Interim Orders Tribunal

Standards of evidence accepted

In order to protect members of the public and the wider public interest, the tribunal has a duty to act. It is  important that cases are referred to the GMC as soon as information becomes available which suggests that a doctor’s registration needs to be restricted on an interim basis.

It may not always be possible to gather all possible evidence that might potentially be available before referring the matter, notwithstanding, the complainant must present credible information and backed up where possible by  evidence that can corroborate an allegation (although lack of corroborative evidence should not in itself be a bar to a referral to an interim orders tribunal, e.g., the complainant may not be in a able to provide such evidence at that stage).

By the time the tribunal meets to consider the case there will need to be a high enough level of evidence available to enable the interim orders tribunal to assess the strength of the allegations made. What credence is put on that evidence is a question for deliberation by an interim orders tribunal.

What factors are considered before referring a case?

A number of factors are taken into account by GMC case examiners, the GMC investigation committee or a medical practitioners panel before referring a case. These factors can include any or all the following;

• The level and severity of risk to members of the public if the practitioner were to continue to hold unrestricted registration. In assessing this risk the interim orders tribunal will consider the how serious the allegations are, the strength of the evidence which also included the evidence about the likelihood of further offences occurring whilst the allegations are resolved.
• If public confidence in the medical profession is likely to be seriously damaged if the practitioner were to continue to hold unrestricted registration whilst allegations are resolved.
• Whether it is in the doctor’s interests to hold unrestricted registration.

Other factors that might be relevant here include whether the doctor has complied with any undertaking given or conditions previously imposed in relation to this matter and the practitioner’s history (if any) with the General Medical Council.

The types of cases include those where allegations indicate that there might be clinical issues representing a risk to the public, and also circumstances were there may be non-clinical risks to the public.

What clinical issues are judged to represent risk to the public?

This categorisation includes circumstances where, if allegations were substantiated, there would be an ongoing risk to the public arising from the doctor’s clinical practice. These types of cases would typically involve either a series of events where there has been a failure to provide a proper standard of care, or related to one particularly serious failure. Allegations may also involve accusations relating to serious lack of basic medical knowledge or inadequate skills. Where such allegations exist, there may well the requirement to refer the doctor in question to an interim orders tribunal.

In addition to the former case types, the category of ‘risk to the public: clinical issues’ also covers cases of doctors whose registration has been either been;

• suspended or erased by another medical practitioners tribunal or,
• where immediate suspension has not been imposed and where the erasure or suspension has not yet taken effect.

If fresh information is received which was not made available at the time of the original determination showing that the doctor poses immediate risk to the public, a referral to the interim orders tribunal would then be appropriate.

What non-clinical issues are judged to represent risk to the public?

In cases not directly related to clinical practice, but where the allegations are made, which if substantiated, would show that the doctor poses a risk to the public if they were allowed to continue in unrestricted practice, interim orders can be made. This categorisation includes allegations of indecent assault or doctors with serious health problems who are attempting, or might attempt, to practise whilst unfit to do so.

This category of ‘risk to the public: non-clinical issues’ also includes cases where the doctor faces allegations of a nature so serious that it would not be in the public interest for the doctor to hold unrestricted registration while allegations are resolved, in which case an interim order may be put in place even though there may be no evidence of a direct risk to the public. The question here would be whether the publics confidence in the profession might be seriously damaged if the doctor concerned held unrestricted registration while allegations were resolved. Matters of this type include very serious alleged offences and include allegations of murder, attempted murder, rape, attempted rape and the sexual abuse of children.

There are also cases involving a breach of conditional registration or of undertakings to limit practice, where the doctor has breached conditions imposed on their registration or has breached undertakings to the GMC to limit their practice.

GMC Defence Barristers have considerable experience dealing with the General Medical Council and are proficient in representing doctors facing a wide range of GMC complaints. Our GMC lawyers frequently advise and represent doctors facing investigations from the outset often challenging whether there is a case to answer. We offer expert representation at interim orders hearings. We also offer assistance right through to substantive hearings. Finally we can appeal the decision of the GMC to the High Court if a case merits it.

As many of our barristers have spent parts of their careers working within the healthcare sector, we appreciate the complex regulatory and legal challenges faced by doctors. Consequently, we can properly appreciate the many issues doctors face on a daily basis.

Our dedicated barristers have assisted doctors working in a range of settings and at all grades from medical students up through to consultants. GMC defence barristers frequently act for clinicians facing allegations raised about their practice due to health, poor practice or misconduct.