Nursing Council complaint investigation: what nurses can expect

The process is built on natural justice: you will see the information gathered and be given the chance to respond before any decision is made about you.

• Get advice before you reply. The Council itself encourages nurses to seek a legal representative, professional advisor or support person. If you are an NZNO member, contact them first; your indemnity insurer or a lawyer experienced in health practitioner work are other options.
• Stay out of contact with the complainant, and leave every record exactly as it stands. A late entry made now, without a clear date and reason, can turn a care concern into an honesty concern.
• Note the deadline in the letter and ask for more time in writing if you need it.
• Write your own private timeline while your memory is fresh: dates, shifts, staffing, who was present. Share it with your adviser, not on social media or with colleagues.
• Look after yourself. Use your employee assistance programme or GP. Being well makes you a better witness to your own practice.

The Nursing Council treats fitness to practise as three separate questions, each with its own process under the Health Practitioners Competence Assurance Act 2003 (HPCA Act):

When a complaint arrives, the Registrar decides which pathway applies, considers any opinion from the Health and Disability Commissioner (HDC), and carries out an assessment of risk. One event can touch more than one pathway, for example a medication error (competence) followed by an altered chart (conduct).

Who can complain, and how

The Council accepts written complaints from any person, through its online form or any other written format. A complaint needs enough detail for the Council to decide what to do. Anonymous complaints are not usually investigated unless further inquiry is possible. If the complainant gives a name but no contact details, the complaint can still be provided to you. The Council can also refer a matter to a PCC without any complaint if it holds information that raises questions about your conduct or safety to practise.

Some complaints fall outside the Council's jurisdiction, such as a pure employment dispute with no link to professional conduct or public safety.

Complaints that a nurse's practice affected a patient are forwarded by the Council to HDC. The Commissioner decides whether to investigate, take another step, or refer the matter back to the Council. The Council then waits on HDC before dealing with that complaint, though it can step in on an interim basis to protect the public.

Most HDC complaints are assessed rather than formally investigated; outcomes range from no further action or advocacy-supported resolution to recommendations or a formal investigation, whose opinion on any breach of the Code of Rights goes to the Council. The HDC's Director of Proceedings can also lay a charge before the Health Practitioners Disciplinary Tribunal in serious cases.

So you may face two processes in sequence: the HDC first, then the Council. Responses you give the HDC can later be read by the Council, so make them accurate, complete and reflective from the start. Our fitness to practise overview explains how the HDC, responsible authorities and the Tribunal fit together.

Before or during an investigation, the Council may suspend your practising certificate or add conditions to your scope of practice, such as working under supervision. Normally you are given the chance to make oral and written submissions first.

If the Council considers that what is alleged could seriously harm the public, it can suspend a nurse before hearing from you, and you then have a right to be heard, which the Council must offer within 20 working days. A PCC that forms a similar view during its investigation must notify the Council and give its reasons.

If a complaint is serious and within the Council's jurisdiction, it is referred to a PCC. Where its seriousness or jurisdiction is unclear, the Council may first do an initial assessment, and you will be given a written opportunity to respond before any referral. Here is how the PCC stage usually unfolds, based on the Council's own guide:

1. Referral notice. You and the complainant are told the complaint has gone to a PCC and given the name and contact details of the legal advisor, usually a Council staff member who is your point of contact.
2. PCC membership. The committee is two nurses (one with experience in your general area of practice) and one layperson. Where you or the complainant are Māori, a Māori member is appointed, reflecting the Council's commitment to Te Tiriti o Waitangi. Any ethnic or cultural component of the complaint also guides membership. You receive the proposed names and may ask, with reasons, for a change; members must declare conflicts of interest.
3. Particulars within 14 days. You must receive details of the complaint within 14 days of the referral, and within 14 days of any extra matter the PCC decides to investigate.
4. Investigation. The PCC's investigator interviews the complainant and other witnesses (in person, by phone or Zoom), prepares statements for them to sign, and requests records. You are not interviewed at this stage.
5. Meeting date. As the investigation nears completion, a date is agreed between you, your representative, the complainant and the PCC. Adjournments are usually agreed if you need time to prepare.
6. Disclosure. The information gathered is sent to you at least three weeks before the meeting. You can object to material, usually on relevance grounds; the legal advisor decides. The PCC receives the bundle one week before the meeting.
7. The meeting. It is held near where you live, often in a hotel conference room, and usually lasts no more than two hours. You may attend in person or by Zoom, or send a written statement instead.
8. Decision. The PCC may give an oral decision or email it shortly afterwards. Reasons go to the Registrar, you and the complainant.

The Council's guide notes that investigations may take some months. The investigation is carried out in private, and the PCC makes no public comment while it runs.

