Professional Conduct Committee investigations for allied health practitioners

A Professional Conduct Committee (PCC) is a statutory committee that a responsible authority appoints under the Health Practitioners Competence Assurance Act 2003 (the HPCA Act) to investigate one practitioner's conduct. It is set up for your matter, it investigates independently of the authority's board or council, and it is the only body other than the Health and Disability Commissioner's Director of Proceedings that can lay a disciplinary charge against you before the Health Practitioners Disciplinary Tribunal.

The same machinery applies whether you are a psychologist, physiotherapist, paramedic, occupational therapist, dietitian, podiatrist, chiropractor, osteopath, optometrist, dispensing optician, medical radiation technologist, medical laboratory scientist, anaesthetic technician, psychotherapist or Chinese medicine practitioner. What changes from one profession to the next is the code and standards the PCC will measure your conduct against, and that is covered further down.

The conduct pathway is one of three routes in the HPCA Act. Competence concerns (whether your practice meets the required standard) normally go to a competence review, and health concerns (a condition that may be impairing how safely you practise) are handled on the health pathway. A PCC deals with questions about conduct, and with convictions. Common triggers are:

• a complaint from a client, patient, whānau member, colleague or employer that raises a conduct issue;
• a matter that the Health and Disability Commissioner (HDC) has dealt with and referred back to the authority;
• notice that you have been convicted of an offence, which authorities must refer to a PCC;

The HDC goes first where a complaint alleges that your practice or conduct affected a health consumer. The authority must send it to the HDC and cannot take its own disciplinary steps until the HDC has decided what to do, although it can still act to protect the public in the meantime. The Physiotherapy Board, for example, tells complainants it cannot take disciplinary action until the HDC has decided whether to investigate. This is why some allied practitioners hear about a PCC months or even years after the original event.

Expect a three-person committee, made up of a pair of practitioners from your own profession plus a lay member. At least one of the professional members usually has experience in your general area of practice. A PCC appoints an investigator, who gathers documents and statements on its behalf, and has legal advice. Where cultural considerations matter, authorities may appoint a member with relevant cultural expertise; the Nursing Council, to give one example, includes a Māori member whenever a Māori nurse or complainant is involved. It is worth asking whether your own authority follows a similar practice.

Because the committee includes peers, its questions will be practical: what would a reasonable psychologist, physiotherapist or paramedic have done in that situation, and does your conduct depart from that? Because it includes a layperson, it will also ask how your conduct looks to the public.

Section 77 of the HPCA Act gives a PCC power to call for information and documents relevant to its investigation. In practice that can include your clinical notes and session records, appointment and billing records, emails and text messages with the complainant, your employer's incident reports, rosters, and statements from colleagues.

Two points follow. First, do not alter, add to or tidy existing records once you know a concern exists. Any retrospective note has to carry the date it was actually written and say plainly that it is late, and an undisclosed change to a record can turn a modest conduct question into a dishonesty one. Second, think about what you write now. Section 44(4) shields what you say for competence and recertification purposes from later use against you, but how far that reaches over private reflective notes has not been tested. Write any reflection about the matter with your lawyer's advice, focused on learning, and assume it could be read.

Each authority runs its PCCs a little differently, but the steps are broadly the same. The Nursing Council's published guide gives the clearest timing benchmarks, and allied authorities follow the same Act.

1. Notice of referral. You receive notice that a PCC now has the matter, with the particulars of the complaint (the Nursing Council's guide says within 14 days of referral).
2. Investigation. The investigator collects records, statements and, where needed, expert or peer opinion. This can take some months.
3. Disclosure. You receive the investigation material before the meeting (at least three weeks before, in the Nursing Council's process).
4. Your response. Natural justice means you must have a chance to respond. You can usually send a written statement, attend the meeting in person or online, or both, with your lawyer or a support person.
5. Deliberation. The PCC decides on recommendations, a determination, or both, and gives reasons.
6. Notice of the outcome to you and your authority.

Your written response is the single most important document you will produce. A good response answers the specific allegations, explains the context without blaming others, shows what you understood then and understand now, and sets out concrete steps you have taken since. The fitness to practise overview places this in the wider New Zealand system.

