Regulating doctors, ensuring good medical practice

Fitness to Practise Panels

This page provides information about Fitness to Practise Panels of the Medical Practitioners Tribunal Service.

Contents


Introduction

Fitness to Practise Panels hear evidence and decide whether a doctor’s fitness to practise is impaired.

Who sits on a Fitness to Practise Panel?

A Fitness to Practise Panel comprises medical and non-medical people appointed to inquire into allegations of impaired fitness to practise.

The panellists are appointed through open competition by the Medical Practitioners Tribunal Service against agreed competencies.

The pool of panellists is large (almost 300) but panels considering individual cases normally comprise three to three panellists.

In addition to the chairman, who may be medical or non-medical, there must be at least one medical and one non-medical panellist on each panel.

View the MPTS's current fitness to practise panellists.

A legal assessor sits with each panel and advises on points of law and of mixed law and fact, including the procedure and powers of the panel.

One or more specialist advisers may also be present. Their role is to provide advice to the panel in relation to medical issues regarding a doctor’s health or performance.

View guidance for specialist advisers (pdf).

How do Fitness to Practise hearings work?

The GMC - which brings the case against the doctor - and the doctor are both invited to attend. The GMC is normally represented at the hearing by a barrister and the doctor is usually present and legally represented.

Both parties may call witnesses to give evidence and if they do so the witness may be cross-examined by the other party. The Panel may also put questions to the witnesses.

The Panels meet in public, except where they are considering confidential information concerning the doctor’s health or they are considering making an interim order.

The Panel's decision

Once the Panel has heard the evidence, it must decide:

  • whether the facts alleged have been found proved
  • whether, on the basis of the facts found proved, the doctor’s fitness to practise is impaired
  • if so, whether any action should be taken against the doctor’s registration.

If the Panel concludes that the doctor’s fitness to practise is impaired, the following sanctions are available:

  • to take no action
  • to accept undertakings offered by the doctor provided the panel is satisfied that such undertakings protect patients and the wider public interest
  • to place conditions on the doctor’s registration
  • to suspend the doctor’s registration
  • to erase the doctor’s name from the Medical Register, so that they can no longer practise.

In deciding on the appropriate sanction the panel must have regard to the GMC's indicative sanctions guidance .

The guidance aims to ensure consistency of decision-making and has been welcomed by the courts which hear appeals against decisions taken by panels.

Warnings

If a Panel concludes that the doctor’s fitness to practise is not impaired, it may issue a warning to the doctor.

But in order to do so the panel must be satisfied that there has been a significant departure from the standards set out in Good Medical Practice or where there is cause for concern following an assessment of the doctor’s performance.

Standard of proof and judgment

Where the Panel makes a finding on disputed facts, it applies the civil standard of proof.

Where the Panel decides whether or not the doctor’s fitness to practise is impaired, it uses its judgment. The same is true when the Panel decides what sanction should be imposed on the doctor. 

The Panel must be satisfied that any proposed action is sufficient to protect patients and the public interest.

Appeals

Doctors have a right of appeal to the High Court (Court of Session in Scotland) against any decision by a panel to restrict or remove their registration.

The Professional Standards Authority for Health and Social Care may also appeal against certain decisions if they consider the decision was too lenient.

Applications for Restoration

Any doctor whose name was erased from the Medical Register (the Register) by a Fitness to Practise Panel can apply for their name to be restored to the Register.

Doctors cannot apply to have their name restored to the Register until after a period of five years has elapsed since the date their name was erased.

View guidance for doctors on restoration following erasure by a Fitness to Practise Panel (pdf).