What do practice managers need to know if a GP at their practice is subject to a ‘fitness to practice’ investigation by the General Medical Council (GMC)? Marie Dancer, managing partner at Richard Nelson LLP and founder of the Medic Assistance Scheme, explains the investigation process and what the different outcomes could mean for a GP and the practice they work in
A GMC investigation is, undoubtedly, unsettling for a GP practice, as well as the individual GP. The GMC process largely falls into three aspects: an initial investigation, any interim hearings and then a final hearing.
1. The initial investigation
When the GMC receives a referral about a doctor they will conduct an initial investigation and the GP will be given an early opportunity to comment on the allegations. Once the GMC has finalised the initial investigation the GP will be given formal allegations and the GMC’s evidence for their final response.
Top tip: encourage the GP to obtain professional legal advice before responding to the GMC. The GP is likely to lack objectivity and, if they respond inappropriately, they can do untold damage to their overall case.
The GMC will then refer the GP to two case examiners who will examine the documentation and make one of the following decisions to:
- close the case;
- issue a formal warning;
- agree undertakings;
- refer the GP to the Medical Practitioners Tribunal Service (MPTS).
Top tip: It can often take months to obtain the case examiner’s decision. It may be beneficial during this time to encourage a GP to speak to an impartial GP – to ensure they’re looking after their own health during this stressful period.
2. Interim hearings and possible orders
In every case, the GMC will conduct a risk assessment to decide whether, given the nature of the allegations, it is necessary to refer the GP to the MPTS for an interim orders’ tribunal. If so, there will be a hearing and a panel will hear representations from the GMC and the GP’s lawyers. The panel will decide whether to make no order, to impose interim conditions, or to impose an interim suspension order.
- If interim conditions are imposed the practice will need to obtain a copy of the conditions to assist the GP with compliance.
- If, on review, the practice feels that the interim conditions are unworkable the GP’s lawyers may be able to put forward evidence from the practice, at a review hearing, to support an application to vary the conditions to make them more manageable.
- If an interim suspension order is made the practice will need to make immediate plans to replace the GP in the short term.
3. Final MPTS hearing and possible sanctions
At the hearing the MPTS panel will hear evidence from both sides and make a decision about whether the allegations are proven. If they are the panel will decide whether the GP’s fitness to practise is impaired and, if so, they will decide on the most appropriate sanction. The sanctions open to the MPTS are:
- to take no further action;
- to impose undertakings (an undertaking is an agreement between the GP and the GMC. They are often used when the GP’s own health is an issue and may require the GP to register with their own GP, work under medical supervision, agree not to prescribe for themselves, etc.);
- to impose conditions on the GP (for up to three years – examples include working under supervision, having chaperones, not undertaking short-term locum work, etc.);
- to suspend the GP (for up to one year);
Top tip: A testimonial from the practice manager and other colleagues may be very beneficial. If the panel can see that the practice is prepared to support the doctor this will bolster the GP’s credibility before the panel. However, the practice will need to make a careful decision regarding whether such support is appropriate in each case.