GMC MPTS Review Hearings
Review Hearings in GMC/MPTS Cases
There are two types of review hearing held at the MPTS. The first relates to reviews of interim orders (called Interim Orders Tribunal (IOT) hearings), and the second relates to substantive fitness review sanctions. To read more about IOT reviews, see our dedicated article on GMC/MPTS IOT Proceedings. The remainder of this article examines Reviews in GMC Medical Practitioner Tribunal substantive fitness to practise hearings.
At a fitness to practise hearing, where a doctor’s fitness to practise has been found to be currently impaired, and where the tribunal had imposed an interim order of conditions or suspension, there will be a review hearing.
At the review hearing the doctor must present evidence relating to their current fitness to practise. Where a doctor’s fitness to practise is found to be still impaired a further sanction can be imposed, which could be a period of suspension, conditions, or in some cases erasure. It is therefore very important that a doctor prepares well for a GMC/MPTS Review Hearing.
The tribunal will usually have listed the types of evidence that a doctor might choose to present, which would be of assistance to the tribunal tasked with reviewing the evidence. Some doctors fail to appreciate how important it is to follow through on that guidance. Further, there are often a number of other steps that a doctor can take to increase their prospects of success at a hearing.
In Abrahaem v GMC  EWHC 183 (Admin), the judge opined (at para 23) that:
“In Practical terms there is a persuasive burden on the practitioner at a review to demonstrate that he or she has fully acknowledged why past professional performance was deficient and through insight, application, education, supervision or other achievement sufficiently addressed past impairments“.
It should also be noted that at paragraph 163 of the Sanctions Guidance (2018) holds that:
“It is important that no doctor is allowed to resume unrestricted practice following a period of conditional registration or suspension unless the tribunal considers that they are safe to do so“.
Such principles will influence the decision-making of the tribunal and a doctor must therefore ensure that they present the appropriate evidence needed to satisfy such concerns that may arise from a long period away from unrestricted practice.
Where a doctor does not accept the past findings of a MPT tribunal, it will create a difficulty for the doctor to show developed or developing insight. However, it has been held in Blakeley v General Medical Council  EWHC 905 (Admin) (April 2019) that a doctor does not necessarily have to accept that they did conduct themselves as alleged, though this is in relation to substantive first instance FTP tribunal hearings, rather than reviews. In some ways this judgment is confusing but it directs the tribunal and lawyers to focus on a number of themes that show that the doctor understands the wider ramifications of such conduct, even if they maintain their denial. This case might possibly cause tension within the tribunal process where a doctor denies wrongdoing at a review hearing, but if the appeal period has long expired the case law probably has scant relevance. See also: Amao v Nursing and Midwifery Council  EWHC 147 (Admin) () and Yusuff v General Medical Council  EWHC 13 (Admin). (January 2018)
In the appeal case of Professional Standards Authority v The Health and Care Professions Council and Doree  EWCA Civ 39 it was stated that:
“Whether a registrant has shown insight into his misconduct, and how much insight he has shown, are classically matters of fact and judgment for the professional disciplinary committee in the light of the evidence before it. Some of the evidence may be matters of fact, some of it merely subjective. In assessing a registrant’s insight, a professional disciplinary committee will need to weigh all the relevant evidence, both oral and written, which provides a picture of it.” (January 2014)
The doctor will need to demonstrate developed insight and show that they have maintained their knowledge and skills insofar as is possible. It may be necessary to undertake a clinical attachment, attend courses in person and online, and provide reflections on the past failings and on the updating that the doctor has done. These are not straightforward matters and we would recommend that a doctor takes legal advice when preparing for a review hearing.
Doctors Defence Service advises and represents doctors in relation to and at GMC/MPTS Review Hearings. For more information, contact us on 0800 10 88 739