MPTS Rules & Case Management Directions – Advice for doctors

Doctors who do not comply with MPTS Rules and case management directions risk increased adverse outcomes and costs awarded against them.

MPTS Rules & Case Management Directions – What are they?

Where the General Medical Council (GMC) refers a fitness to practise case for a full hearing, the Medical Practitioner’s Tribunal Service (MPTS) will notify the doctor in writing of the date of their Medical Practitioner’s Tribunal (MPT) hearing.  Included in this correspondence will be, for example, instructions, known as case management directions, to comply with.  Under Rule 16(7A), a case management direction is binding on the parties and on any subsequent MPT considering the case.

What is case management for?

In essence, MPTS Rules and case management directions requires all parties (the doctor and GMC) to prepare their cases and to cooperate with each other to keep delays to a minimum.  Case management directions should facilitate an effective MPTS hearing, so to minimise the stress on doctors (and on witnesses).  Case management directions also seek to serve to facilitate agreement about a number of key issues in the case.

Consequences for failure to comply with Rules or case management directions

Whilst the above might appear simple enough, doctors must be aware that MPTS and case management rules are comprehensive, complex and prescriptive.  There are potentially serious consequences for doctors who do not comply with MPTS Rules and/or case management directions.

The MPT can take the following actions where doctors have not complied with the Rules or directions:

• draw an adverse inference;
• refuse to admit evidence; and/or
• award costs.

What does adverse inference mean?

In this context, to draw an adverse inference means that the MPT may draw a negative conclusion from a doctor’s failure to comply with a Rule or case management direction.  A negative conclusion will not assist a doctor in their hearing and/or defence. 

What does refusal to admit evidence mean?

A refusal to admit evidence means that the MPT may refuse to receive evidence (e.g. witness statements or other documents) that the doctor wish to rely on in their defence or to challenge evidence submitted by the GMC. 

Factors that the MPT may consider when deciding on the admissibility of evidence will include:

• when the evidence was obtained;
• the relevance of the evidence to the issues in the case;
• any reasonable excuse given for the failure to produce the evidence in accordance with the Rule or case management direction; and/or
• whether there is any other mechanism, other than excluding the evidence, that would allow the hearing to proceed fairly.

Failure to admit evidence can be devastating for a doctor and their defence.  It will leave the doctor’s case vulnerable and may serve to strengthen the GMC’s case against them. 

Conversely, doctors have a right to apply to the MPT to draw an adverse inference or refuse to admit evidence.  This might apply in cases where the GMC have not complied with the MPTS’ Rules or directions.  There are separate rules and procedures for this.  In certain cases, a doctor may benefit greatly from making such an application but, again, a clear and thorough understanding of the process and procedures is key – which is where the value of legal advice and representation is clear. 

It is worthwhile for doctors to remember that MPTS hearings are overseen and managed by Legally Qualified Chairs.  These chairs are chosen from a pool of very experienced legal practitioners – defined as “a barrister, chartered legal executive or solicitor in England and Wales; an advocate or solicitor in Scotland; or a member of the Bar of Northern Ireland or solicitor of the Supreme Court of Northern Ireland”. 

Costs awards

A costs award is an order made by an MPT that one party (either the doctor or the GMC) must pay some of the other party’s costs. The MPT may consider making a costs award either if one party makes an application for costs, or of its own initiative.  

The MPT’s decision on costs is separate from its decision on the fitness to practise proceedings. This means that even if the MPT finds that your fitness to practise is not impaired, the GMC could still make an application for costs against you. Equally, you can still make an application for costs, even if your fitness to practise is found impaired.

Better outcomes for doctors

Understanding the MPTS’s rules and directions are key to meaningful engagement, which, in turn, is key to better outcomes for doctors.  Legal advice and representation is critical in aiding doctors to understand these rules and directions.

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. 

Is legal representation the answer?

It is widely accepted and proven that legal representation makes a real difference to the outcome of investigations and results in lesser sanctions for doctors.

What is also unquestionably clear is that GMC investigations and MPTS hearings are complex, daunting, prolonged and legalistic leaving doctors stressed and anxious.  Where legal advice and representation can have the biggest impact on this, is helping doctors understand the process, what to expect and how to engage with the GMC during an investigation and hearing.

Research has shown that registrant’s engagement and legal representation can impact on decisions about seriousness, and that the lack of legal representation has been identified as being associated with more severe sanctions outcomes in fitness to practise cases, stating:

“Legal representation was seen as important by participants because legal advice could support and guide registrants through the FtP process, which is complex and legalistic. Legal advice was seen as important in aiding registrants to understand regulators’ expectations, especially in terms of the need for registrants to demonstrate insight and perhaps to show evidence of remediation activities. Lack of legal representation was, therefore, seen to potentially have an impact in terms of the seriousness of the outcome for registrants who are perhaps unaware of how to present their case to best effect.”

 A compassionate approach to legal representation

The right legal advice and representation is not just about the legalities and technicalities of a case.  Our barristers fully understand the stress and anxiety that doctors experience during prolonged GMC investigations.

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 never lose sight of the human aspects of FtP investigations and hearings.  We will always give an open and honest assessment of cases, but we will marry that with an approach that also supports health and care professionals through the duration of a case.

“I was not optimistic about the case, I felt that it is a lost case that we couldn’t do much about and especially just before the start of the trial I lost my confidence and was very nervous. Mr McCaffrey was there to prove me wrong. He turned everything around in a victorious , panegyric manner. I was stunned.” – CL

Catherine is professional, empathic and very knowledgeable. She provided all the necessary assistance throughout the long thorough investigation. – AR

A colleague recommended me to Catherine. She was very experienced , professional, empathetic , non-judgemental and listened to me. – Mel

I found myself consumed with dark thoughts, isolated and afraid. Stephen worked with me and slowly but surely formulated a plan not to just to fight my case and win, but to build me back up bit by bit so as to prepare me to face external scrutiny and present with confidence to panels where this was necessary. – FJ

What you can Expect when Instructing Kings View

All clients are entitled to an initial, no obligation and free telephone consultation about their case.  During this consultation, we will outline the stages and next steps, including indicative timeframes and fixed price quotations for preparation and representation and confirmed in writing at each and every stage.

We understand that timescales are entirely dependent on the stage you are at in proceedings, what work needs to be done and dictated by internal investigations or hearing dates.  We always meet those timescales however should more time be needed, then we will apply for such on your behalf and with your permission.

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.

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.