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Associates tribunal hearings

Step 2: make a decision on impairment

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Deciding impairment

  1. At stage two of an associates tribunal (AT) hearing, the AT decides if the PA or AA’s fitness to practise is impaired.

  2. If the AT has concluded at stage one that no facts have been proved, this means the GMC has not discharged the burden of proof in respect of the allegations that the PA or AA’s fitness to practise is impaired. The AT should therefore confirm there is no basis upon which to make a finding of impairment, and the hearing will conclude.

  3. The AT will only make a finding of impairment where a decision is reached that the PA or AA poses a 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 facts found proved at the first stage of the hearing and any further relevant evidence presented to the AT.

  4. The decision on impairment is one for the AT alone, exercising their judgment. There is no burden or standard of proof.

  5. 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
    • misconduct5
  6. Where there is a legal basis for considering a PA or AA’s fitness to practise, to assess whether that PA or AA poses any current and ongoing risk to public protection, an AT will consider:
    • the seriousness of the facts found proved,
    • any relevant context known about the PA or AA and/or their working environment, and
    • how the PA or AA has responded to the allegation(s).
  7. If there is more than one legal basis for considering the PA or AA’s fitness to practise ie the allegations fall under more than one ground for action, an assessment of current and ongoing risk must be made in respect of each of them.

  8. The AT will always need to record reasons for their decision on impairment and be clear about which part(s) of public protection are engaged. Where the AT’s decision departs from the principles in this part of the guidance the AT must carefully explain how this is justified, given the specific circumstances of the case. They must also explain how the decision relates to any submissions made by the parties.

5 Part 1 (2)(a) of the Order.