Medical practitioners tribunals

This page provides information about medical practitioners tribunals

Contents

Introduction

Medical practitioners tribunals hear evidence and decide whether a doctor’s fitness to practise is impaired.

Who sits on a medical practitioners tribunal?

A medical practitioners tribunal comprises medical and non-medical people appointed to inquire into allegations of impaired fitness to practise. The tribunal members are appointed through open competition by the Medical Practitioners Tribunal Service against agreed competencies.

The pool of tribunal members is large (around 280) but tribunals considering individual cases normally consist of three tribunal members. There must be at least one medical tribunal member and one non-medical tribunal member. View the MPTS's current list of tribunal members.

The tribunal will be assisted by either a Legal Assessor (LA) or a Legally Qualified Chair, but not both. LAs and LQCs are experienced barristers or solicitors appointed to advise the tribunal on questions of law and of mixed law and fact, including the procedure and powers of the tribunal.

In hearings with an LQC, the tribunal will comprise of the LQC and a least two other tribunal members. The LQC and tribunal members make decisions together.

How do medical practitioners tribunal hearings work?

The GMC - which brings the case against the doctor - and the doctor are both invited to attend the hearing. The GMC is normally represented at the hearing by a barrister. The doctor is usually present and legally represented.

Both parties may call witnesses to give evidence and if they do so the witness may be cross-examined by the other party. The tribunal may also put questions to the witnesses.

The tribunals meet in public, except where they are considering confidential information concerning the doctor’s health.

The tribunal's decision

Once the tribunal has heard the evidence, it must decide

  • whether the facts alleged have been found proved
  • whether, on the basis of the facts found proved, the doctor’s fitness to practise is impaired
  • if so, whether any action should be taken against the doctor’s registration.

If the tribunal concludes that the doctor’s fitness to practise is impaired, the following sanctions are available:

  • to take no action
  • to accept undertakings offered by the doctor, and agreed with the GMC, provided the tribunal is satisfied that such undertakings protect the health and wellbeing of the public, in line with the overarching objective (for more information, see the Sanctions guidance)
  • to place conditions on the doctor’s registration
  • to suspend the doctor’s registration
  • to erase the doctor’s name from the Medical Register, so that they can no longer practise.

In deciding on the appropriate sanction the tribunal must have regard to the sanctions guidance. The guidance aims to ensure consistency of decision-making and has been welcomed by the courts which hear appeals against decisions taken by tribunals.

Warnings

If a tribunal concludes that the doctor’s fitness to practise is not impaired, it may issue a warning to the doctor.

In order to do so the tribunal must be satisfied that there has been a significant departure from the standards set out in Good medical practice or where there is cause for concern following an assessment of the doctor’s performance.

Standard of proof and the tribunal's judgment

Where the tribunal makes a finding on disputed facts, it applies the civil standard of proof.

Where the tribunal decides whether or not a doctor’s fitness to practise is impaired, it uses its judgment. The same is true when the tribunal decides what sanction should be imposed on the doctor's registration.

In cases where a doctor’s fitness to practise has been found not impaired, the tribunal exercises its judgment on whether a warning should be issued to the doctor.

The tribunal must be satisfied that any proposed action is sufficient to protect the health and wellbeing of the public, in line with the overarching objective (for more information, see the Sanctions guidance).

Appeals

Doctors have a right to appeal against any decision made by a tribunal to restrict or remove their registration.

The Professional Standards Authority has the right to refer a medical practitioners tribunal’s decision to the relevant court if it believes it is not sufficient for the protection of the public.

More information about appeals can be found on the main Appeals page of our website, located within the decisions tab.

Reviews

At a review hearing, a tribunal considers if a doctor's fitness to practise is still impaired, and whether further action needs to be taken. 

The MPTS is able to hold a review 'on the papers' as an alternative to holding a hearing, if both the doctor and the GMC agree on an appropriate outcome. This means the review of a case by a tribunal or tribunal chair without the attendance of the doctor and the GMC. 

View Policy guidance for medical practitioners tribunals and chairs: conducting reviews on the papers (pdf).

Applications for restoration

Any doctor whose name was erased from the Medical Register by a medical practitioners tribunal can apply for their name to be restored to the Register, after a period of five years has elapsed since the date their name was erased.

View Guidance for doctors on restoration following erasure by a medical practitioners tribunal (pdf).

Non-compliance hearings

As part of an investigation, the GMC may direct that a doctor undergo an assessment of their health, performance, or knowledge of English Language, or that a doctor provide information. 

Where a doctor is found to be consistently or explicitly refusing to comply with a direction to undergo an assessment or to provide information that is key to the progress of an investigation, they may be referred to an MPTS non-compliance hearing.

View Non-compliance hearings guidance for medical practitioners tribunals (pdf).

View How the non-compliance hearing process works factsheet (pdf)