Understanding the GMC Fitness to Practice Processes and Rules

Unfortunately, doctors in the UK should treat investigations by the GMC as an ‘occupational hazard’.  The trauma experienced by a doctor facing a full GMC investigation cannot be overstated – and the phrase ‘second victim’ is very apt here. Research published by the GMC in February 2021 found that “many doctors perceive GMC investigations to be adversarial and bias towards patients.”

A GMC investigation is a very dark cloud that looms large over the whole of your personal and professional life for a substantial period of time, even if your fitness to practise is eventually found not to be impaired and no sanctions are imposed.  The GMC acknowledge that its investigation process can take up to 12 months to conclude.  It can take a further 10 – 12 months if the case is referred to the MPTS.

It is important that you understand what to expect if your GMC investigation leads to an MPTS tribunal hearing, and why the tribunal process is universally described as ‘daunting’.

The entire GMC fitness to practise process is governed by strict statutory rules that doctors will be expected to adhere to.  Failure to adhere to these rules is most likely to result in adverse inference drawn by the GMC (or MPTS) and consequently lead to worse outcomes for doctors.

“From the outset, they had an overarching strategic vision of how best to defend me: They knew when to proffer a robust defence, and when to “keep the powder dry“. This dynamic approach to my defence, was made possible by their model of working – direct engagement with the Barristers undertaking the defence, rather than working through a larger firm of indirectly involved solicitors.”

MS on Trust Pilot (we are rated “Excellent”)

Engaging with the GMC (and MPTS)

Under the GMC’s statutory rules, there are several opportunities presented to doctors to engage with the GMC, including proving evidence, rights of reply and responding to allegations. There is often a temptation for doctors to feel they need to be overly helpful in their engagement with the GMC, but this may prove detrimental if not properly considered or thought through.  Doctors should remember that any evidence or information supplied by them to the GMC will be used as evidence.

In certain circumstances, it may be advisable that doctors refrain from responding to the GMC or to robustly challenge the evidence or information.

Joint head of chambers and GMC defence barrister, Stephen McCaffrey, points out that:

“Many clients, and indeed lawyers, think that putting in ‘a robust’ initial response will somehow convince a regulator to abandon their case. It often does not. What is does do, generally, is direct them to the weaknesses in their case and allow them to alter their investigation to accommodate them. This means that when the appropriate time arrives for a response, they are live to what is coming. This is strategically naïve. Never underestimate the importance of having an agreed strategy with barristers who can explain the basis of it and the rationale for it.”

Insight and Remediation

The GMC (and MPTS) attaches substantial weight to evidence of insight and remediation in fitness to practise proceedings.  Insight and remediation is often a very long process.

Whether evidence of insight and remediation is actually necessary and, what that evidence looks like will depend on the individual merits of each case but will form part of an agreed strategy.

Evidence of insight and remediation will not be necessary in all cases, but it is essential that doctors take expert legal advice on whether it would be necessary and, if so, what form(s) this should take.

“Following on from my fitness to practise hearing, I once again sought counsel. I thought about going it alone but I am very glad I didn’t. I had to prepare for this hearing in the same way as the previous, and Catherine gave me the tools to do this. I was guided through the process and the GDC could not argue when they viewed the work I had done on remediation, reflection and insight in which Catherine had set for me.”

M on Trust Pilot (we are rated “Excellent”)

Continued below ↓

Insight Works Training

Restoration Courses

Courses suitable for any health and social care practitioner who is considering making an application for restoration back onto the register.

Insight Works Training

Insight & Remediation

Courses that are suitable for any healthcare practitioner who is facing an investigation or hearing at work or before their regulatory body.

Insight Works Training

Probity, Ethics & Professionalism

Courses designed for those facing a complaint or investigation at work or before their regulator, involving in part or in whole honesty, integrity and /or professionalism.

Things will go wrong, and we are here when you need us

Kings View has been advising and representing doctors for many years, and we know that despite the best efforts of healthcare professionals, some things do go wrong.  Through our experience, we know that the circumstances that lead to things going wrong are never straightforward.

It is a well-established fact that healthcare professionals who seek legal advice and representation at an early stage in any fitness to practise process, generally, receive better outcomes and lesser sanctions, if any.  We can advise on the right strategy to take and represent you before a fitness to practise hearing.

Kings View are public access barristers, meaning that you can instruct us directly without having the additional expense of hiring a solicitor first (so we are generally at least one third cheaper).

You can speak to us today for a free, no obligation assessment of your case.

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.