GMC dishonesty allegation: the Ivey test explained

A GMC dishonesty allegation changes the character of the case. A clinical error invites questions about skill and systems. By contrast, a finding that a doctor lied, falsified a record or misled an employer goes to trust. The regulators treat it accordingly. Your case may include the word dishonestly, or an allegation that you knew something was untrue. If so, you need to understand the test the tribunal will apply and the weight it gives to the result.

Why honesty sits at the centre

Good medical practice, in force since 30 January 2024, sets out the GMC's core standards. It requires you to make sure your conduct justifies patients' trust in you and the public's trust in the profession. It also requires you to be honest about your experience, qualifications and role. Any information you communicate as a medical professional must also be accurate and not false or misleading. That includes not deliberately leaving out relevant information.

The MPTS guidance that came into effect on 24 November 2025 treats dishonesty as one of eight specific case types. It states that a dishonesty allegation may fall at the high end of the spectrum of seriousness. Even a single incident, it says, can have a significant harmful impact. Its examples of dishonesty affecting patient safety include falsifying records, providing false or misleading references or CV information, and theft of drugs from a hospital. It says it will be unusual for a proven allegation of dishonesty not to undermine public confidence in the profession. In addition, the GMC's 2025 statistical report lists dishonesty among its examples of serious concerns that may proceed beyond the initial stages of its process.

The test: Ivey v Genting Casinos

The test comes from the Supreme Court's decision in Ivey v Genting Casinos (UK) Ltd t/a Crockfords [2017] UKSC 67, given on 25 October 2017. Lord Hughes gave the judgment, with which the other four justices agreed. The case concerned a professional gambler, but the test it set out is general. It replaced the second limb of the older test from R v Ghosh. That limb had asked whether the defendant realised that ordinary people would regard the conduct as dishonest.

Under Ivey the test now has two steps. The tribunal first establishes, subjectively, what you knew or believed about the facts. The reasonableness of a belief is evidence of whether you held it, often decisive evidence. But there is no separate requirement that it be reasonable. The question is whether you held it genuinely. Next, the tribunal decides whether your conduct was dishonest. It does so by applying the objective standards of ordinary decent people. Paragraph 74 states that there is "no requirement that the defendant must appreciate" that the conduct was dishonest by those standards. The MPTS guidance adopts the same test.

That two step structure tells you where a defence lies. Most dishonesty cases turn on the first step, on what you knew and believed at the time. A form completed wrongly because you misunderstood the question is a mistake. By contrast, the same form completed in the knowledge that the answer was false is dishonest. Evidence of your state of mind therefore matters most. That includes the guidance or training you received and the messages you sent at the time. It also includes the policy as it stood then and whether anyone told you otherwise. The GMC bears the burden of proving dishonesty on the balance of probabilities. It must prove your state of mind as well as the act.

Lower risk cases

Not every dishonesty concern leads to a hearing. In September 2020 the GMC first published its Supplementary guidance on violence and dishonesty that may represent a lower risk to public protection. Last updated in March 2026, it lists features that make a concern less likely to pose a current risk. They include dishonesty outside your working life, a single incident, a low financial or other benefit and no effect on patient care. Others are no attempt to conceal professional errors or blame others, no history of dishonesty, nothing suggesting repetition and no vulnerable person affected. In May 2025 the GMC said that guidance it published in 2024 had given decision makers more discretion in lower risk violence and dishonesty cases. So the date of the version applied to your case matters.

Sanction at a tribunal

The MPTS guidance sets sanction bands for dishonesty according to the level of risk. Where the risk is lower, the band is suspension of up to three months. A medium risk brings suspension of three to nine months. A higher risk brings suspension of nine months up to erasure. If the risk is medium or high, the tribunal must consider suspension or erasure. References and testimonials have limited relevance, if any, to sanction in dishonesty cases. Also, where the allegation sits at the higher end of seriousness, evidence of insight and remediation has less impact. So a tribunal can find impairment even where a doctor has shown insight.

How you respond matters

The MPTS guidance lists being blatantly dishonest with the GMC or the tribunal, including knowingly advancing a false case, as a sign of lacking insight. You may accept that something you did was dishonest. If so, the guidance gives weight to the timing and completeness of an acknowledgement. Saying so early and explaining what led to it therefore puts you in the strongest position open to you. If you deny dishonesty, build the evidence of what you knew and believed at the time. Keep your account consistent from the first letter onwards. Make sure someone can check every explanation you give against a document.

Sometimes a police investigation for a dishonesty offence runs alongside the GMC case. In that situation the MPTS guidance asks an interim orders tribunal to consider the public interest in letting you keep working unrestricted while the case is resolved. Coordinate the two cases from the start, because what you say in one will be read in the other. Our guide to a police interview under caution explains the criminal side.

Other healthcare professionals

Every healthcare regulator treats dishonesty as among the most serious matters. The GPhC's threshold criteria ask whether your honesty or integrity can no longer be relied on. In the HCPC's sanctions policy, dishonesty comes first among the acts for which striking off will be appropriate. The GDC's guidance addresses registrant character and dishonesty. The NMC's library has a guide on dishonesty charges and the duty of candour, and the GOsC's and GCC's sanctions guidance cover it. See our pages for each profession.

Eloquia acts for doctors facing dishonesty allegations at every stage of a GMC case, with a specialist barrister involved from the outset and included in the fee. Where the police are also involved, police station work runs through our criminal defence partner firm. We state every fixed fee by stage plus VAT.

Dishonesty allegations: why the GMC treats them so seriously and how the Ivey test works

Why honesty sits at the centre

The test: Ivey v Genting Casinos

Lower risk cases

Sanction at a tribunal

How you respond matters

Other healthcare professionals

Sources

Arrange a confidential conversation

Why honesty sits at the centre

The test: Ivey v Genting Casinos

Lower risk cases

Sanction at a tribunal

How you respond matters

Other healthcare professionals

Sources

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Insight and remediation: what tribunals look for and how to evidence it

Interview under caution: a doctor's guide

Appealing a tribunal decision: the High Court route, the 28 day limit and the grounds

Arrange a confidential conversation