What GOsC Complaints Can Lead to a Formal Investigation?

The General Osteopathic Council may launch an investigation or refer an osteopath to a fitness to practise hearing for a variety of reasons. This usually comes in response to complaints made by patients, colleagues, employers or other regulators, or from information received through criminal or civil proceedings.

The GOsC may decide that a complaint warrants investigation where there is a concern that an osteopath's ability to practise safely and effectively may be impaired. Investigations are common where allegations fall into one or more of the following categories:

• Clinical competence and patient safety, which can include everything from the use of inappropriate or unsafe treatment techniques, to misdiagnosis or failure to refer a patient, to poor record keeping. While a series of incidents may indicate an ongoing competence issue, even a single serious failure can be sufficient if it places a patient at risk of harm.
• Professional misconduct that leads to questions about an osteopath’s integrity, judgement or professionalism. Breaches of confidentiality, falsifying patient records or allegations of sexual misconduct will usually lead to an investigation. This does not only include clinical misconduct. Behaviour outside the workplace may be relevant if it undermines public confidence in the profession.
• An osteopath being convicted of a criminal offence, receiving a police caution or being subject to criminal proceedings, even if this did not result in imprisonment. Offences involving violence, dishonesty, sexual behaviour, drugs or safeguarding are particularly likely to prompt regulatory action, although any conviction may be considered depending on the circumstances.
• Any evidence that a physical or mental health condition is affecting an osteopath’s ability to practise safely may result in a fitness to practise procedure. The focus of these investigations is whether a mental health condition or cognitive impairment is being managed correctly, or whether substance misuse could be affecting patient outcomes.
• A failure to comply with regulatory requirements, including other GOsC processes. For example, if the GOsC initiated previous proceedings that resulted in conditions being imposed, and these are no longer being followed, this can lead to a follow-up review. Any problems in meeting continuing professional development requirements can also lead to fitness to practise matters being raised.

In deciding whether to refer a case to a hearing, the GOsC considers whether the osteopath’s clinical practice is impaired. This involves assessing both the nature of the original complaint, including whether the issue is likely to recur, the seriousness of the offending behaviour, and any ongoing risk to patients. Where an osteopath has failed to uphold proper professional standards or represents a threat to public confidence in the profession, the regulatory body may launch proceedings.

How Does the GOsC Investigation Process Work?

When the GOsC receives a complaint about an osteopath and decides to conduct a fitness to practise or conduct investigation, the process will usually proceed as follows:

1. The complaint is screened to make sure it has substance, after which the GOsC will begin gathering evidence and witness statements.
2. The osteopath will be contacted to provide a written response to the complaint and the evidence collected thus far. This gives the professional a chance to put across their own account of events, and high-quality representation from an experienced solicitor is vital at this stage.
3. The GOsC Investigating Committee will review the information to find evidence of unacceptable professional conduct, professional incompetence, a criminal conviction or a medical condition that would affect the osteopath’s fitness to practise.
4. If the committee finds there is a case to answer, a public hearing will be convened to determine whether the allegations are proven.
5. Subject to a finding against the practitioner, the GOsC will decide what action will be taken against the osteopath.

A carefully drafted response to allegations can avoid further proceedings, or limit the case against you to the investigating committee stage. Where this is not possible, thorough preparation for a contested final hearing will ensure that your position is advanced in the best possible light.

What Happens During a GOsC Fitness to Practise Hearing?

If the GOsC decides there is a case to answer, it will refer the matter to the Fitness to Practise Committee. The registrant will receive a formal notice of the hearing, with details of the allegations and copies of the evidence upon which the GOsC intends to rely. Early intervention by a solicitor can help you to build the strongest possible defence.

You may submit your own evidence, witness statements, references and any remediation material in advance, and the team at JMW can help you to gather and organise this documentation. In some cases, an interim order may already be in place, restricting practice pending the outcome. We can advise and make representations about whether the restrictions are necessary and proportionate in addressing the risk.

The process of a hearing generally follows three stages. In the first, the panel decides whether the alleged facts are proved. The GOsC presents its case, and may call witnesses to give evidence. Your lawyer can cross-examine witnesses, challenge evidence and call witnesses to speak in support of your case. While you may give evidence, you will not be required to do so.

If the facts are not proved, the case will end at this stage. On the other hand, if some or all facts are proved, the panel will consider whether the registrant’s fitness to practise is currently impaired in light of the relevant facts. An experienced defence lawyer can help you to mount the strongest possible defence to deliver a positive final outcome.

In cases where impairment is found, the panel considers what action is appropriate. The panel must act proportionately in choosing to impose sanctions and explain its reasoning. The purpose is public protection, not punishment. There is a right of appeal to the High Court within the prescribed time limit and, if you believe that the panel's decision was unjust, we can support you through the appeals process.

What Sanctions Can the GOsC Impose?

If the GOsC Professional Conduct Committee chooses to uphold the complaint, it may impose one of the following sanctions:

• An official admonishment, which will be kept on record
• Specific conditions for change and improvement that the osteopath must meet within a specified period of time
• Suspension from the GOsC register for a set period, after which the osteopath may need to undergo additional training before being allowed to return
• Disqualification from the GOsC register, meaning the osteopath will no longer be allowed to practise

Suspension and conditions orders are reviewed before they expire. At a review hearing, a panel will consider whether the registrant has addressed the concerns and whether the order should be allowed to lapse, extended, varied or replaced with a more serious sanction. Legal advice during this process can also help to prevent any further action from being taken.

If you disagree with a ruling that has been handed to you by GOsC, it may be possible to pursue an appeal at the High Court. Due to strict time limits, you will need to speak to a solicitor as soon as possible to find out how to approach this.