Interim orders tribunal
This page provides information about interim orders tribunal hearings, which are carried out by the Medical Practitioners Tribunal Service.
When do we refer cases to an interim orders tribunal?
An interim orders tribunal hearing looks at whether a doctor's registration should be restricted while allegations about their conduct are resolved.
We refers cases to the Medical Practitioners Tribunal Service for interim orders tribunal hearings when doctors are facing allegations where:
- it may be necessary for the protection of members of the public
- 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:
- preserving public trust in the profession.
- maintaining good standards of conduct and performance.
What are the powers of an interim orders tribunal?
An interim orders tribunal can make an order to suspend a doctor's registration or to impose conditions on a doctor's registration for a maximum of 18 months.
The order must be reviewed within six months of being imposed, and thereafter, at intervals of no more than six months. The review can be considered at an oral hearing, or in certain circumstances on the papers should the doctor and the GMC agree on the proposed outcome.
If an interim orders tribunal wishes to extend an order beyond the period initially set, we must apply to the High Court for permission to do so.
Factors to be taken into account before referring a case to an interim orders tribunal
When considering whether to refer a case to an interim orders tribunal, our case examiners, our Investigation Committee or a medical practitioners tribunal, as appropriate, should take account of the following factors.
- The seriousness of risk to members of the public if the practitioner was to continue to hold unrestricted registration. In assessing this risk the interim orders tribunal 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.
- 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.
- 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 themselves.
The following factors may also be relevant.
- Whether the practitioner has complied with any undertaking given or conditions previously imposed in relation to this matter.
- The practitioner's history with the GMC (if any).
Where referral to an interim orders tribunal 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 interim orders tribunal
The following examples are illustrative of cases which, depending on all the circumstances may require referral to an interim orders tribunal. The list is not exhaustive and there may be others not shown here where referral would be appropriate.
Risk to the public: clinical issues
This category concerns cases where, if the allegations are substantiated, there is an ongoing risk to the public 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 interim orders tribunal.
This category also includes cases of doctors whose registration has been either suspended or erased by another medical practitioners tribunal, 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 the public, then a referral to the interim orders tribunal would be appropriate.
Risk to the public: 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 the public 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 the public. 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 interim orders tribunal 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 interim orders tribunal 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 their registration or has breached undertakings to the GMC to limit their practice. Examples include cases where the doctor:
- breaches conditions imposed by a medical practitioners tribunal
- 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 interim orders tribunal
An interim orders tribunal 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 interim orders tribunal.
However, the complaint must 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 interim orders tribunal (for example, the complainant may not be in a position to provide such evidence at that stage).
However, by the time the interim orders tribunal meet to consider the case there will need to be sufficient evidence to enable an interim orders tribunal to assess the force of the allegations. What weight is put on that evidence is a matter for an interim orders tribunal.
Interim orders tribunal decisions
You can view previous interim orders tribunal decisions on the MPTS website.