When Can the GMC Launch an Investigation?

The GMC can take action if a doctor’s fitness to practice is under question for any number of reasons. Usually, an investigation is launched in response to a complaint (or multiple complaints) which may be connected to:

• Misconduct
• Poor performance
• A criminal conviction or caution in the UK (or elsewhere, for an offence that would be deemed criminal if committed in the UK)
• A decision made by a regulatory body, either in the UK or overseas
• Lack of the required knowledge of the English language to be able to practise safely

A concern can come from a patient or their family member, an employer, another professional, the police, the court, a coroner, or another regulator. An investigation can concern everything from a doctor's health and medical education to alleged threats to public confidence in the profession. Building a defence requires a thorough assessment of the evidence being relied on and the nature of the underlying complaints.

What Is the GMC Investigation Process?

When the GMC receives a complaint as described above, it first reviews the information to decide if it meets the threshold to be considered under fitness to practise procedures, or if it can be closed at an early stage.

The GMC may make provisional enquiries as part of its assessment. This is an initial fact-finding stage to decide if a full investigation is necessary, and it may involve asking for basic documents or an initial response. Some cases can be closed at this point if the information does not justify moving forward. Specialist advice and early intervention by your solicitor can mean that fitness to practise proceedings do not move past this stage in some cases.

If the GMC opens a full investigation, it will gather evidence. This can include:

• clinical records and other documents
• witness accounts
• material from your employer
• expert evidence

Your solicitor can also gather evidence that supports your version of events and works in your defence. You may be asked to provide a written response to the allegations posed by the GMC in the early stages of its investigation.

Sometimes, the GMC will seek interim restrictions while an investigation is ongoing, via an Interim Orders Tribunal process. Interim outcomes can impose conditions on your practice or result in a suspension while the case continues. This is relevant where there would be a legitimate risk to patient safety if you were allowed to continue in your role without restrictions.

Following a GMC investigation, the evidence will be assessed by two case examiners who will then decide whether sanctions are necessary.

What Are the Possible Outcomes of a General Medical Council Investigation?

If the GMC has enough evidence to suggest a doctor’s fitness to practise has been impaired, it can take any of the following actions:

• Close the case with no further action
• Issue a warning
• Agree undertakings with the doctor in question, which represent restrictions on your practice
• Place conditions on the doctor's registration
• Suspend the doctor's registration
• Refer the case to the Medical Practitioners Tribunal Service (MPTS) for a hearing

While it is possible to appeal a decision made by the GMC with the High Court on the grounds that errors were made in the investigation or that the decision is unfair, it is best to work with a solicitor from the start of the process to work towards the best possible outcome.

What Powers Does the Medical Practitioners Tribunal Service Have?

The MPTS is the tribunal body that runs hearings and makes independent fitness to practise decisions for doctors. If the GMC refers an investigation for an MPTS hearing, the tribunal body will be asked to make findings on facts and decide what happened based on the evidence. It will determine if the clinician’s fitness to practise is impaired at the time of the hearing - applying the tribunal’s published guidance - and can impose sanctions where impairment is found. In the most serious cases, the MPTS can remove the doctor from the medical register.

MPTS appeals must be made within 28 days of receiving your decision, but there are limited grounds on which you can object to the body's decisions. JMW's specialist GMC lawyers can advise you on whether an appeal has a realistic prospect of success based on your specific circumstances.

Do I Need a GMC Defence Lawyer for Fitness to Practise Proceedings?

Working with a solicitor during any GMC investigation is the only way to feel confident that the process will conclude with the best possible resolution. JMW provides advice and a full range of services at all stages of the process, which can help you to build and mount your defence comprehensively. We will:

• Advise you on relevant, up-to-date legislation relating to your situation
• Prepare responses on your behalf
• Offer advice on the acceptance of warnings and undertakings
• Advise on whether an Investigation Committee Hearing should be requested
• Help you to prepare for, and ultimately represent you, during MPTS hearings
• Appeal to the High Court, where necessary, following MPTS decisions
• Offer guidance in relation to NHS England investigations
• Help you to prepare for, and represent you, during Performance Advisory Group hearings at NHS England
• Assist you with the gathering of evidence, including witness statements
• Represent you at the police station
• Offer defence in criminal courts

Where concerns raised in patient complaints have been addressed, we can present evidence, expert reports and supporting documents to show that remedial action has been taken. Our interim orders representation can enable you to continue unrestricted practice while an investigation is underway. If restrictions are unavoidable, JMW will advise and make representations on whether the GMC’s proposals are necessary and proportionate in dealing with the perceived risk. JMW's approach to building a robust defence that will demonstrate no need for further action by the regulator is often successful in having investigations discontinued at an early stage or minimising the sanctions imposed.