Interim orders tribunal hearings

Step 2: where an interim order remains, decide what is a proportionate response

Deciding what is a proportionate response

Where a tribunal concludes that an interim order remains necessary, they will need to decide what the proportionate response is. To do this, the tribunal should review their reasons for deciding that an interim order remains necessary and, consider any submissions received from the parties on the appropriate outcome.

In making its decision, the tribunal must carefully consider the proportionality of its response in dealing with the risk(s) identified and the adverse consequences of any action taken on the doctor’s own interests.

What action is needed will depend on the individual circumstances of the case and is a matter for the tribunal’s judgment. The tribunal should provide reasons for their decision, and in doing so explain how it relates to any submissions made by the parties.

Where a tribunal or tribunal chair is reviewing an interim order on the papers, they should consider if the order agreed by the parties is sufficient. If they are not satisfied the order is sufficient, if insufficient information has been provided, or there is doubt over the doctor’s capacity to agree to the proposed outcome, the tribunal or tribunal chair must direct that a hearing should be held.

It will usually be proportionate to allow an existing interim order of conditions to continue where the tribunal’s assessment of the risk to the protection of the public, the interests of the public or the interests of the doctor themselves has not changed or has not significantly increased.

It will usually be proportionate to allow an existing interim order of suspension to continue where the tribunal’s assessment of the risk to the protection of the public, the interests of the public or the interests of the doctor themselves remains the same or has increased.

the assessment of the immediate risk to the protection of the public, the interests of the public or the interests of the doctor themselves has not changed or has not significantly increased, and
the tribunal considers that one or more interim conditions are no longer needed, or that alternative or additional interim conditions are needed, to address the risk(s) identified.

It may be proportionate to replace the current interim order with a different interim order where:
1. the assessment of the immediate risk(s) to the protection of the public, the interests of the public or the interests of the doctor themselves has increased or decreased, and
2. the tribunal considers that an alternative order is a more proportionate response.
A doctor practising in breach of an interim order of conditions put in place to protect the public or put in place in the public interest will usually put patient safety at risk and/or have the effect of undermining public confidence in the profession. It may also put the doctor themselves at risk. Where this is the case, it will often be proportionate to replace an interim order of conditions with an interim order of suspension.

Where an interim order of suspension is in effect, and at the review hearing the tribunal’s assessment is that the risk(s) to the protection of the public, the interests of the public or the doctor themselves has reduced since the last hearing, consideration should be given to whether an interim order of conditions would now adequately address the nature of the risk(s) identified. Where it would, the tribunal should follow the guidance in the sub-section Interim conditions in Part A of Section two: IOT hearings.

Where the tribunal decides to replace an interim order with another type of interim order, it can only stay in effect up until the expiry of the period for which the interim order was imposed.

To enable the doctor to understand the outcome, the tribunal should give clear and adequate reasons for its decision on what action to take when an interim order remains necessary. In doing so, the tribunal should explain how their decision relates to any submissions received from the parties.

Where a matter has been reviewed on the papers, the tribunal or tribunal chair should confirm whether they are satisfied that the order the parties have agreed on is sufficient.