GMC/MPTS Non-Compliance Hearings

Non-Compliance Hearings at the GMC / MPTSNon-Compliance Hearings and the GMC / MPTS

Where a doctor fails to participate in a GMC health assessment or otherwise is non-compliant with directions that they have been given to undergo a GMC performance assessment, or a GMC English language assessment, they can be referred to a non-compliance hearing. The same applies where a doctor fails to properly engage in an assessment, where they submit to one. The non-compliance hearing is held before a Medical Practitioners Tribunal (MPT).

A doctor will need to provide a justifiable explanation for their non-compliance (providing a good reason), or demonstrate that one is not necessary due to other evidence.

A reasonable explanation for non-compliance might include medical evidence, factual or character witness evidence, evidence in documentary form, proof of travel arrangements, the sickness or death of family members. This list is not exhaustive.

Where a doctor has been directed to provide information and they have failed to provide it they may be found to be non-compliant.

Often the easiest way to demonstrate that there are no concerns is for a doctor to attend and cooperate with an assessment but not all doctors wish to go through the process. There will be occasions whereby through a change of circumstances it is successfully argued that there has been no non-compliance.

It is expressly directed that tribunals should not determine the issue of fitness to practise at a non-compliance hearing. Therefore different assessment criteria will apply.

Good preparation is essential prior to attending a non-compliance hearing. Expert evidence may be needed, and disclosure of various documents may also be necessary. Where third-parties hold relevant documents the GMC may be able to obtain them.

Non-compliance hearings can lead to suspension (of up to 12 months), or conditions of practice, including conditional registration (of up to three years), that prohibit a doctor from working in a particular way or at all unless they undergo an assessment by a particular date.

While a doctor cannot be erased by a non-compliance tribunal, if they are suspended for two consecutive years they can the be permanently suspended without further review. Where non-compliance is not found, the tribunal can still impose interim orders that would be reviewed in the usual way.

Restrictions or suspension can have a catastrophic impact on a doctor’s ability to earn a living. Clearly, a suspension and some conditions may also affect a doctor’s ability to remediate any suboptimal clinical performance, language skills, or health disorder that could or has impacted on safe practice.

Having made a finding of non-compliance and having made an order for disposal, the tribunal can additionally direct that a review hearing should take place at a future date.  A doctor will therefore need to prepare for such a review hearing in good time. The tribunal will usually set out the evidence that a doctor might prepare for such a review hearing, and impose a date by which time the review should take place.

See our guidance on review hearing – note that non-compliance reviews will be about whether there is still any concern about non-compliance rather than fitness to practise, per se.

A doctor may appeal a decision of the non-compliance MPTS tribunal to the High Court and must do so within 28 days or be out of time.

If you are a doctor facing a non-compliance referral or hearing, contact Doctors Defence Service, in strict confidence and without obligation, to see how we might assist you. Call us on 0800 10 88 739 or use our Contact Form.

Guidance, Law and Rules governing GMC Non-Compliance Hearings

For further information, see the GMC/MPTS’s guidance note for tribunals: Non-Compliance Guidance for Medical Practitioners Tribunals

See also the GMC Rules governing Non Compliance Hearings: Rule 17ZA of the Fitness to Practise Rules 2004 (as amended).

Challenge to Order of  Suspension in Non-Compliance Hearing

In Ramaswamy v General Medical Council [2021] EWHC 1619 (Admin) the High Court  quashed the non-compliance determination, and the sanction imposed. ? Remitted back for new consideration. (June 2021)

Challenging an Interim Order Imposed at Non-Compliance Hearing

In Ramaswamy v General Medical Council [2023] EWHC 100 (Admin) the High Court declined to end an interim order, where there were unresolved concerns relating to the mental health of a doctor. (January 2023)