When a decision by the MPTS is made in relation to a doctor’s fitness to practise, that decision can be subject to an appeal by various parties. 

PSA v GMC & Hilton

Mr Andrew Hilton, a surgeon, was subject to a complaint by “Patient A”.  The complaint to the General Medical Council (GMC) was the Mr Hilton had dishonestly informed Patient A that he had known from a post operative assessment that a screw had been misplaced during her surgery but that he had not wanted to worry Patient A. 

The GMC referred the complaint to the Medical Practitioners Tribunal Service (MPTS) for a determination of Mr Hilton’s fitness to practise. 

The MPTS found the allegation to be proved and that Mr Hilton had acted dishonestly and was guilty of misconduct.  Notwithstanding this however, the MPTS did not find Mr Hilton’s fitness to practise impaired because he “…had no malicious intention to deceive Patient A, merely to create a positive environment in which he could apologise to Patient A for his error and reassure him that there had been no adverse outcome resulting from that error and no further action was taken.”  Consequently, no further action was taken. 

The MPTS did consider submissions in relation to issuing Mr Hilton with a written warning.  However, due to the risk of damaging Mr Hilton’s reputation (considering the MPTS finding), the decision was taken not to issue a warning. 

The Professional Standards Authority (PSA) appealed the MPTS’ determination in this case on a number of grounds, but including, “That no reasonable Tribunal would have decided not to issue a warning when impairment had not been found but dishonesty had been found proved.”

The High Court agreed with the PSA on this particular ground of appeal.

Who can bring an appeal against a MPTS Fitness to Practise decision?

This case helpfully illustrates the various rights of appeal in relation to MPTS decisions.

Medical Act

Under the Medical Act, the following parties can bring appeals in relation to decisions by the MPTS:

  1. Doctors subject to decisions by the MPTS;
  2. The General Medical Council (since December 2015);
  3. The Professional Standards Authority.

If a case proceeds to a court hearing, the judge can:

  • dismiss the appeal
  • allow the appeal, in whole or in part, and quash the relevant decision
  • substitute the decision appealed against for any other decision which could have been made by the tribunal
  • refer the case to the Registrar of the General Medical Council for them to refer it to a medical practitioner’s tribunal to dispose of the case in accordance with the directions of the court.

Interestingly, there is no right of appeal in relating to complainants and patients under the Medical Act.

The Professional Standards Authority, as regulator of the nine statutory bodies that regulate health professionals in the United Kingdom, can bring an appeal if it feels that public has not been sufficiently protected for example, if a decision has been overly lenient.


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Dr in GMC case