintain professional standards, compassion must sit alongside this obligation. Compassion goes beyond empathy; it requires an active commitment to understanding individuals and removing unnecessary barriers in the process.
The Difference Between Empathy and Compassion
Empathy is the ability to recognise and share another person’s feelings, it’s stepping in their shoes—acknowledging that a registrant or witness is under stress. Compassion, however, takes this understanding further. Compassion asks us not just to recognise someone’s difficulty but to act on that understanding and ask, What can I do to help this individual?
Let me give you a real-world example: During the pandemic, like many others, I was living alone. Stuck at home in London, I spent Christmas in isolation due to the restrictions imposed at the time. To manage my mental and physical well-being, I relied on exercise and a disciplined approach to diet. My boss at the time understood this about me. She knew what I needed to stay grounded.
When work became overwhelming, I would often work late into the evening without taking breaks. Recognising this, my boss would intervene. She would stop me mid-afternoon, while it was still light outside, and say, “You need to fit in a run. Go while it’s light. The work will still be here tomorrow.” That simple act—giving me explicit permission to step away—removed a barrier. It allowed me to recharge. This wasn’t just empathy; it was compassion in action.
Let’s apply how this may work with a Nurse going through the Nursing and Midwifery Council (NMC) fitness to practise investigation:
A nurse, let’s call her Sarah, is under investigation by the NMC for a medication error. The NMC case officer assigned to Sarah’s case notices that she seems particularly distressed during their communications. Upon gentle inquiry, the officer learns that Sarah is a single parent and is struggling with the stress of the investigation while trying to care for her young child. Recognising the potential impact on Sarah’s mental health, the case officer takes several compassionate actions:
- The officer arranges for Sarah to have a consistent point of contact throughout the investigation, reducing her anxiety about dealing with multiple people. She looks at communication methods and times, and discusses what’s best for Sarah.
- Knowing that Sarah might be hesitant to take time for self-care, the officer explicitly encourages her to prioritise her well-being. They might say, “Sarah, I understand this is a stressful time. Please make sure you’re taking care of yourself. If you need to reschedule our calls to accommodate childcare or personal time, just let me know.”
- The officer provides information about the NMC’s support services, including access to confidential counselling, and encourages Sarah to use these resources.
- When scheduling hearings or meetings, the officer is flexible, offering times that work around Sarah’s childcare responsibilities.
- The officer ensures that communications are clear and timely, reducing unnecessary waiting and anxiety.
This approach demonstrates compassion by acknowledging Sarah’s personal circumstances and taking practical steps to support her well-being during the investigation process. It doesn’t compromise the integrity of the investigation but recognises the human impact of regulatory processes
Treating Individuals as People, Not Case Numbers
In fitness to practise investigations, it can be all too easy for regulators to view practitioners, patients, and witnesses as “cases” or “administrative processes” moving through a system. I once met a change director who described such processes in exactly this way: as though each step could be completed in isolation, with one person handling Task A, another handling Task B, and so on. While this might appear efficient on paper, it risks erasing the fundamental humanity of those involved.
Every registrant, patient, or witness is an individual. Their experience of an investigation may be marked by fear, confusion, or emotional strain. Compassion requires regulators to meet them where they are. This involves tailoring regulatory processes to reduce stress wherever possible.
Regulators can take several strategic actions to avoid adding unnecessary stress:
- – Clear and accessible information: Provide plain-language explanations of the investigation process, timelines, and expectations, so individuals understand what to expect.
- – Improved communication: Assign a single point of contact to each individual to ensure continuity and avoid repetitive questioning. Pre-warn them of sensitive correspondence, and use empathetic language in all communications.
- – Support access: Signpost individuals to professional associations, legal advisors, or counselling services. Offer helplines or dedicated contacts to provide immediate support.
- – Respect timing: Avoid sending correspondence late in the day, over weekends, or during holidays, and offer flexible scheduling for interviews or hearings to suit individual circumstances.
- – Streamline processes: Reduce duplication by ensuring individuals do not have to provide the same information multiple times and fast-track low-risk cases where appropriate.
- – Mental health support: Provide access to counselling or trauma-informed support, and ensure caseworkers are trained to handle stressful interactions sensitively.
- – Alternative resolutions: Where appropriate, use mediation or voluntary agreements to resolve cases without formal investigation, especially in low-risk situations.
These actions are not about lowering standards or shirking regulatory responsibilities; rather, they are about recognising the humanity behind every case. By reducing unnecessary stressors, regulators can ensure that individuals feel respected, supported, and understood throughout the process.
Compassion as a Balancing Act
Balancing compassion with the need to protect the public is not always straightforward, but it is achievable. Regulators can make meaningful changes without compromising the integrity of investigations. This begins with a cultural shift—viewing every interaction as an opportunity to support individuals rather than simply processing a case.
For example, while updating a registrant or witness about the progress of an investigation might seem routine, it is important to consider the timing and content of these updates. Are they truly necessary at that moment? Will they cause undue stress? By asking these questions, regulators can shift the focus to the person behind the case number.
Small Changes, Big Impacts
Compassion does not require sweeping reforms. Sometimes, the smallest adjustments can have the greatest impact. Removing stressors—wherever possible—requires thoughtfulness and a willingness to step into another person’s shoes.
- Recognising when someone may need permission to take a moment for themselves, as my boss did for me, can make a world of difference.
- Communicating in a way that acknowledges the emotional weight of an investigation and ensuring that support is accessible demonstrates a commitment to care.
A Call to Action
Compassion in fitness to practise investigations is not about shirking responsibility or lowering standards. It is about understanding that behind every case file is a person, and behind every person is a story. By making small but deliberate changes, regulators can ease the burdens of those navigating these processes while still upholding public trust and protection.
Regulators owe it to those they serve—and to themselves—to approach their work with empathy and, most importantly, compassion.