At the end of its investigation the PCC can make one of three determinations:

Conciliation is underused and often misunderstood. It is not an admission, and in the Nursing Council's process its cost is met by the Council. For a dietitian whose communication left a client feeling dismissed, or a podiatrist in a billing dispute, a conciliated outcome can resolve the person's real concern faster than any other route.

Separately from its determination, a PCC can recommend that your responsible authority:

• reviews your competence to practise;
• reviews your fitness to practise on health grounds;
• alters your scope of practice or places conditions on it (for example supervision, or no unsupervised sessions with a particular client group);
• suspends your registration;
• arranges counselling or assistance for you, which in practice can mean an educative letter or mentoring;
• refers the matter to the Police.

Recommendations are just that: the authority decides whether to act on them and, if it proposes something that affects your practice, you would normally have a chance to be heard first. Authority decisions about your scope, conditions or practising certificate can be appealed to the District Court.

Section 69 lets the authority (the PCC has no such power) put your practising certificate on hold, or attach conditions to it, during an investigation or prosecution when what is alleged calls your professional conduct into question. If serious harm is feared it may act before telling you, and you must then be given the opportunity to be heard promptly (within 20 working days in the Nursing Council's description). Interim action is protective, not a finding, and it is reviewable. If you are facing it, get legal advice the same day.

There is no appeal against a PCC's determination. The route is judicial review in the High Court, which looks at whether the PCC acted lawfully and fairly (for example, whether it gave you a proper chance to respond), not at whether it reached the best decision on the facts. Judicial review is costly and rarely the first answer. The more useful time to influence a PCC is before it decides, through a full, honest written response and evidence of what you have done since.

A charge is heard by the Health Practitioners Disciplinary Tribunal (HPDT), sitting as a chair or deputy chair, three members of your profession and one layperson. The main ground is professional misconduct, which the Tribunal tests in two stages: whether what happened amounts to malpractice or negligence, or is the kind of conduct that discredits the profession, and, if it does, whether it falls so far short that a penalty is justified. Section 101 sets the menu: censure; a fine capped at NZ$30,000; conditions or a suspension lasting no more than three years; cancellation; and an order to pay costs. In setting penalty the Tribunal weighs public protection, professional standards and rehabilitation, and looks for the least restrictive proportionate outcome. Decisions are published at hpdt.org.nz; name suppression has to be applied for.

Every PCC uses the Code of Health and Disability Services Consumers' Rights as the legal floor. On top of that each profession has its own code and standards. Quote the right one in your response; quoting another profession's code tells the committee you have not engaged with your own.

1. Tell your indemnity insurer and, if you belong to one, your professional association or union. Some provide or fund legal advice for PCC matters.
2. Get a lawyer with HPCA Act experience before you send anything to the PCC.
3. Preserve everything. Notes, diaries, messages, rosters. Change nothing.
4. Leave the person who complained alone: no messages about it, and nothing passed on through friends or colleagues.Tell your employer if your contract or the authority requires it; your lawyer can help with wording.
5. Write a private timeline for your lawyer while memory is fresh.
6. Look after yourself. Use your supervisor, employee assistance programme or GP. A PCC can take months, and practitioners who are supported respond better.

Committees and the Tribunal give weight to rehabilitation, and a practitioner who can show they understand what went wrong and have acted on it is in a stronger position than one who cannot. Targeted learning is one way to show that, but only when it is genuine and specific. One relevant course, completed early, with a careful reflection on how your practice has changed, is worth more than five certificates collected the week before a meeting.

A word on who we are: Fitness To Practice runs independently of the 13 allied authorities, their PCCs and the HPDT, and none of them has endorsed us. A course from us only stands in for an ordered competence or recertification programme, a condition or required education if the body that made the order agrees, and it cannot secure any particular result. Already subject to an order or condition? Ask your authority, supervisor or lawyer whether a particular course would satisfy it, and do that before paying. The concern-to-course map below suggests where each course fits. For routine recertification, see our allied health recertification guide.