Our high impact regulatory decisions 

A high impact regulatory decision involves at least one of the following properties:

  • Existence of a possible large loss (financial, emotional, trust/confidence) in the exercise of our regulatory functions to:
    • an individual
    • group of individuals
    • or organisation
  • The costs (financial, emotional, trust/confidence) to change the regulatory decisions once made are high and have wider implications on fairness. 

We ran workshops across the GMC to explore the high impact regulatory decisions in more detail. To understand how we assure fairness and bias at these decision points. And how this can be further strengthened.

We have identified 41 high impact regulatory decisions that span our functions. These decision points cover approximately 27,000 regulatory decisions made each year.

As part of our wider programme of work to assure fairness, we’ll continue to monitor fairness and bias in our decision points. Particularly when any changes to our regulatory activities occur.

If you would like to know more about these decision points, please contact us. 

List of high impact regulatory decisions

Corporate review and complaints

  • Rule 12 review and reopening (and no review/no reopen) 
  • Termination of complaint (correspondence) 
  • Upholding/not upholding a complaint  
  • Section 40a appeals

Education and Standards

  • Approval of bodies
  • Enhanced monitoring decisions
  • Approvals of post-graduate curricula/assessments

Fitness to Practise

  • Triage decision (Rule 4(5)) – (five year rule) 
  • Triage decision (Rule 4)
  • Final provisional enquiry decision (Rule 4)
  • Additional allegations of impairments (Rule 4)
  • Referral to interim order tribunal (IOT)
  • Final Case Examiner (CE) decision (Rule 8)
  • Voluntary erasure
  • Administrative erasure
  • MPT cancellation (Rule 28)
  • Case Review Team (CRT) Assistant Registrar (AR) decisions
  • Investigation Committee Decisions
  • Information sharing – Disclosure Barring Service (DBS)
  • Rule 5
  • Rule 15 charges – Legal Adviser (LA) drafts
  • Sanction submission – LA drafts
  • IOT sanction submission – Legal Preparation Assistants (LPA) drafts
  • Whether to defend/compromise section 40 appeal defend claim and advise on prospects
  • Whether to defend/compromise IOT challenge / appeal
  • Whether to defend/compromise Judicial Review (JR) challenge
  • Whether to defend/compromise Employment Tribunal (ET) claims
  • Decisions to disclose information in the public interest under s.35B (2)

Medical Practitioner Tribunal Service (MPTS)

  • Decisions made by independent tribunal members at MPTS hearings
  • Appointment process for tribunal members
  • Rule 29 postponement and further adjournment of IOT/MPT hearings
  • Rule 16A Cost Award
  • Pre-hearing and post-hearing publication and redaction

Registration and Revalidation

  • Decisions to grant or refuse provisional registration
  • Decisions to grant or refuse full registration
  • Decisions to grant or refuse Specialist or GP registration (portfolio pathways)
  • Decisions to grant or refuse restoration of registration or licence
  • Decisions on whether to withdraw licence
  • Decisions on acceptability of overseas qualifications 
  • Decision on misconduct in Professional and Linguistic Assessments Board (PLAB) context

Outreach

  • Advice to ROs, designates and employers on FtP and revalidation for GMC registrants
 

Related content

Our role and legislation Find out more about our statutory functions and the legislation that underpins what we do.
How we make decisions about a doctor's fitness to practise We use a range of guidance to reach decisions in cases where concerns have been raised about a doctor.
How we quality assure education and training We set standards for providers of education and training, and we regularly check those are being met. Our quality assurance framework describes how we do this.
Who makes the decisions at tribunal hearings? The Medical Practitioners Tribunal Service run hearings to make independent decisions about whether doctors, physician associates and anaesthesia associates are fit to practise in the UK. They have around 300 tribunal members, with three sitting on each hearing.