Expert opinion on our fitness to practise investigations
As part of our investigations into a doctor’s fitness to practise, we may obtain an independent expert opinion on the actions and decisions of the doctor to help our decision makers determine how to proceed with the case.
The following guidance sets out the principles that underpin our use of expert opinion as part of our processes and what factors should be considered by investigation officers and legal advisers when deciding whether to obtain an expert’s opinion.
The General Medical Council (Fitness to practise) Rules 2004 (as amended) (‘the rules’) give the GMC investigatory powers. In exercising these powers, the GMC may obtain expert evidence.
The rules also give an Investigation Committee or Tribunal the power to admit evidence which they deem to be fair and relevant to the case which includes expert opinion and reports (rules 34 and 27).
When can we obtain an expert opinion?
We can request an expert’s opinion at different stages of our process:
- to provide an early opinion on whether a complaint raises concerns about a doctor’s treatment
- to provide written reports, which would assist decision makers when deciding the outcome of an investigation
- if a doctor is referred to a Medical Practitioners Tribunal hearing we may ask an expert to attend to give oral evidence.
Why do we obtain expert reports?
When we are considering fitness to practise concerns, we may ask for an independent professional opinion from a doctor who is an expert in their own field on the standard of care provided by the doctor and whether that doctor:
- met the standard expected of a reasonably competent practitioner in the relevant field; or
- fell below the standard expected; or
- fell seriously below the standard expected.
Good medical practice and its associated guidance sets out the standards of competence, care and conduct expected of doctors.
The expert’s opinion is part of the evidence collected on a case and helps to inform our decision makers.
When should we get an expert report?
We will usually obtain an expert report where we are investigating clinical allegations about the treatment provided by the doctor. We will ask the expert to give an opinion in the way described above. We may obtain an expert opinion to assist our decision makers to decide whether the relevant allegations about the doctor, if proven, would amount to impaired fitness to practise. For some specific allegations, an expert’s opinion can assist a decision maker in determining whether a factual allegation against the doctor is likely to be proven. We also obtain expert opinions from non-medical experts, for example accounting or handwriting experts.
We can obtain an expert opinion on whether a doctor’s actions and decisions were clinically indicated and/or carried out in accordance with any relevant guidance and standard practice to help our decision makers to consider whether there was a clinical reason for the doctor’s conduct. For example, it may be alleged that a doctor’s actions when providing treatment were sexually motivated, if for instance, we had received an allegation that they carried out an intimate examination which was not required.
Assurance of expert opinion
When instructing an expert, we satisfy ourselves that they have the appropriate expertise to comment on the circumstances of the case. More information about how we assure ourselves of this is contained in our Standards for Experts and section 1 of our Guidance for Experts.
Experts must tell us of anything that may give rise to a potential conflict of interest so that we can decide whether we should still instruct them. More information on this is in section 2 of our Guidance for Experts.
The experts we instruct must have read and understood what is required of them as set out in our Standards and Guidance and agree to provide expert opinions in accordance with this.