GMC investigations and MPTS hearings: defence from the first letter to appeal

The GMC triages it first. The Registrar asks four questions. Is the doctor on the register? Is there a legal basis for assessing fitness to practise? Would the information be serious enough if proven? And is there any reason not to investigate? Most concerns close at this point. In 2025 the GMC triaged 13,465 concerns, closed 12,146 at triage and opened 997 formal investigations. While a concern sits at triage, the GMC does not tell you or your employer about it. Our guide to what happens when the GMC receives a concern explains each step.

A Rule 7 letter is the letter the GMC's Registrar sends near the end of an investigation. It takes its name from rule 7 of the General Medical Council (Fitness to Practise) Rules 2004. The letter sets out the allegation, encloses the documents the GMC holds in support and invites your written representations within 28 days of its date. It must also tell you that the GMC may disclose your representations to the person who raised the concern for comment. Your response then goes to two case examiners, one medical and one lay. Our guide to writing a Rule 7 response explains what persuades them.

Case examiners can close the case with no further action, give advice, issue a warning, agree undertakings with you or refer you to a medical practitioners tribunal. They apply the realistic prospect test. It asks whether there is a realistic prospect of establishing that your fitness to practise is impaired to a degree requiring restrictive action. In 2025 they made 679 decisions, closing 309 with no further action and referring 184 to a tribunal. A warning is not a sanction, but the GMC publishes it on the register for two years in total. Read more in our guide to writing a Rule 7 response.

An interim orders tribunal decides whether to restrict your registration while the GMC investigates. Under section 41A of the Medical Act 1983 it can impose conditions or suspend you. It does so where that is necessary to protect the public, otherwise in the public interest or in your own interests. It does not make findings of fact or decide impairment, and it cannot accept undertakings. In 2025 tribunals reached 350 outcomes, imposing conditions in 229, suspending in 55 and making no order in 66. An order can last up to 18 months, with a review within six months. Our guide to interim orders tribunals explains how to prepare.

The GMC does not ask doctors for reflective notes in order to investigate a concern. Under the MPTS guidance, neither the GMC nor a tribunal can require you to hand over reflective notes produced for your professional development. Whether you offer evidence of insight, and in what form, is your decision. The limit lies with the courts. Recorded reflections are not subject to legal privilege, so a court may request disclosure if it considers them relevant. Write about what you learned rather than the full story of the event. Our article on reflective practice after Bawa-Garba sets out the position.

No. Representation before the GMC and the MPTS is not a reserved legal activity. So Eloquia can act for you from the first letter to the tribunal's decision. Eloquia is a legal consultancy, not a law firm, and the Solicitors Regulation Authority does not regulate it. Saqib Khan, a former solicitor who sat as a fee paid judge of the County Court for more than four years, leads every matter. Some work needs a regulated firm. A High Court appeal runs through a regulated law firm Eloquia works with. Police station work runs through its criminal defence partner firm. A specialist barrister works on your case from the outset.

A medical practitioners tribunal of three members decides your case in three stages. It first decides the facts, with the GMC bearing the burden of proof on the civil standard. If it finds facts proved, it decides whether your fitness to practise is currently impaired. If it finds impairment, it decides the sanction, which can range from no action to conditions, suspension or erasure. You must have at least 28 days' notice of the hearing unless an exception applies. In-person hearings take place at St James's Buildings, 79 Oxford Street, Manchester. Our guide to the MPTS hearing from start to finish follows each step.

You have 28 days. Section 40 of the Medical Act 1983 lets you appeal a direction for erasure, suspension or conditions. You must bring the appeal within 28 days beginning with the date of service of the decision on you. That day counts as the first. In England and Wales the appeal goes to the High Court. A warning is not on the list of decisions you can appeal this way. Eloquia runs appeals through a regulated law firm it works with and stays involved throughout. Our guide to appealing a tribunal decision covers the grounds.