Glossary

A Fitness to Practise Panel has the power to hear cases referred by the Case Examiners or the Assistant Registrar. In order for a FtP Panel to be quorate, it must consist of at least one lay and one medical member and a chair who can be either. The members of the FtP Panel are independent of the GMC.

In order to determine the outcome of allegations, after a discussion on the evidence, FtP Panel members vote in private. The Chair does not have a casting vote and if there is a split vote, it goes in favour of the doctor. The FtP Panel can ask questions of the doctor and witnesses if they give sworn evidence.

The GMC have the power to appoint a doctor to be assessed by two medical examiners. GMC examiners are not employees of the GMC and are independent practitioners. However there is a list of recognised approved GMC health assessors who do receive training and guidance from the GMC. They are usually Consultant Psychiatrists. The GMC will ask the doctor to consent to the examiners having access to their medical records and the ability to contact their GP.

The GMC obtain reports from two examiners and the process usually consists of an instruction by the GMC (including a bundle of information), an interview with the doctor and the production of a written report with a recommendation on whether the doctor is fit to practise. They can be called to give live evidence if the reports are used in FtP proceedings. There is nothing to stop a doctor from obtaining theory own health evidence.

The term impairment does not have a conclusive definition. It is not defined within the GMC’s legislation. Essentially, it means that after the Panel have determined the factual issues, they then have to go on and consider, on the basis of those matters found proved, is this doctor impaired. This is not something that is determined on the balance of probabilities and is a matter of professional judgement.

Essentially, the panel have to ask themselves whether on the basis of the facts found proved, does action need to be taken against the registration of the practitioner. The justification for this does not just relate to patient safety as factors such as the public interest and the reputation of the profession will also be considered by the FtP Panel.

A Legal Assessor sits with both the FtP and IOP to advise them on points of law. A legal assessor is a solicitor, barrister or judge with at least 10 years experience. They can only advise the Panel and can not make rulings. The Panel are expected to follow the advice of the Legal Assessor but are not obligated to do so. If they choose to depart from their advice, they are expected to give full reasons for doing so in their decision.

Normally, the Panel will ask both the GMC and the defence advocate if they have any observations on the Legal Assessors Advice. The Legal Assessor is permitted to be present during in camera discussions, but should not have any input in the decision making process.

• Stage 1 involves an assessment team going into the doctors last place of work and carrying out a record review, third party interview and a case based discussion with the doctor.
• Stage 2 is more objective and can involve a test of competence, OSCE’s and/or simulated surgeries depending on the speciality of the doctor. The Assessment Team will produce a report with a recommendation on whether the doctor is fit to practise.

In October 2009, the GMC intend to introduce licences to practice. Doctors will need to demonstrate they are practising in accordance with the generic standards set out in Good Medical Practice. They will also be required to produce information about their practice. This includes CPD, appraisal, audit and patient/colleague feedback.

The Responsible Medical Officer will need to confirm to the GMC there are no outstanding concerns about their fitness to practice. If you want to exercise privileges such as prescribing and signing death certificates etc, you will need to have a licence as well as your registration.

The GMC have a case management procedure to sort of the logistics of placing a case before a Fitness to Practise Panel. The first telecon determines the date when the case will be heard taking into account the GMC’s service standard and the preparation time required by the GMC lawyers and the defence. A date for GMC disclosure is set and a stage 2 telecon is held shortly after to look at whether the GMC have complied and the case is on track.

The telecon is chaired by a GMC adjudication administrator who is not legally qualified. No substantive issues can be determined on the telecon. However if there are concerns regarding the timetable, disclosure and/or witness evidence, a case review can be requested.