GMC Fitness to Practice Legal Guidance, Advice & Representation

Preparing for a hearing requires careful planning, legal expertise, and strong advocacy. Each stage must be approached strategically, from gathering evidence and coordinating witnesses, to making submissions on impairment and presenting mitigation effectively. We are regularly instructed by doctors facing Fitness to Practise Panel Hearings, including those who were previously unrepresented or dissatisfied with earlier legal advice.

Our focus is always to protect your registration and minimise the long-term impact on your career. If you are facing a hearing, early legal input can make a significant difference to the outcome.

Insights, Redemption and Risk of Erasure

Insight and remediation is often central to the outcome of any fitness to practise case. The GMC and MPTS will expect you to reflect on what occurred, demonstrate a clear understanding of its seriousness, and show that meaningful steps have been taken to reduce the risk of repetition.

We advise doctors on how to approach this from the earliest stage of the process. A carefully prepared reflective statement, supported by evidence of relevant CPD or training, can demonstrate that the concerns have been addressed and that the risk of recurrence is low. In appropriate cases, professional testimonials and character references may also assist.

Where allegations involve dishonesty, sexual conduct, or clinical competence, the tribunal will examine closely whether the doctor has accepted the findings and taken genuine steps to remediate. Where insight is limited or remediation is weak, the risk of suspension or erasure increases significantly.

We support doctors in preparing insight and remediation material at every stage of the investigation and hearing process. This evidence may be submitted to Case Examiners or presented in full at tribunal. Where appropriate, we also advise on how best to deploy the material tactically to strengthen your position and reduce the risk of escalation.

Interim Orders and Restrictions Before the Hearing

Doctors under investigation by the GMC can be referred to an Interim Orders Tribunal (IOT) at any stage of the process. This may occur shortly after an initial referral, or later in the investigation if new concerns emerge.

An Interim Orders Tribunal can impose conditions on your registration or suspend you from practice entirely. These measures are not disciplinary. They are imposed where the tribunal considers it necessary to protect patients, maintain public confidence, or safeguard your own interests while an investigation remains ongoing.

Our solicitors represent doctors at interim order hearings and advise on how to respond to proposed restrictions. We challenge the GMC’s evidence where appropriate, make focused legal submissions, and present mitigation to argue that no order is required. Where conditions are imposed, we advise you on compliance, risk management, and how to position your case for review.

Interim Orders are usually reviewed every six months and can remain in place for up to 18 months, subject to High Court extension. These hearings are often listed at short notice, and early legal advice is essential.

We act quickly to prepare your case and protect your ability to practise wherever possible.

Standard of Proof and Fitness to Practise Determinations

At a Fitness to Practise hearing, the Medical Practitioners Tribunal applies the civil standard of proof. This means the GMC must prove the allegations on the balance of probabilities, establishing that the alleged conduct is more likely than not to have occurred.

If the facts are found proved, the tribunal will then consider impairment. This is a legal assessment focused on current risk, not simply past conduct. The tribunal will consider whether your fitness to practise is impaired today, taking account of insight, remediation, any risk of repetition, and the need to maintain public confidence and uphold professional standards.

If impairment is found, the tribunal will then determine the appropriate sanction. This can include conditions, suspension, or erasure from the medical register. In some cases, even where impairment is not found, the tribunal may still issue a warning if there has been a departure from expected professional standards.

Our solicitors advise and represent doctors at every stage of this process. We prepare detailed submissions on evidence, impairment and mitigation, challenge allegations where appropriate, and provide robust representation throughout the tribunal hearing.

Referral from GMC to MPTS

Not all fitness to practise cases proceed to a tribunal hearing. However, where the GMC believes there is a realistic prospect of a finding of impairment, the case may be referred to the Medical Practitioners Tribunal Service (MPTS).

Referral marks the beginning of the adjudication stage and typically follows a full investigation and a Case Examiner decision. In certain cases, referral is effectively unavoidable, particularly where the concerns involve a criminal conviction or serious allegations such as dishonesty, violence, or sexual misconduct.

Once a referral is made to a hearing, the MPTS takes over management of the proceedings. This involves case management, directions on evidence, and a timetable leading to the final hearing. The tribunal will then determine the facts, decide whether impairment is established, and if necessary, impose a sanction.

Our solicitors support doctors throughout this process. We advise on evidence strategy, liaise with the GMC and MPTS, instruct expert witnesses where needed, and represent clients at hearings. Referral to the MPTS is often the most serious stage of the process, and early specialist advice can be critical to the outcome.

Frequently Asked Questions for Fitness to Practise

Contact Our Fitness to Practice Solicitors Today

If you are facing a fitness to practise investigation or hearing, you should seek specialist legal advice as early as possible. The decisions made during this process can affect your ability to work, your reputation, and your future in medicine.

At Clifford Johnston & Co, we understand the pressure doctors face during GMC proceedings. We provide practical, strategic advice and representation at every stage, from initial referral through to full hearings before the Medical Practitioners Tribunal Service.

We focus on what matters: protecting your registration, safeguarding your reputation, and securing your long-term career.

We are regularly instructed in serious and high-stakes disciplinary cases and provide nationwide support to medical professionals. Our professional disciplinary lawyers have extensive experience advising doctors on every aspect of fitness to practise proceedings, including interim orders, evidence strategy, insight and remediation, and tribunal advocacy.

Contact us today to speak with our specialist GMC solicitors and take the first step in defending your future.