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Associates tribunal hearings

AT review hearings

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AT review hearings

General introduction

  1. The role of an associate’s tribunal (AT) carrying out a review of a final measure of conditions or suspension is to decide whether a PA or AA’s fitness to practise remains impaired and if so, what restrictive action, if any, is needed to protect the public. 

  2. References made to ‘public protection’ throughout this guidance refer to the GMC and MPTS’ legal duty to protect the public which is split into three distinct parts. It means an AT must act in a way that: 
    • protects, promotes and maintains the health, safety and wellbeing of the public 
    • promotes and maintains public confidence in the profession, and
    • promotes and maintains proper professional standards and conduct for members of the profession. 
  1. Where a final measure of conditions or suspension has been imposed on a PA or AA’s registration, a case examiner or AT may direct that the final measure is reviewed prior to its expiry.1 Additionally, the GMC may direct a review of a final measure at any time, of their own choice or because they have agreed to a request for a review made by a PA or AA.2 Usually, a review of a final measure will be referred to a case examiner, however it may sometimes be appropriate to refer the case directly to an AT.  

  2. The purpose of this guidance is to support ATs to make fair and consistent decisions when reviewing a final measure at a hearing. 

Review hearings

  1. An AT review hearing has two distinct stages: 
    • Stage one: the AT will reach a decision on whether the PA or AA’s fitness to practise remains impaired 
    • Stage two: the AT will consider their conclusion on impairment and decide what action, if any, is required in response. 
  1. At stage one, to decide if a PA or AA’s fitness to practise remains impaired, the AT must assess whether that PA or AA poses any current and ongoing risk to one or more of the three parts of public protection requiring restrictive action in response. This assessment must be made with reference to the findings of the original AT or case examiners (‘decision maker’), the findings of any decision makers who have conducted a previous review of the case, and any relevant new evidence presented to the AT. 

  2. An AT can only assess whether a PA or AA is fit to practise where there is a legal basis for doing so. There are two grounds for taking regulatory action for PAs and AAs. These are: 
    • inability to provide care to a sufficient standard, or 
    • misconduct.3 
  1. The AT should assess whether the PA or AA’s fitness to practise remains impaired having regard to whichever ground for action the PA or AA was previously found to be impaired by. While they cannot add or consider new grounds for impairment in the absence of separate matters against the PA or AA having been referred for determination, the AT should assess if the PA or AA is currently fit to practise by considering all the available relevant evidence.4 

  2. At stage two, the AT will consider their conclusion on impairment and decide what action, if any, is required in response.  

  3. Where the PA or AA’s fitness to practise does not remain impaired, the AT can:4
    • allow the existing measure to expire, or 
    • revoke the existing measure. 
  1. Where the PA or AA’s fitness to practise remains impaired, the outcomes available to the AT are to:5  
    • take no further action, i.e. allow the existing measure to expire 
    • extend the existing measure for up to 12 months 
    • vary the existing measure of conditions for up to 12 months, or  
    • revoke the existing measure and impose a different one  
  1. The process that the AT should follow at a review hearing to decide if a PA or AA’s fitness to practise remains impaired and what action to take, if any, is illustrated in diagram one.  

Review hearings where there are also new allegations

  1. Where new allegations about a PA or AA’s fitness to practise have been referred to an AT hearing, the new matter and review must be listed together.6 The hearing will have three stages: 
    • Stage one: the AT will use the guidance in Part A: stage one - facts  of the guidance for Associates tribunal hearings to consider and decide the facts in the new matter 
    • Stage two: the AT will reach a decision on whether the PA or AA’s fitness to practise remains impaired, considering both their findings at stage one in relation to the new allegation and information relevant to the review which includes the findings of the original decision maker, the findings of any decision makers who have conducted a previous review of the case, and any relevant new evidence presented to the AT7  
    • Stage three: the AT will consider their conclusion on impairment and decide what action, if any, is required in response. 
  1. If a new allegation has been referred to the MPTS shortly before a scheduled review hearing, with insufficient time for the new allegation to be prepared so the matters can be considered together, the AT should adjourn the review hearing. In these circumstances, the AT may extend the current measure or consider whether any interim measure should be imposed, extended, varied, revoked or revoked and replaced with a different interim measure so that there is no public protection gap. 

1 Rule 62(1) of the fitness to practise rules 2024 (‘the rules’).

2 Rule 62(2) of the rules.

3 Part 1 (2)(a) of the Anaesthesia and Physician Associate Order 2024 (AAPA Order 2024) (the Order). 

4 The AT should refer to the section review hearings where there are also new allegations where separate matters against the PA or AA have been referred for determination. 

5 Article 14(3) of the Order.

6 Rule 73(14) of the rules. 

7 Rule 73(17) of the rules.