How are fitness to practise processes applied in UK higher education institutions? - A systematic review

This systematic review will establish how Fitness to Practise (FtP) processes are applied in UK Higher Education Institutions (HEI), in relation to both Health and Care Profession Council or Nursing and Midwifery Council approved programmes.

Healthcare students are required to complete both practice and theory elements, in order to gain their degree and qualify as a healthcare practitioner such as a nurse. It is a requirement of UK HEIs which provide healthcare programmes, to provide evidence to the appropriate regulatory body that FtP policies and processes are in place, and that they review and manage any concerns in relation to a student's standard of practice. Regulatory bodies provide HEIs with strategic guidance on policy which can be interpreted and incorporated into existing policies; this means that there is no standard approach to the FtP process in HEI settings, allowing individual policies and procedures to exist.

A systematic review, registered on PROSPERO (CRD42022291532 on the 21st January 2022).

Peer reviewed studies published in ten databases were used which included: Medline, Cochrane Library, PubMed, ScienceDirect, Education Source, PsycInfo and Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete. Citation searching also occurred.

This systematic review utilised Preferred Reporting items for Systematic reviews and Meta-Analysis (PRISMA) techniques. The Critical Appraisal Skills Programme (CASP) checklists were used to appraise the quality of the research.

In total twenty-five articles were retrieved including five papers that were finally selected for review. A thematic analysis identified three themes: a lack of identification of what FtP expectations are; the importance of collaborative working between Higher Education Institutions and practice; the inconsistencies with Higher Education Institution processes in managing FtP concerns.

A lack of understanding of what FtP expectations are for students was identified. Collaborative working between Higher Education Institutions and practice is necessary to ensure healthcare students meet FtP requirements consistently in order to protect the public. Although HEIs FtP processes contain similar principles, it has been identified that there are inconsistencies in this process across universities in the UK. These differences include: what initiates the FtP process, to the outcomes. This could have an impact on patient care and safety, the need for review of national guidance, and potential amendments being required to the policies and procedures of both NHS Trusts and private organisations.