The PCC meeting is not a court hearing. The committee does not decide whether you are guilty of professional misconduct; that is for the Tribunal. It asks two questions: is there enough evidence to support the allegations, and do they reach a level of seriousness that could support a charge of professional misconduct? Because witnesses do not give evidence under cross-examination, a PCC cannot make findings of credibility.

• The complainant speaks first, without you present. They may read a statement and bring a support person or lawyer. The session is recorded, and you may listen to the recording before you meet the PCC.
• Then you respond to all the information gathered and to anything new the complainant raised. If a new matter appears and you have not had time to prepare, you may ask for an adjournment.
• Tikanga can be accommodated, for example karakia to open and close the hui and the presence of the Council's kaumātua.
• The legal advisor attends to advise on law and procedure but leaves before the PCC deliberates.
• The meeting is recorded, and you can ask for a transcript or copy.

What helps you at the meeting

Committees respond to clear, honest accounts: the events, the reasons behind them, the different choices you would now make and the changes you have made since. Learning completed since the event, with a written reflection on the impact on the person and on trust in nursing, usually says more than a general apology. References from senior colleagues who know about the complaint also help.

A PCC can make recommendations to the Council, determinations, or both.

The education letter

A recommendation that the Council counsel you leads to an education letter. It recommends an improvement in your conduct or reminds you of your professional obligations. It is not a disciplinary finding, but treat it seriously: act on it, keep it, and be ready to show what you learned. You are given the chance to respond to any recommendation before the Council decides.

Conciliation

A conciliator, paid for by the Council, may help you and the complainant reach agreement. After the conciliator reports, the PCC decides whether to lay a charge, make a recommendation or take no further steps.

A charge before the Tribunal

A charge cannot include allegations you were not given the chance to answer during the investigation. For nursing charges, the Tribunal sits as a lawyer chair, three nurses and a layperson; hearings are usually public, and the Tribunal has adopted a tikanga approach. If misconduct is proven, the HPCA Act lets the Tribunal censure a nurse, impose conditions or suspend for a maximum of three years each, cancel registration, fine up to NZ$30,000 and award costs. Tribunal decisions are published at hpdt.org.nz.

Challenging a decision

You cannot appeal a PCC decision, but judicial review is available; the High Court then checks only that the process was lawful and the result not clearly unreasonable. From the Tribunal, either you or the PCC may appeal to the High Court.

A competence review, whether it follows a PCC recommendation or a direct notification, asks one question: are you practising at the required standard? It is educative rather than disciplinary. You will receive the notification, be asked for a practice profile and evidence of professional development and competence assessments from the last three years, and have a reasonable opportunity to make written submissions and to be heard, personally or through a representative, with a support person of your choice.

If the review finds your competence is not at the standard, the HPCA Act requires the Council to make one or more orders:

• a competence programme, which may include examinations or assessments, practical training or experience, a course of instruction, or supervised practice, within a timeframe the Council sets;
• scope conditions, for example supervision, regular reports from your employer, or restrictions on giving medicines;
• an examination or assessment; or
• counselling or assistance from one or more nominated people.

If you do not meet the requirements of a competence programme, the Council may alter your scope or suspend your registration, although failure is not by itself a ground for discipline. Under the HPCA Act, statements you make for a competence review or programme are generally not admissible against you in other proceedings.

The table below links the most common themes in nursing complaints to the Nursing Council's Code of Conduct and Professional Boundaries guidelines, and to courses that build the understanding a PCC looks for. Completing a course is not a defence; it is one way to show insight and change.

All courses are online and self-paced, with instant access, a 20-question final assessment (80% pass) and a certificate with a structured reflective account. Most are 3 CPD hours at NZ$139; Reflective Practice is 2 hours at NZ$109.

We run Fitness To Practice independently: the Nursing Council, HDC, the HPDT, NZNO and other nursing bodies have given us no accreditation, approval or endorsement, and we are not connected to them. Completing a course cannot secure a particular result from HDC, a PCC, a competence review or the Tribunal, and they are not legal advice. They are not a substitute for a competence programme, condition or education ordered by the Council or the Tribunal unless that body accepts them.

• Check any order first. Nurses who already have conditions or an education requirement should have the Council, their supervisor or a lawyer confirm in advance that the course will be accepted.
• Get representation. NZNO and other unions offer members support with Council processes; a lawyer experienced in health practitioner matters can help you prepare submissions.
• Use learning honestly. Present certificates and reflections for what they are: evidence of your own learning since the event.

Recertification is separate from complaints. For your annual practising certificate hours and audit, see Nursing Council recertification requirements. Browse all NZ courses.