In order to obtain registration a candidate must complete a Declaration of Fitness to Practise. If you have one of a variety of matters in your history, e.g. a criminal conviction, a caution, fixed penalty notices or have had some disciplinary problem, e.g. at medical school or with a regulator in another jurisdiction, then you may need advice and assistance in the completion of the Declaration.
Since 16.11.09, in order to practise in the UK doctors have been required to be licensed to practise as well as to be registered. From late 2012 doctors will be required to undergo "revalidation". Revalidation is a process by which doctors will have to demonstrate to the GMC, normally every five years, that they are up-to-date and fit to practice and are complying with the relevant professional standards. You may need guidance about this process.
Many complaints against doctors are not referred to the GMC but are dealt with by local health care authorities through local complaints procedures. Although these may be complaints about less serious matters than those referred to the GMC you may still require advice and guidance which we can provide.
The more serious matters which may be referred to the GMC either by individuals or by health care authorities include:
• serious or repeated mistakes in carrying out medical procedures or in diagnosis, such as prescribing drugs in a dangerous way
• failure to examine a patient properly or to respond reasonably to a patient's needs
• fraud or dishonesty
• serious breaches of a patient's confidentiality
• any serious criminal offence.
On receiving a complaint, the GMC will make a preliminary assessment of the seriousness of the matter. Less serious cases will be referred to the doctor's employer for investigation locally. More serious cases will be investigated by the GMC itself, and their investigation can include:
- obtaining documentary evidence from employers, the complainant, or other parties;
- obtaining witness statements;
- obtaining expert reports on clinical matters;
- an assessment of the doctor's performance;
- an assessment of the doctor's health.
An investigation can be lengthy the GMC says it aims to complete an investigation within six months.
At any stage in the investigation the doctor may be referred to the Interim Orders Panel which can suspend or restrict a doctor from practising during the investigation.
At the end of the investigation the case is considered by two GMC case examiners - one medical and one non-medical. If they agree, they can deal with the matter by concluding the case with no further action, issuing a warning, agreeing undertakings, (e.g. to retrain or work under supervision) or they may refer the case to a Fitness to Practise Panel. If the two case examiners fail to agree though, the case will be considered by the GMC Investigation Committee. The Investigation Committee will hold a public hearing where a doctor has disputed the facts upon which a decision to issue a warning has been made or has requested a public hearing.
If the two case examiners are in agreement or otherwise the Investigation Committee decides that the matter is not suitable to be dealt with by a warning or undertakings, they will decide to refer the matter to the Fitness to Practise Panel. The Panel hearings are generally in public, though they may be in private if there is good cause. The doctor may be represented. The standard of proof required to establish findings of the Panel is "on the balance of probabilities" (i.e. 51%).
Having heard the evidence, the panel will decide whether the facts alleged are proved, whether on the basis of the facts which are found to be proved the doctor's fitness to practise is considered to be impaired, and if so whether any action should be taken, and if so, what. If the panel decides that the doctor's fitness to practise is not impaired but nonetheless there has been a significant departure from medical good practice, it may issue a warning.
If the panel does consider that the doctor's fitness to practise is impaired, several outcomes are possible. The panel may decide to accept undertakings offered by the doctor if it is satisfied that such undertakings would protect patients and the wider public interest. Otherwise it may impose conditions on the doctor's registration, suspend the doctor's registration, or even erase the doctor's name from the medical register. In case of erasure, the doctor will no longer be able to practise.
A decision of the Fitness to Practise Panel will not take effect until the appeal period has expired or any appeal has run its course, although the Panel may impose an order for suspension or conditions with immediate effect. The more severe sanctions of the Panel may be appealed to the High Court within 28 days starting with the date on which notification of the decision was served. If the Council for Healthcare Regulatory Excellence considers a decision to be too lenient, it too may appeal.
A doctor whose name has been erased from the Medical Register may apply to have his/her name restored to the register when a period of five years has elapsed since the date of erasure.
There are Medical Defence Organisations, such as the Medical Defence Union Limited and the Medical Protection Society, which can give you advice and assistance throughout these disciplinary processes. If you are not a member of one of these organisations or if you would rather make your own choice of legal representation, we can help you. It is important that you should seek advice and guidance at the earliest possible stage in any investigation.
