Fitness to practice

The Council’s role is to protect the health and safety of the public by ensuring that nurses are competent and fit to practise. The Council carries out this role by considering the competence, health or conduct of a nurse and deciding whether the nurse should have to comply with certain conditions in order to practise.

In serious cases where there is a public safety risk, the Council may suspend the nurse from practice. 

For more information, see the documents in the right hand downloads box on this page, or contact us.


Nurses must meet the required standards of competence for their scope of practice. If there is evidence to suggest that a nurse is not meeting the required standards of competence, the first step should be performance management in the workplace.

If the nurse resigns or is dismissed for reasons relating to competence, the employer must promptly notify the Council.

The HRANZ/DHB Agreed Guidelines for Competence Referrals (July 2010) have been developed to assist HR practitioners, professional leaders, managers and regulatory authorities to manage competence issues and competency referral.

HRANZ DHB Guidelines for Competency Referrals (PDF, 174 KB)

The notification is to be in writing to the Registrar and include the reasons why the person making the notification believes that the nurse may pose a risk of harm to the public by practising below the required standard of competence. You will find the Competence Notification Form in the downloads box on the right of this page.

The Council will inform the nurse of the notification and make further inquiries before deciding if a review of competence is required. You may be asked to provide further evidence to support your notification.

The Council may require the nurse to have his or her competence reviewed. Following that review the nurse may be required to have further education or practise under supervision for a period of time. In serious cases where there is a risk to public safety, the nurse may have his or her registration suspended until he or she completes a competence programme.


As an employer of nurses or as a person in charge of an organisation that provides health services, you must notify the Council in writing if you have reason to believe that a nurse is unable to perform the functions required for the practice of nursing because of some mental or physical condition (including alcohol or drug abuse). You will find the Health Notification Form in the downloads box on the right of this page.

If the nurse continues his or her employment with you and you are managing the health concerns together, the Council may decide not to take any action. 

If the nurse has resigned, been dismissed, does not comply with a treatment or return to work programme, or has a significant drug or alcohol abuse issues, the Council will usually require the nurse to have a medical assessment. If the assessment identifies a health concern that may affect practice, the nurse is given the opportunity to meet with a health committee. The nurse may have conditions included in his or her scope of practice (such as employer approval, employer reports and monitoring of the health condition) to enable him or her to practise safely in a supportive place of employment. In serious cases nurses may have their registration suspended until they are well enough to return to practice.


Health and Disability Commissioner

Any complaint about the conduct of a nurse where the nurse is providing care and the conduct has affected a health consumer must be referred by the Council to the Health and Disability Commissioner. The Commissioner may decide to investigate the complaint or may refer the complaint back to the Council to investigate. 

Complaints process 

Unlike health and competence, there is no mandatory requirement to make a complaint about a nurse's conduct. However there is an obligation to make a complaint if the nurse’s alleged conduct involves public safety. 

Complaints must be in writing to the Registrar. You will find the Conduct Complaint Form in the downloads box on the right of this page.

Complaints of a serious professional nature are investigated and considered by professional conduct committees (PCCs), who decide whether to refer the complaint to the Health Practitioners Disciplinary Tribunal or whether no further disciplinary action is required. PCCs can also recommend:

  • reviewing a nurse's competence or health
  • including conditions in a nurse's cope of practice
  • sending a letter of counsel (education letter) to the nurse. 

Court convictions

Court registrars are required to send a notice of conviction to the Council when a nurse has been convicted of an offence that is punishable by imprisonment for a term of 3 months or longer, or for other offences listed in the Act. These convictions must be referred to a PCC.

The Council has appointed a PCC to consider these convictions. This PCC meets every 3–4 months to ensure that these convictions are considered in a timely manner.

These nurses are invited to attend a meeting to provide a response to their conviction.

Court conviction process (PDF, 629 KB)

Practising without a practising certificate

Nurses who have practised without a practising certificate for a significant period of time and who have failed to provide a reasonable explanation for the lapse may be referred to a PCC.

The Council has appointed a PCC to consider these nurses. This PCC meets every 3–4 months. Nurses are invited to attend a meeting or to provide a written explanation for the lapse. 

Practising without a practising certificate (PDF, 77 KB)

Practising outside scope of practice

A PCC has also been appointed to consider nurses who may have practised outside their scope of practice.

Breaching conditions

PCCs may also consider nurses who have failed to comply with any conditions included in their scope of practice. These conditions may have been included following an order of the Health Practitioners Disciplinary Tribunal or the Health Committee.

Health Practitioners Disciplinary Tribunal

Charges against a nurse are brought before the Health Practitioners Disciplinary Tribunal, which is a separate tribunal. The Tribunal's website provides a guide to disciplinary proceedings and summaries of its decisions.

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