Interim Orders Panel
This page provides information about the Interim Orders Panel (IOP) of the Medical Practitioners Tribunal Service.
When are cases referred to an IOP?
An interim orders panel hearing looks at whether a doctor's registration should be restricted while allegations about their conduct are resolved.
The GMC refers cases to the Medical Practitioners Tribunal Service for IOP hearings when doctors are facing allegations where:
- it may be necessary for the protection of members of the public, or
- it may be in the public interest or
- in the interests of the doctor
for the doctor's registration to be restricted whilst the allegations are resolved.
As well as the protection of the public, the public interest includes:
- a. Preserving public trust in the profession.
- b. Maintaining good standards of conduct and performance.
What are the powers of an IOP?
An IOP may make an order suspending a doctor's registration or imposing conditions upon a doctor's registration for a maximum period of 18 months.
An IOP must review the order within six months of the order being imposed, and thereafter, at intervals of no more then six months.
If an IOP wishes to extend an order beyond the period initially set, it will direct the GMC Registrar to apply to the High Court for permission to do so.
Factors to be taken into account before referring a case to an IOP
When considering whether to refer a case to an IOP, GMC Case Examiners, the GMC Investigation Committee or a fitness to practise panel, as appropriate, should take account of the following factors:
- a. The seriousness of risk to members of the public if the practitioner was to continue to hold unrestricted registration. In assessing this risk the IOP will consider the seriousness of the allegations, the weight of the evidence, including evidence about the likelihood of further offences occurring whilst the allegations are resolved.
- b. Whether public confidence in the medical profession is likely to be seriously damaged if the practitioner were to continue to hold unrestricted registration whilst the allegations are resolved.
- c. Whether it is in the doctor's interests to hold unrestricted registration. For example, the doctor may clearly lack insight and need to be protected from himself/herself.
The following factors may also be relevant
- a. Whether the practitioner has complied with any undertaking given or conditions previously imposed in relation to this matter.
- b. The practitioner's history with the GMC (if any).
Where referral to an IOP is appropriate it will be irrelevant whether or not the doctor has a licence to practise.
Types of cases that might be referred to an IOP
The following examples are illustrative of cases which, depending on all the circumstances may require referral to an IOP. The list is not exhaustive and there may be others not shown here where referral would be appropriate.
Risk to patients: clinical issues
This category concerns cases where, if the allegations are substantiated, there is an ongoing risk to patients from the doctor's clinical practice. Such cases will normally involve either a series of failures to provide a proper standard of care, or one particularly serious failure. Allegations indicating a serious lack of basic medical knowledge or skills may well require referral to an IOP.
This category also includes cases of doctors whose registration has been either suspended or erased by another Fitness to Practise Panel, where immediate suspension has not been imposed and the erasure or suspension has not yet taken effect. If new information is received which was not available at the time of the original determination showing that the doctor poses an immediate risk to patients, then a referral to the IOP would be appropriate.
Risk to patients: non-clinical issues
These are cases not directly related to clinical practice but where the allegations, if substantiated, would demonstrate that the doctor poses a risk to patients if allowed to continue in unrestricted practice. This category 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 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 whilst the allegations are resolved, even though there may be no evidence of a direct risk to patients. The question would be whether public confidence in the profession might be seriously damaged by the doctor concerned holding unrestricted registration whilst the allegations are resolved.
Matters of this kind, which would normally already be under investigation by the police, would include very serious alleged offences including allegations of murder, attempted murder, rape, attempted rape and sexual abuse of children.
Police investigations into other matters including allegations of indecent assault and manslaughter may also necessitate a referral to an IOP depending on the individual circumstances of the case.
The point at which doctors who are the subject of criminal investigations should be referred to an IOP is flexible and will depend on all the circumstances of the case.
Cases involving a breach of conditional registration or of undertakings to limit practice
These are cases where the doctor has breached conditions imposed on his or her registration or has breached undertakings to the GMC to limit his or her practice. Examples include cases where the doctor:
- Breaches conditions imposed by a Fitness to Practise Panel
- Breaches voluntary undertakings
- Refuses to co-operate with a performance or physical or mental health assessment under the performance procedures or medical examination under the health procedures, or prevaricates or falls ill temporarily so that completion of the assessment is delayed.
Evidence and an IOP
An IOP has a duty to act to protect members of the public and the wider public interest. It is therefore important that cases are referred as soon as information suggesting that the doctor's registration needs to be restricted on an interim basis becomes available.
It will not always be possible to gather all the evidence that might potentially be available before referring the matter to an IOP.
The complaint must, however, be credible and backed up where possible by corroborative evidence although the lack of corroborative evidence should not in itself be a bar to a referral to an IOP (for example, the complainant may not be in a position to provide such evidence at that stage).
However, by the time the IOP meet to consider the case there will need to be sufficient evidence to enable an IOP to assess the force of the allegations. What weight is put on that evidence is a matter for an IOP.
Interim Orders Panel decisions
To access previous IOP decisions, please see our Fitness to Practise and IOP decisions page.