The right of appeal in fitness to practise cases and why early legal engagement matters

Fitness to practise proceedings are among the most consequential processes a health or care professional can face. Decisions made by regulators such as the General Medical Council or the Nursing and Midwifery Council can determine not only a practitioner’s ability to continue practising, but also their professional standing and personal wellbeing. Although the statutory right of appeal is often seen as a critical safeguard, it is a mistake to treat it as the primary line of defence. In reality, the most effective protection for professionals lies much earlier in the process, through timely and strategic legal engagement.

Rights of Appeal

Health and care professionals generally have a right to appeal adverse fitness to practise findings and sanctions to the High Court or equivalent appellate courts. These appeals may challenge findings of impairment, the proportionality of sanctions, or the fairness of the process.

The court will not simply reconsider the case from the beginning; instead, it will focus on whether there has been an error of law, procedural unfairness, or a decision that is irrational or disproportionate. This creates a high threshold. Compounding that difficulty are strict statutory time limits—typically 28 days—which are rigorously enforced and can quickly become a barrier for those who delay seeking advice.

Eskander v GMC

The recent decision in Eskander v General Medical Council provides a clear illustration of how professionals can encounter difficulty at the appellate stage. In that case, Dr Eskander sought to challenge a decision of a Medical Practitioners Tribunal but did so outside the prescribed time limit. The Court of Appeal was therefore required to consider whether it had discretion to extend time and, if so, how that discretion should be exercised. The court confirmed that a discretion does exist and clarified that the approach to timing in Fitness to practise appeals is not entirely rigid. However, it emphasised that such discretion is limited and must be exercised in light of several factors, including the length of the delay, the reasons for it, the merits of the proposed appeal, and the public interest in finality.

The outcome is instructive. While the court acknowledged that extensions of time may be granted, it reinforced that late appeals face a significant procedural and evidential hurdle. The existence of discretion does not weaken the expectation that professionals comply with statutory deadlines. Nor does it provide a safety net for those who have not acted promptly. In practical terms, Eskander demonstrates that by the time a professional turns their mind to appealing a decision, they may already be operating from a disadvantaged position—particularly if key deadlines have been missed or if earlier opportunities to shape the case have been lost.

Early Legal Engagement

This is why early legal engagement is so critical. Fitness to practise proceedings are not confined to the final hearing; they are cumulative processes in which each stage influences the next. The initial response to allegations, often made during employer investigations or at the point of referral to a regulator, can determine whether concerns escalate at all. Early legal advice can ensure that responses are appropriately framed, that relevant evidence is preserved and presented effectively, and that any admissions or reflections are carefully structured. These early steps can significantly affect how a case is perceived by both the regulator and any eventual tribunal.

As the process progresses, legal representation becomes equally important in managing interim orders, preparing evidence, and developing a coherent hearing strategy. By the time a case reaches a substantive fitness to practise hearing, the evidential landscape is largely fixed. Decisions about witnesses, expert evidence, and submissions must be made with precision. A well-prepared case at this stage may avoid adverse findings altogether or result in a materially more favourable outcome, thereby removing the need to consider an appeal in the first place.

Appeals, while essential, are therefore best understood as a limited corrective mechanism rather than a strategic fallback. Courts will generally defer to the expertise of specialist tribunals, particularly in relation to factual findings and professional judgment. New evidence is rarely admitted, and the threshold for intervention remains high. As Eskander v General Medical Council makes clear, even gaining access to the appellate process can be problematic if procedural requirements are not strictly followed.

The overarching lesson is straightforward but often overlooked: waiting until an adverse decision has been handed down before seeking legal advice can significantly weaken a professional’s position. Early, informed, and strategic engagement not only enhances the prospects of a successful outcome at first instance but also preserves the integrity of any subsequent appeal, should one become necessary.

Kings View Chambers: specialist fitness to practise defence

With over 30 years of combined experience, Kings View Chambers is recognised as one of the leading teams in fitness to practise defence. We understand that fitness to practise investigations are not just regulatory processes—they are deeply personal, often stressful experiences that can affect your career, wellbeing, and reputation.

Our approach is built on:

• Expertise – decades of specialist experience in GMC and MPTS defence.
• Empathy – recognising the anxiety and uncertainty doctors face during investigations.
• Excellence – consistently rated ‘excellent’ by clients for our commitment, clarity, and results.
• Support – guiding you through every stage of the process with professionalism and care.

Contact us today for a free, no-obligation telephone consultation and speak directly with one of the most experienced fitness to practise defence barristers. You deserve expert support—especially when the stakes are this high.