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Interim measures tribunal hearings

Step 1b: consider if it is necessary to restrict the PA or AA’s registration

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Is it necessary to restrict the PA or AA’s registration? 

  1. To decide whether it is necessary to restrict the PA or AA’s registration, the tribunal should consider whether one or more parts of the test for imposing an interim measure are met. The test for imposing an interim measure is whether it is necessary for the protection of the public or is otherwise in the interests of the public and/or in the interests of the PA or AA.10 

  2. The tribunal should be mindful that where the risk identified relates to the protection of the public, the PA or AA’s registration can only be suspended where it is ‘necessary’. However, there is no such qualification on suspension where it is desirable in the public interest to maintain public confidence. 

  3. To be proportionate when considering the need for an interim measure, the tribunal will need to consider any risk(s) to the protection of the public, the public interest and/or the interests of the PA or AA themselves and weigh and balance these against the adverse consequences that interim action has on the PA or AA. 

  4. When considering whether it is necessary to make an interim measure, the tribunal cannot accept any undertakings given by the PA or AA as it has no power to accept them and they are, in any event, unenforceable. 

Does the PA or AA pose a real and immediate risk to the protection of the public?

  1. In the context of interim action, a measure may be necessary for the protection of the public where the concern or allegation about the PA or AA’s fitness to practise indicates there is a real and immediate risk to patient safety. Most often this will arise from concerns about a PA or AA’s behaviour, performance, or the impact of a health condition on their ability to provide safe care.  

  2. The seriousness of the concern, allegation or breach of conditional registration imposed by an associates tribunal (AT), will inform the tribunal’s view on whether there is any real and immediate risk to patient safety if the PA or AA were to continue to hold unrestricted registration while the concern is investigated, or the allegation is decided.  

  3. When considering whether there is any real and immediate risk to patient safety, the likelihood of the behaviour or poor performance giving rise to the concern or allegation being repeated will be relevant. The nature of a health condition and whether any impact it is having on the PA or AA is being effectively managed, is also a relevant consideration. 

  4. To decide if the PA or AA poses a real and immediate risk to patient safety, the tribunal should also refer to the guidance in the specific case types section. 

Is it in the interests of the public to restrict the PA or AA’s registration?

  1. The interest of the public incorporates three elements: 
    • the protection of patients and the public generally from a PA or AA whose fitness to practise may be impaired 
    • the maintenance and promotion of public confidence in the profession, and/or 
    • the maintenance and promotion of proper professional standards and conduct for PA or AAs. 
  1. There is some overlap between the protection of the public and (a) given the impact on patient safety. However, (b) and (c) are also likely to be relevant in cases involving serious clinical concerns, particularly if the act or omission is persistent or repeated, or the circumstances surrounding the concern have attracted widespread public concern. This is because public confidence in the profession and the maintenance of professional standards and conduct would be undermined if the PA or AA’s registration was not restricted due to the serious nature of the risk to patients.  

  2. Where an interim measure is needed for the protection of the public because there is a real and immediate risk to patient safety, then it is likely that imposing it will also be in the interests of the public. 

  3. In some instances, a PA or AA may not appear to pose a real and immediate risk to patient safety, but an interim measure may still be needed on the basis that they pose a risk to public confidence. This is because public confidence in the profession may be seriously damaged if the PA or AA is allowed to continue in unrestricted practice while the matter is being considered. A risk to public confidence may arise from behaviour or poor performance in the PA or AA’s working life but can also arise from something unrelated to the PA or AA’s practice, such as a criminal charge or other serious alleged misconduct in their private life. 

  4. When considering whether an interim measure is needed in the interests of the public, the tribunal should ask themselves whether trust in the profession is likely to be seriously damaged if the PA or AA continues to hold unrestricted registration while the concern is being investigated or pending the allegation or outcome of a breach of conditional registration being determined.

  5. A PA or AA practising in breach of a final measure put in place to protect the public will usually have the effect of undermining the public’s trust in the profession and therefore, pose a risk to the public interest.  

  6. To decide if it is in the interests of the public to restrict the PA or AA’s registration, the tribunal should also refer to the guidance in the specific case types section. 

Is it in the interests of the PA or AA to restrict their registration?

  1. When considering whether an interim measure is needed in the interests of the PA or AA, the tribunal will need to consider if it is in the PA or AA’s own interests to hold unrestricted registration. When deciding this, the PA or AA’s insight into the concern or allegation will be relevant, particularly where it relates to the impact of a health condition. 

  2. To decide if it is in the interests of the PA or AA to restrict their registration, the tribunal should also refer to the guidance in the specific case types section. 

The tribunals decision on whether an interim measure is needed

  1. The tribunal should give clear and adequate reasons for its conclusion on whether an interim measure is needed to enable the PA or AA to understand their decision. In doing so, the tribunal must provide a clear explanation about their assessment of risk based on the information available at the time, and state which parts of the test for imposing an interim measure have been met. 

  2. The tribunal should also explain how their decision relates to any submissions received from the parties. 

10 Article 11(1) of the Order.