The Investigation Committee
If the medical and non-medical case examiner fail to agree at the investigation stage, the Investigation Committee, a statutory committee of the GMC, will consider all the information collected during the investigation and will hear any other evidence it considers desirable before deciding whether the case should be referred to a Fitness to Practise (FTP) Panel. The hearing will take place in public.
Following the hearing, the Investigation Committee may:
- confirm that the warning should be issued;
- conclude the case with no action; or
- refer the case forward to a FTP Panel (where new evidence arising during the hearing indicates that it would be appropriate to do so).
The Interim Orders Panel (IOP)
The IOP may make an order suspending a doctor's registration or imposing conditions upon a doctor's registration - prior to the doctor appearing to answer the full allegations. The IOP meets in private, unless the doctor requests a public hearing.
Cases are referred to an IOP where the doctor faces allegations of such a nature that 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.
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 Registrar to apply to the High Court for permission to do so.
Fitness to Practise Panel Adjudication
FTP Panels hear evidence and decide whether a doctor's fitness to practise is impaired. FTP Panel hearings are the final stage of GMC procedures following a complaint about a doctor.
A panel consists of specially trained people who will hear all the evidence and will decide at the end of the hearing whether they need to take action regarding the doctor's registration.
If the GMC refers a case to an FTP Panel, they will write to the doctor setting out the specific allegations and explaining the process leading up to the panel hearing.
FTP Panels will normally be held in public, except where a panel is considering evidence about a doctor's health. The GMC also have special arrangements for vulnerable witnesses.
The GMC aims to hold all FTP Panel hearings within nine months of the decision to refer the case forward.
At the end of the Fitness to Practise Panel hearing
At the end of the hearing, the FTP Panel may decide that the doctor's fitness to practise is not impaired and will either take no action or issue a warning. Where they make a finding that the doctor's fitness to practise is impaired they may do one of the following:
- put conditions on the doctor's registration (this might mean the doctor is only allowed to do medical work under supervision or might restrict him/her to certain areas of practice);
- suspend the doctor's name from the medical register so that s/he cannot practise during the period of suspension in which their licence is withdrawn;
- erase (remove) the doctor's name from the medical register so that s/he will not be able to work as a doctor in Great Britain for at least five years; the GMC's intention is that erasure should normally be for life.
Appeals to the High Court
A doctor has 28 days in which to appeal to the High Court against any decision by an FTP panel. The panel's decision will not take effect until either the appeal period expires or the appeal is determined. However, the panel can impose an immediate order for suspension or conditions if it believes it needs to protect the public or if it is in the best interests of the doctor.
Council for Healthcare Regulatory Excellence
The Council for Healthcare Regulatory Excellence (CHRE) has the power to refer a decision by an FTP panel to the High Court (or its equivalent elsewhere in the UK) for the protection of the public, if it considers that the FTP Panel decision is unduly lenient. The CHRE has 28 days to decide whether to refer a decision following the doctor's 28-day appeal period. CHRE reviews all decisions by FTP Panels that have not resulted in erasure.
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