1. Home
  2. Parties and representatives
  3. Guidance for tribunals
  4. Tribunal guidance for doctors hearings
  5. Medical practitioners tribunal hearings
  6. Step 1b - make a finding on impairment
Medical practitioners tribunal hearings

Step 1b: make a finding on impairment

Text alternative for this image can be found linked directly below.

Text alternative: step 1b: make a finding on impairment

  1. On the basis of their conclusions to the questions in step 1a, the medical practitioners tribunal (MPT) should decide if the doctor continues to pose a current and ongoing risk to public protection requiring restrictive action in response and make a finding on impairment. 

  2. If there is more than one legal basis for considering the doctor’s fitness to practise an assessment of current and ongoing risk should have been made in respect of each of them to inform the MPT’s decision on impairment. 

  3. Where the MPT has concluded the current and ongoing risk posed by the doctor has decreased, the MPT may consider that the doctor: 
    • no longer poses any current and ongoing risk to public protection requiring restrictive action in response, or 
    • despite the risk to one or more parts of public protection having decreased, the doctor continues to pose a current and ongoing risk to public protection requiring restrictive action in response.  
  1. In cases where the MPT has concluded the risk has not materially changed or has increased, this means the doctor will continue to pose a current and ongoing risk to public protection requiring restrictive action in response.

  2. The MPT should find the doctor’s fitness to practise impaired in cases where they have concluded there is a current and ongoing risk to one or more of the three parts of public protection requiring restrictive action arising from any of the grounds. Where there is no such risk, they should make a finding of no impairment.

  3. Where the MPT makes a finding of impairment, they should be clear about which parts of public protection – patient safety, public confidence and/or upholding professional standards – are engaged, making reference to the general guidance and specific case types sections in the Introduction, as appropriate. 

  4. The MPT should also state the level of risk they’ve identified – low, medium, or high. This is because the level of current and ongoing risk will be relevant to the MPT’s decision on what is a proportionate response. The MPT should then go on to consider the guidance in the section Decide what action to take, if any  to decide what action is needed to protect the public.

  5. Where the MPT does not make a finding of impairment, they should still consider the guidance in the section Decide what action to take, if any  to decide what action, if any, is needed in respect of the current sanction.

  6. The MPT must record reasons for their conclusion on whether the doctor poses any current and ongoing risk to one or more of the three parts of public protection requiring restrictive action in response, to explain their decision on impairment.

Review hearings where there have also been new findings of fact    

  1. Where the medical practitioners tribunal (MPT) hearing commenced as a new hearing to consider new allegations about the doctor’s fitness to practise, the MPT will have used the Guidance for MPT hearings  to determine the facts of the new matter. Where facts are found proven, the MPT will need to assess the current and ongoing risk to public protection posed by the doctor in relation to both the new and review matters. These assessments should then be considered together to reach one decision on impairment.

  2. It is possible that the MPT may conclude that there is:
    • no current and ongoing risk to public protection requiring restrictive action in response arising from the new allegation or the review matter 
    • no current and ongoing risk to public protection requiring restrictive action in response arising from the new allegation, but there remains a current and ongoing risk to public protection requiring restrictive action in the review matter
    • a current and ongoing risk to public protection requiring restrictive action in response arising from the new allegation, but no longer a current and ongoing risk to public protection requiring restrictive action in the review matter, or 
    • a current and ongoing risk to public protection requiring restrictive action in response arising from both the new allegation and the review matter. 
  1. The MPT should make a finding that the doctor’s fitness to practise is impaired where they have concluded there is a current and ongoing risk to one or more of the three parts of public protection requiring restrictive action arising from any of the matters before it. Where there is no such risk, the MPT should make a finding of no impairment.