GMC Interim Sanctions – Overview

A General Medical Council (GMC) fitness to practise investigations can take many months, if not years.  Whilst doctors could continue to work unrestricted during a GMC investigation, they could be referred to an Interim Orders Tribunal (IOT) (formerly the interim orders panel (IOP)) at any time during the investigation.

The GMC’s decision to refer a case to an IOT hearing will depend on whether the information gathered during an investigation, at any stage, means that the GMC believes that interim practise restrictions may be needed.

The allegations leading to referral to an IOT will fall within one or more of the following categories:

• Misconduct
• Deficient professional performance
• Conviction/caution
• Adverse physical or mental health
• Not having the necessary knowledge of English
• Determination by another regulatory authority

Notice of your hearing

Doctors will receive a written “Notice of Hearing” from the Medical Practitioners’ Tribunal Service (MPTS) at least seven days before a hearing is due to take place.  The notice will:

• Give the date, time and venue of the hearing
• Confirm that a doctor has the right to attend the hearing and be represented
• Confirm that the hearing can proceed in the doctor’s absence if the IOT is satisfied that you have been given notice of the hearing
• Explain the IOT’s powers

According to MPTS guidance:

“As soon as you receive notice that the GMC has referred your case to an IOT hearing, you should take urgent action to decide how you will be represented at that hearing… We strongly advise you to seek advice and be legally represented.”

[Emphasis added]

Attend or not?

Doctors do not have to attend the IOT hearing, but it is usually in their best interests to do so. For example, questions might arise that only the doctor (or his legal representative) can answer, and a doctor will miss the opportunity to give the IOT comments and responses in relation to the GMC’s application to impose an interim order.

The hearing may go ahead without the doctor (or their representative) being present if the IOT is satisfied that the doctor have been given notice of the hearing and it is “appropriate” to proceed.

A doctor could apply for a postponement but they should seek legal advice.  A postponement application will be considered by a legally qualified MPTS case manager.

Finding of fact not fitness to practise

The IOT will not make findings of fact about the allegations, and will not decide whether a doctor’s fitness to practise is impaired. Instead, the IOT will assess the risk posed if the doctor practise remains unrestricted during the GMC’s investigation.

IOT Powers

An interim orders tribunal hearing can:

• Make no Order;
• Interim order of conditions – this means that a doctor must comply with the conditions specified by the IOT in their decision until the order expires, is otherwise revoked or varied by the IOT; or
• Interim order of suspension – this means that a doctor’s registration is suspended and they will not be able to practice until the order expires, is revoked or varied by the IOT.

What information is published?

The detailed decisions of IOT hearings and of interim orders reviews on the papers are not published.  However, where the tribunal makes an interim order to suspend a doctor or impose conditions on their registration pending the outcome of a GMC investigation:

• these are published in a website notice on the recent decisions page of our website and are removed after six weeks
• they are also published on the medical register while they are active.

What are reviews on the papers?

Legislation and rules allow interim orders cases to be reviewed without the need for you or the GMC to attend a hearing.  For a review on the papers to go ahead, cases must meet the following conditions:

• the doctor and the GMC must agree on a proposed outcome;
• there must be enough time to prepare for a review on papers; and/or
• if applicable, the doctor must have supplied evidence that you have complied with existing conditions.

Before agreeing to a review on papers, doctors must seek legal advice because this process may not be appropriate in all cases and may, in some cases, prove more detrimental for doctors.

Interim Order Reviews

The IOT will decide the length of the order, up to a maximum of 18 months. Reviews must take place within six months of being imposed. After that, reviews will happen at intervals of no more than six months.

The interim order may be extended beyond the initial length of the order by Order of the relevant court.

An interim order review can run without the attendance of the doctor and the GMC. This is a review ‘on the papers’.

Legal advice

Doctors can be represented before an IOT.  When considering the need for legal representation, doctors must consider the following:

• hearings are usually held in private, although, in exceptional circumstances, they can be held in public by request or if the IOT considers it appropriate.
• the chair of your hearing may be a legally qualified chair. The legally qualified chair will be either an experienced solicitor or barrister who will advise the IOT on questions of law as to evidence and procedure.
• a legal representative instructed by the GMC will be present and will present the GMC’s case.

To reiterate the MPTS’ guidance:

“As soon as you receive notice that the GMC has referred your case to an IOT hearing, you should take urgent action to decide how you will be represented at that hearing… We strongly advise you to seek advice and be legally represented.” [Emphasis added]

Kings View Barristers

With over 30 years combined experience, Kings View Chambers have established itself as one of the best when it comes to fitness to practise defence.  We fully understand that fitness to practise defence is not merely about processes and procedures.  We also understand that we are working with people who are anxious and worried about what investigations might mean for them, their professions and the reputations.

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.

Contact us today for a no obligation and free telephone consultation about your case in the knowledge that you are speaking to one of the best in the business.