GMC Interim Orders Tribunal Representation
GMC fitness to practise investigations can take many months, or even years, to conclude. Can you afford to not work, or work under restrictions, during this time?
GMC Interim Orders
The General Medical Council (GMC) investigates allegations relating to impairment by reason of serious misconduct, adverse health, deficient performance and/or matters relating to convictions or police cautions. It is worth noting that the GMC does not usually investigate allegations that are more than five years old.
A General Medical Council (GMC) fitness to practise investigations can take many months, or even years, to conclude. In fact, in 21/22, the GMC had over 200 doctors under investigation for more than a year, with some under investigation for as many as 156 weeks.
Whilst it is the case that doctors could continue to work unrestricted during a GMC investigation, many doctors are referred to an Interim Orders Tribunal (IOT) (formerly the interim orders panel (IOP)). Such a Tribunal has the power to impose restrictions on a doctor’s practise or issue an interim Suspension Order which is devastating for any doctor.
It is doubtful that any doctor could afford to not work, or work under restrictions, for such an extended length of time. It is therefore clearly in the doctor’s interest to seek expert legal advice when faced with the prospect of an Interim Orders Hearing (IOT). Expert legal advice and representation could significantly reduce the likelihood of adverse outcomes for doctors.
How legal advice benefits doctors
Process – The Interim Orders Tribunal is governed by strict statutory rules and processes set out in 41 Medical Act (1983), as amended. It is important for doctors to be clear on the statutory process, the significance of each step and how to respond. A lack of understanding of these could be disadvantageous to doctors.
Evidence – An Interim Orders Tribunal does not make a ruling on whether a doctor’s fitness to practise is impaired (i.e. does not make any factual findings). It does however look at the evidence before it to assess the risk of a doctor continuing to practise without any restriction(s). In doing so, it will take into account a range of evidence from both the GMC and the doctor. Expert legal advice will advise the doctor on the necessity and relevance of evidence but, crucially also, how and when to respond to evidence submitted by the GMC.
Insight and Remediation – Evidence of insight and remediation are relevant considerations before an Interim Orders Tribunal. GMC guidance makes clear that, in reaching a decision whether to impose an interim order, a Tribunal should consider evidence of insight and remediation.
Through Insight Works Training, we help doctors evidence insight and remediation.
Hearing or review “on the papers” – Doctors will need to carefully consider their approach, whether to attend a hearing or agree to a review “on the papers”. Doctors should seek legal advice if faced with these choices because the wrong approach may result in a worse outcome for the doctor.
Legally qualified chairs – Most hearings will have a legally qualified chair who is part of the tribunal and advises on points of law. Some cases may have a legal assessor who advises the tribunal on points of law, but plays no part in decision-making.
Appeal or Review? – A decision to impose an Interim Order takes effect immediately. Where an Interim Order has been imposed, a doctor can appeal the Order to the High Court.
However, in some circumstances, it may be more effective for a doctor to consider an early review of their Interim Order. Under normal circumstances, if an IOT decides to impose an Interim Order, the Order must be reviewed within the first six months of it coming into force and then at intervals of at least every six months.
However, the MPTS has the discretion to consider an early review of an Interim Order when new evidence, relevant to the current Interim Order, becomes available, which could mean the current Order is no longer appropriate. Both the GMC and a doctor can apply to the MTPS for an early review of an interim order.
The GMC may refer a case to an Interim Orders Tribunal at any point during its investigation. This may mean that an Interim Order is sought at an early stage in the GMC’s investigation, before it may have had sight of all the relevant facts and/or information. Therefore, if the IOT did not see all the evidence that might have persuaded them to come to a different conclusion, or there is new evidence, an early review may be more appropriate.
Furthermore, it might become apparent during the GMC’s investigation that there is no case to answer or that a doctor has demonstrated sufficient insight and remediation to close the investigation. Under these circumstances, an early review of an Interim Order may also be appropriate.
