Changes to MPTS Tribunal Guidance: What doctors need to know

This update, the MPTS said, introduces “clearer decision-making frameworks for panels assessing allegations in fitness to practise proceedings.” Key areas of focus include professional boundaries, online and social media conduct, and a more structured approach to aggravating and mitigating factors. The guidance also refines how tribunals handle dishonesty and sexual misconduct cases and has been reorganised for improved clarity and consistency.

Key substantive changes

Professional boundaries

The updated guidance places greater emphasis on context and power imbalance when evaluating breaches of professional boundaries. Tribunals are directed to assess patterns of behaviour, the vulnerability of those affected, and the doctor’s position of trust or authority. Factors such as consent, recurrence, supervision arrangements, and the doctor’s role in enabling or preventing the conduct are now explicitly listed.

Social media and online conduct

For the first time, social media and online behaviour are explicitly addressed. Tribunals are instructed to consider the intent behind posts, their reach, any breach of confidentiality, and the impact on individuals and public confidence. Remediation efforts—such as removing content or issuing apologies—must be supported by evidence of insight and behavioural change.

Aggravating and mitigating factors

The guidance expands and clarifies the lists of aggravating and mitigating factors. Panels are expected to explain how each factor influences their assessment of seriousness and sanction. Aggravating factors include repeated misconduct, targeting behaviour, and harm to vulnerable individuals. Mitigating factors such as early admission, effective remediation, and positive references must be supported by objective evidence.

Dishonesty and sexual misconduct

Tribunals are now required to apply refined thresholds and reasoning in dishonesty and sexual misconduct cases. The guidance stresses the seriousness of these allegations and the importance of demonstrating insight and rehabilitation before considering restoration or reduced sanctions. Panels must show how their decisions align with GMC standards and relevant case law.

Structure and examples

The revised guidance has been reorganised for easier navigation and includes practical examples and indicators of seriousness to support consistent decision-making.

Comparison with previous hearing resources for doctors

Earlier MPTS hearing resources for doctors focused primarily on procedural aspects of hearings, such as timelines and general expectations. They offered limited guidance on behavioural assessment and emerging conduct contexts.

The new guidance, effective 24 November 2025, builds on these resources by introducing substantive criteria for evaluating conduct, remediation, and insight. Doctors and representatives should now rely on the updated guidance to ensure their submissions and evidence align with current tribunal expectations.

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Implementation and transitional application

The revised guidance will apply to all hearings taking place on or after 24 November 2025. Tribunals that start before this date will be required to follow existing guidance.

Practical impacts for doctors facing fitness to practise investigations

Doctors should expect increased scrutiny of online behaviour and a higher standard of evidence when demonstrating remediation and insight. Mitigation must directly address the updated aggravating and mitigating factors.

In dishonesty or sexual misconduct cases, restoration prospects will depend on detailed timelines, corroborative evidence, and independently verified remediation. While the guidance promotes consistency, it also raises the evidential threshold for securing lesser sanctions.

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It is a well-established fact that healthcare professionals who seek legal advice and representation at an early stage in any fitness to practise process, generally, receive better outcomes and lesser sanctions, if any.  We can advise on the right strategy to take and represent you before a fitness to practise hearing.

Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.