Regulatory Law
Doctors

We handle cases where doctors are being investigated by their regulatory body, the General Medical Council (GMC).

The Regulatory Process

In the United Kingdom, doctors are regulated by the General Medical Council (GMC), which is responsible for maintaining the medical register, setting professional standards and investigating concerns about a doctor’s fitness to practise. The regulatory framework is governed principally by the Medical Act 1983 and the associated Fitness to Practise Rules. Where a concern is raised, the GMC will first assess whether the matter falls within its jurisdiction and whether there is sufficient evidence to justify investigation. If the matter proceeds, the doctor will normally be notified of the allegations and given an opportunity to respond. The GMC may obtain evidence from employers, witnesses, medical experts and assessments of the doctor’s performance, health or knowledge of English where appropriate.

Where necessary to protect members of the public, otherwise in the public interest, or in the interests of the doctor, the GMC may refer the matter to an Interim Orders Tribunal administered by the Medical Practitioners Tribunal Service (MPTS). The Tribunal may impose temporary conditions on registration or suspend the doctor from practising while the investigation or proceedings continue. Such orders may initially remain in force for up to 18 months, subject to statutory review and extension procedures. Interim orders must normally be reviewed within six months and at intervals of no more than six months thereafter, although a doctor may request an earlier review once three months have elapsed since the previous review. The GMC may apply to the relevant court for extensions of up to 12 months at a time, with no statutory limit on the number of further extension applications.

At the conclusion of the investigation, GMC Case Examiners may decide to take no further action, issue advice or a warning, agree undertakings with the doctor, or refer the matter to the MPTS for a formal fitness to practise hearing. Where a warning is proposed but the doctor disputes the relevant facts or requests an oral hearing, the matter may be referred to the GMC’s Investigation Committee. The Committee can decide whether to issue a warning or close the case, and in specified circumstances may refer the matter to a Medical Practitioners Tribunal. Warnings may be issued where conduct or performance falls below the standards expected of doctors but their fitness to practise is not considered impaired.

Formal hearings are conducted before an independent Medical Practitioners Tribunal administered by the MPTS, normally consisting of three members, including medical and lay representation. At the hearing, the doctor is entitled to attend, be legally represented, make representations, call witnesses and submit evidence in their defence. The Tribunal will determine whether the factual allegations have been proved on the balance of probabilities, whether a relevant statutory ground of impairment has been established and whether the doctor’s fitness to practise is currently impaired.

If the Tribunal determines that the doctor’s fitness to practise is impaired, sanctions may include conditions on registration for up to three years, suspension from the medical register for up to 12 months, or erasure from the medical register. Conditions and suspension orders may be reviewed and, where appropriate, extended. Where the Tribunal determines that fitness to practise is not impaired, it may nevertheless issue a warning concerning the doctor’s future conduct or performance. A warning does not restrict the doctor’s registration or right to practise. Where impairment arises solely from adverse physical or mental health, insufficient knowledge of English, or a combination of those grounds, erasure is not available, although conditions on registration or suspension may be imposed.

Where a Medical Practitioners Tribunal directs that a doctor should be suspended or erased from the medical register, it may also impose an immediate suspension order where necessary for the protection of the public, otherwise in the public interest, or in the doctor’s own interests. Similarly, where conditions on registration are imposed, the Tribunal may order that those conditions take effect immediately. Such orders operate during the statutory appeal period and, where applicable, while an appeal is pending, rather than waiting for the substantive sanction to take effect.

Erasure prevents the doctor from practising as a doctor in the United Kingdom unless and until their registration is restored. A doctor erased from the medical register following fitness to practise proceedings cannot apply for restoration until at least five years have elapsed from the date of erasure. Restoration is not automatic and requires a Medical Practitioners Tribunal to be satisfied, following consideration of appropriate evidence, that the doctor is fit to practise. Only one application for restoration may be made within any 12-month period. Following a second or subsequent unsuccessful restoration application, the Tribunal may suspend indefinitely the doctor’s right to make further applications, subject to the applicable appeal and review provisions.

A doctor may appeal against an appealable decision of a Medical Practitioners Tribunal to the Court of Session where their registered address is in Scotland, the High Court of Justice in Northern Ireland where their registered address is in Northern Ireland, or otherwise to the High Court in England and Wales. Such appeals must normally be brought within 28 days of notification of the decision being served. Warnings are not subject to the ordinary statutory appeal procedure, although judicial review may be available in appropriate circumstances. Interim orders may also be challenged before the relevant court in accordance with the applicable statutory procedures.

In addition, the GMC currently has the power to appeal against certain decisions of a Medical Practitioners Tribunal where it considers that the outcome is insufficient to protect the public. The Professional Standards Authority (PSA) may also refer certain tribunal decisions to the relevant court on public protection grounds. Consequently, even where a doctor receives a relatively lenient sanction, the decision may subsequently be challenged and a more severe outcome may result.

Internal Disciplinary Proceedings

We also assist and represent doctors where they are the subject of internal disciplinary proceedings by their employer.

What To Do If Regulatory Proceedings Are Commenced Against You

Should internal disciplinary proceedings or GMC regulatory proceedings be commenced against you, then please either telephone us on 0333 301 0700, or complete our questionnaire.