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Brief Guide to the GMC Fitness to Practice Disciplinary Procedure


For any professional, having your fitness to practice your vocation is a very stressful and uncertain time. If these procedures do not go in the favour of the doctor it can have a substantial impact on the doctor’s ability to continue in their professional. However, in the reverse the GMC is committed to providing an excellent standard of care to all patients in need.

This article seeks to give doctors an overview of what happens during the fitness to practice disciplinary procedure and the steps you can expect your case to take. There are 5 main stages to the disciplinary procedure and they are as follows:

Referral to the GMC

Most complaints that are heard by the GMC begin with a patient complaint. This will start at a local level to the local NHS Hospital Trust, Primary Care Trust, or private healthcare body. The local body will then make their own investigations. The investigation may end here with no further action or internal action being taken. If the offence is more serious and the local authority believe that further investigation is needed then the case will be referred to the GMC.

Don’t panic if your case has been referred to the GMC, inappropriate cases are dealt with quickly and the GMC will only take forward those cases they believe serious enough to warrant further investigation. 


If a case has enough merit to get past the local authority investigation and the initial GMC screening it will be sent for investigation. In the outset the GMC will conduct a preliminary enquiry to help decide if a full investigation is needed. At this stage the case may not be taken further, or it may be sent to the doctor’s employer if appropriate.

The next stage in the process is the full investigation. At this point the GMC will have decided that the case is serious enough and has enough merit to investigate fully. The complaint will be sent to the doctor and their employee and the doctor will have the opportunity to comment. The nature of the investigation at this point very much depends on the type of complaint they are dealing with.

At the end of the investigation the case is heard by one medical and one non-medical member of staff. These staff members can issue warnings or decide not to take further action. For more serious consequences they will refer the case to the MPTS.

Investigations committee and interim orders panel

If a warning has been issued the doctor has the right to request an oral hearing in front of the committee. Additionally, if the case examiners could not agree on the appropriate course of action it is sent to the committee for a decision. The committee can take no action or they have the power to issue warnings, agree and undertaking or refer to interim orders panel.

The IPO is one of the most serious sanctions for the doctor as they have the power to direct interim conditions that restrict the practice of the doctor, or suspend the doctor with immediate effect. 

Medical Practitioners Tribunal Service

This is the final stage of the fitness to practice procedure and is an in-person hearing, often lasting a few days, that requires the input of legal professionals including barristers and a solicitor. The legal professionals will put forward arguments and look at all aspects of the doctor’s fitness to practice. The MPTS then have a variety of different disciplinary tools at their disposal. 

High Court Appeal

As with any legal process in England and Wales, if you lose at the MPTS the doctor or the GMC have the right to appeal this decision to the High Court. This appeal needs to be done within 28 days of the decision being made. The sanction imposed by the MPTS will not take effect until after the 28 days if no appeal is lodged, or will be suspended until after the appeal has been heard. 

For cases being heard by the MPTS and the High Court it is important that the doctor seeks the help of a legal professional. These are complex hearings governed by the equal complex rules of civil procedure. A legal professional will be able to guide you and put forward your best chances of winning your case. 

For more information visit our General Medical Council page. Alternatively, call our GMC Solicitors on 0330 127 8888 for a free 30-minute consultation on your matter.


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