The GMC may refer a doctor for an interim orders hearing at the Medical Practitioners Tribunal Service [MPTS] at any stage in proceedings.

The role of the Interim Orders Tribunal [IOT] is to consider whether the doctor’s registration should be restricted on an interim basis by suspending or imposing conditions on their registration. Most IOTs are heard in private.

The Case Examiners and Investigation Committee also have the power to direct the Registrar to refer the case to an IOT.

Cases should be referred to an IOT where the doctor faces allegations of the kind where it may be necessary for the protection of the public or otherwise in the public interest to restrict the doctor’s registration while the allegations are investigated.

Whilst an interim order can be imposed in order to protect the public, the IOT can also impose an interim order if it considers that it is in the interests of the doctor to do so.

Generally once imposed interim orders must be reviewed within 6 months and then every 6 months thereafter however the doctor may request an early review. A review of an interim order can be held at any time if new information relevant to the order becomes available.

The Test:

The IOT must consider whether to impose an interim order if it is satisfied that:
a. In all the circumstances that there may be impairment of a doctor’s fitness to practise which poses a real risk to members of the public, or may adversely affect the public interest or the interests of the practitioner; and
b. After balancing the interests of the doctor and the interests of the public, that an interim order is necessary to guard against such a risk, the appropriate order should be made.

The IOT will consider the seriousness of the risk to the public, the seriousness of the allegations and likelihood of further incidents.

In weighing up all factors, the IOT must consider proportionality of the risk to the public and the adverse consequences on any action taken, on the doctor’s interests.

The IOT will specify the duration of the interim order when imposed. The maximum period is 18 months and if the GMC need to extend that period they will have to make an application to do so to the Court.

NOTE – IOT hearings will NOT consider the merits of the case against the doctor in question. They will take the GMC case at its highest and consider the above. In other words they will not make any findings of fact on the evidence presented – they will essentially assume it is true and work from there. As such arguments resisting an IO on the basis that the evidence is weak or incoherent are unlikely to gain much momentum. This is very frustrating for doctors but is the method by which they are decided.

There are tangible and substantial arguments which can be placed before a Interim Order Tribunal however be realistic – if you are looking at a suspension try to be imaginative with conditions which could allow the Tribunal to consider alternatives. This is not the forum to argue your case and generally a good lawyer should have reached some form of agreement with the GMC prior to the hearing if it is at all possible.

If you are facing a fitness to practise allegation and have been referred to an IOT, we can help.

The imposition of an interim order can have a hugely detrimental impact on you professional career and personal life.

I understand how Interim Orders Tribunals make decisions on interim orders and can help prepare for an interim orders hearing to ensure the best outcome is achieved.

Stephen McCaffrey

I am a GMC Defence Barrister who has represented large number of medical professionals before their regulatory bodies in either first instance proceedings or appeals.  I can help with all matters relating to GMC Fitness to Practise Referrals issues including:

  • GMC fitness to practise referrals
  • GMC fitness to practise hearings
  • Appeals against a MPTS Tribunal determination
  • MPTS Interim Order hearings
  • Appeals against a MPTS Interim Orders Tribunal determination
  • Preparing your case before the Case Examiners
  • Help with the decision of the Case Examiners
  • Help with voluntary removal
  • Registration advice
  • Appeal against refusal of registration
  • Restoration to the Register
  • Investigation and disciplinary hearings at work
  • Criminal investigation and proceedings
  • Police cautions
  • DBS [Disclosure and Barring Service] issues


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