What are GMC Rules 7 & 8?

At the end of the investigation, the GMC will disclose to the doctor the allegation and any documents and evidence gathered in relation to the allegation. The doctor will be given at least 28 days to provide written comments – also known as a Rule 7 letter.  Under Rule 8, the information and evidence is referred to GMC Case Examiners for consideration and decision.

GMC Rule 7 – GMC Referral and investigation

On receipt of a complaint or self-referral by a doctor, the GMC will decide whether to investigate the complaint or allegation.  Under GMC Rule 4, the GMC will write to the doctor to notify them that of an allegation.

In most cased, the GMC will conduct what is known as a provisional enquiry to decide whether a full investigation is necessary. If, after a provisional enquiry, the matter is referred for full consideration to assess whether the doctor should be referred to an MPT. The nature of the investigation that is carried out will depend upon the allegation, but may include:

• seeking further information from the complainant
• seeking comments from the doctor under investigation
• obtaining medical records
• obtaining other documentary evidence from third parties such as the police, or the doctor’s employers
• taking statements from witnesses
• obtaining expert reports on clinical or other matters
• directing the doctor to undergo an assessment of their health or performance, or knowledge of the English language

Under Rule 7, at the end of the GMC’s investigation, the GMC will disclose to the doctor the allegation and any documents and evidence gathered in relation to the allegation. The doctor will be given at least 28 days to provide written comments.

GMC Rule 8 – Case Examiners

At the conclusion of the investigation stage, the case examiners will be provided with the allegation(s), any evidence collected and, if provided, the doctor’s written comments.

Having reviewed all relevant information, the case examiners may decide, in agreement, to conclude a case with the following:

• no action
• the issuing of a warning
• inviting the doctor to comply with undertakings, or
• referring the matter for adjudication before an MPT

If no agreement can be reached between the case examiners, or a doctor asks for an oral hearing following the issuing of a warning, the matter will be referred to the Investigation Committee.

Allegations will only be referred to the MPTS if the case examiners consider that there is a realistic prospect a tribunal would find the practitioner’s fitness to practise impaired to a degree justifying action on registration (the realistic prospect test).

Does Rule7 provide an opportunity for doctors to resolve their cases early?

Broadly the speaking, about 75% of all GMC complaints are closed either during the initial triage stage or during the investigation.  In reality this number is higher because about 20% of cases are “in progress” and many of these will also not be referred to a full hearing.

The majority of cases are therefore dispensed with during the investigation stage.  Whilst there might be a variety of reasons for this, the opportunities for doctors to influence the outcome is a contributing factor.

There is opportunity for doctors, under Rule 7, to seek an early resolution to their cases, but great care must be taken when considering responding to GMC correspondence and legal advice is highly recommended.  In some cased, doctors may be advised to not respond to the GMC or to request an oral hearing.

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.

In upholding the appeal, Alan Bates, sitting as a Deputy Judge of the High Court, said:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.

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.