In general, a doctor facing a General Medical Council (GMC) investigation can often continue to practise medicine without restrictions unless otherwise notified. A GMC referral and investigation does not necessarily mean that there are serious concerns about your fitness to practise, and depending on the nature of the concerns raised, GMC proceedings and fitness to practice investigations may result in no further action being taken.

With that said, there are steps the organisation can take to restrict a doctor’s practice or registration during an investigation, or if evidence suggests there may be an immediate risk requiring interim action. Whether a doctor remains in active practice depends on the nature of the allegations and whether the GMC identifies a risk to patient safety, public confidence, or the doctor's own interests. If the GMC believes that it is necessary to protect patients, it may suspend or restrict your ability to practise.

JMW provides legal representation for doctors navigating the GMC’s procedures. Many doctors are able to continue to work, and you will have the opportunity to defend yourself or challenge any proposed interim order, and in appropriate cases appeal or seek review of an interim order or substantive suspension during the investigation process. In this guide, our expert GMC investigation solicitors outline the factors determining whether you can continue to practise, the role of the Interim Orders Tribunal, and the steps you can take to defend your medical career.

What Is the GMC's Investigation Process

A GMC investigation assesses a doctor's fitness to practise. The process usually begins when the GMC receives a referral or complaint from a patient, colleague or employer, or a self-referral from a doctor themselves. The GMC may conduct a provisional enquiry to clarify facts before committing to a full investigation. Following a triage stage to determine if the matter falls within its remit, the GMC may refer the matter for investigation where the concern raises a question about whether fitness to practise may be impaired.

Where the matter proceeds, the GMC writes to the doctor, provides relevant documents, invites written representations, and may gather clinical records, witness statements and expert reports to determine whether a doctor's ability to practise safely is impaired, and which of the possible outcomes is the best solution to the problem.

Read our guide on the GMC investigation process to learn more about what to expect.

Can You Continue to Work During a Formal Investigation?

The opening of an investigation does not result in an automatic suspension. Doctors generally remain free to work under their employment contracts unless the GMC applies for an interim order, although many employment contracts require doctors to disclose if they are under investigation. Failure to notify an employer may trigger internal disciplinary proceedings independent of the GMC outcome.

The Interim Orders Tribunal

If the registrar, a case examiner or the investigation committee considers that an interim order may be required, the matter may be referred to the Interim Orders Tribunal (IOT), which is part of the Medical Practitioners Tribunal Service (MPTS). The tribunal assesses risk rather than the truth of the allegations, and can impose an interim order as a temporary measure while the investigation or any hearing is completed.

Alternatively, the doctor may receive an interim suspension from the medical register for a set period (up to 18 months and be unable to practise medicine. Interim suspensions and conditions are recorded on the GMC register, although IOT hearings are usually private and health details are not normally published, which influences eligibility for work with locum agencies and private practice.

The Interim Orders Tribunal balances a doctor's right to work against the necessity of protecting the public, maintaining public confidence and upholding proper professional standards in determining whether any restrictions are necessary. The tribunal evaluates factors such as patient safety, potential clinical risks, the doctor's health and whether a suspension or conditions would be in the public interest of maintaining confidence in the medical profession.

The decision of whether to involve an interim orders tribunal is made on a case by case basis, and is more likely where there is an allegation that a doctor's fitness to practise is seriously impaired, or where they have been convicted of a criminal offence that may harm the reputation of the medical profession.

Can you challenge an interim order?

You are entitled to legal representation during an Interim Orders Tribunal, and you should seek advice from a solicitor at your earliest opportunity. The team at JMW can work to minimise any risk of your GMC registration being subject to restrictions or an interim suspension, by challenging disproportionate restrictions and working towards the least restrictive outcome. Our professional regulation solicitors will prepare the necessary evidence to argue for no restrictions to be imposed, and challenge evidence brought by the GMC. Where this is not possible, we will advocate for interim conditions over suspension, to make sure that any measures imposed are proportionate to the identified risk.

Interim orders must be reviewed within six months of being imposed and then at intervals of no more than six months, subject to earlier review in certain circumstances. If the GMC seeks to extend an order beyond 18 months, it must apply to the High Court. This provides a mechanism to remove or vary conditions if the risk has diminished, and JMW can also work to have restrictions removed as part of this process.

What Leads to an Interim Order in GMC Fitness to Practise Proceedings?

The GMC is more likely to refer a doctor to an Interim Orders Tribunal in serious cases, where it perceives a legitimate risk to public safety or the public interest. The referral threshold is lower than the threshold for actually imposing an order: the GMC only has to think an interim order may be needed to start the process, where the tribunal decides whether it is necessary.

This may happen in a number of contexts. The seriousness of the allegation, including the nature of the conduct, how far it departs from professional standards, and any aggravating features determine whether the matter results in a referral. For example, doctors should take advice on notification obligations; GMC guidance clearly requires notification of matters such as charges, cautions and convictions, but not every criminal investigation will automatically trigger the same obligation. The GMC may seek an interim order while awaiting the outcome of criminal proceedings. They also have a professional duty to self-refer in circumstances where their health may put patients at risk or otherwise engage the GMC’s fitness to practise processes.

Beyond these, other matters that may increase the likelihood of a tribunal being part of a GMC investigation include:
- Sexual misconduct
- Dishonesty, particularly workplace or professional dishonesty
- Violent or abusive behaviour, especially towards patients, colleagues, or the public
- Discrimination linked to a protected characteristic
- Health concerns that create a serious and immediate risk
- English language ability, if a deficiency creates a real and immediate patient safety risk

While these referrals will often lead to an investigation, the registrar, case examiners or Investigation Committee may evaluate the evidence and, where appropriate, the case examiners may invite undertakings or refer the matter to the MPTS; an IOT or MPT may impose interim conditions or suspension where the statutory test is met. They will evaluate the risk of the behaviour or conduct being repeated, whether local restrictions are adequate, and whether any previous fitness-to-practise history or poor compliance with previous restrictions could impact safety.

Can You Defend an Interim Orders Tribunal?

By seeking legal advice early in the process, you can secure representation for not only an interim orders tribunal, but the entire investigation process, which can give you the best possible outcome and prevent any unnecessary restrictions from being imposed.

Early legal intervention is the most effective way to manage a GMC case. JMW helps doctors to prepare strong responses to initial notices, which can succeed in having the investigation process discontinued before any interim orders and minimise the risk of an MPTS tribunal taking place.

We will collate remediation evidence, such as reflective diaries or training certifications, to demonstrate that risks have been mitigated, and strive to maintain your ability to work from the initial triage stage through to any MPTS hearings that take place. We know that risks to a doctor's registration can have a significant impact on their life, and we provide representation for all healthcare professionals, from medical students to senior consultants, to deliver the best possible outcome.