There is clear evidence that legal representation and advice leads to better outcomes for doctors.
Kings View Chambers
We regularly advise doctors and understand the significance and impact complaints can have on the reputation and career of a doctor. A well-prepared case is essential to ensure the best outcome for you, your career and professional reputation. It is imperative that you seek legal advice from someone who specialises in GMC defence work.
What we do:
- GMC fitness to practise referrals
- GMC fitness to practise hearings
- Appeals against a MPTS Tribunal determination
- MPTS Interim Order hearings
- Appeals against a MPTS Interim Orders Tribunal determination
- Preparing your case before the Case Examiners
- Help with the decision of the Case Examiners
- Help with voluntary removal
- Registration advice
- Appeal against refusal of registration
- Restoration to the Register
- Investigation and disciplinary hearings at work
- Criminal investigation and proceedings
- Police cautions
- DBS [Disclosure and Barring Service] issues
- Insight & remediation training & coaching
Insight Works Training will help give you a clear and easy to follow understanding of the regulatory process, explanation of the central role of impairment, how to approach insight and remediation, how to evidence this at your hearing and a directed approach to presenting your learning with evidence in writing and verbally.
We are proud to be rated ‘excellent’ by our clients. Our commitment to client care is genuine in both seeking the very best outcomes for our clients, but also ensuring we do what we can to support them through the process.
In upholding the appeal, Alan Bates, sitting as a Deputy Judge of the High Court, said:
- Failure to assess witness credibility and reliability The panel did not sufficiently evaluate the general credibility and reliability of key witnesses, whose evidence was essential to the charges. It failed to consider factors such as contradictions between witnesses' accounts and whether their testimonies should be approached with caution. This omission undermined the panel's ability to justify its conclusions.
- Lack of explanation for preferred evidence The panel failed to provide adequate reasons for preferring the complainants' evidence over the appellant nurse's and the paramedic's. Simply stating a preference for certain witnesses' accounts without detailed justification left the appellant without a clear understanding of why her evidence was rejected.
- Errors in evidence evaluation The panel assessed each charge in isolation without considering broader patterns or contextual evidence. It failed to recognize that inaccuracies in one allegation (contradicted by CCTV) could cast doubt on the reliability of witnesses' accounts in other allegations, leading to flawed conclusions.
- Improper handling of contextual evidence The panel neglected to evaluate the behaviour of the complainant nurses during the investigation, which was relevant to determining their credibility. Additionally, it overlooked the appellant nurse's claims that the allegations were fabricated to remove her from her managerial position.
- Insufficient reasoning for findings The panel provided inadequate reasoning for its findings of misconduct. It did not fully explain how the evidence supported its conclusions, including why the NMC had met the burden of proof for each disputed allegation. This failure left the appellant with unsubstantiated conclusions, undermining the credibility of the process.
Lessons
This case highlights several critical considerations for fitness to practise tribunals. One key lesson is the importance of thoroughly evaluating the credibility and reliability of witnesses, particularly when their testimony is central to the charges. Without such assessments, the accuracy and fairness of the tribunal’s findings can be compromised. Witness accounts must be examined not only in isolation but also in a broader context, taking into account patterns and inconsistencies to achieve a holistic evaluation.
Additionally, tribunals must provide clear and rational reasoning for their decisions. Merely preferring one witness’s account over another without detailed explanations can lead to procedural unfairness. Ensuring transparency in decision-making fosters trust in the process and supports robust outcomes. Tribunals must also maintain procedural fairness by upholding the burden of proof on the prosecuting body. Accused parties should never feel pressured to disprove allegations, as fairness is crucial to preserving the system’s integrity.
Finally, the impact of procedural delays cannot be underestimated. Prolonged proceedings can cause undue harm to the accused, affecting their career and reputation. Timely resolutions are essential to upholding justice while minimizing unnecessary stress on all parties involved. By focusing on these principles, fitness-to-practise tribunals can enhance the fairness and effectiveness of their proceedings.
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.
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