When GMC case examiners refer your case to a medical practitioners tribunal, the matter passes to the Medical Practitioners Tribunal Service (MPTS). The MPTS runs the hearing separately from the GMC. From that point the GMC is a party, presenting its case like any other. In 2025 there were 160 new tribunal hearings about doctors. The GMC reports that around nine in ten involved allegations of misconduct, criminal convictions or both. This guide follows an MPTS hearing from the notice to the final decision.

Before the hearing

First, the GMC must serve a notice of hearing. It sets out the allegation and the facts the GMC relies on, and the date and venue. It also states your right to attend and to have a representative, and the tribunal's power to proceed in your absence. Under rule 15 of the General Medical Council (Fitness to Practise) Rules 2004, you must have at least 28 days' notice of the date and location. The exceptions are where you consent to less, or where the Registrar considers a shorter period reasonable in exceptional circumstances.

Most cases then go through case management. A legally qualified case manager, independent of both parties, can hold a case review. At that review the case manager can give directions on disclosure of documents, witness statements, expert reports and the timetable. These directions decide what evidence the tribunal will see. So if you need an expert of your own, or the GMC has not disclosed a document you need, the case review is the place to raise it.

In-person hearings take place at the MPTS hearing centre on the seventh floor of St James's Buildings, 79 Oxford Street, Manchester. Hearings also run virtually, and the hearing record on the MPTS website shows which format applies. A hearing day usually starts between 9 and 9.30 in the morning and finishes between 4.30 and 5 in the afternoon. Hearings take place in public, except where the tribunal is considering confidential information or information about your health.

Who decides

Each tribunal has three members, including at least one registrant and one lay member. Most hearings have a legally qualified chair who sits as part of the tribunal and advises on points of law. Some have a legal assessor instead, who advises on law but plays no part in the decision. The tribunal applies the MPTS guidance that came into effect on 24 November 2025. Earlier versions still govern hearings that started during their own effective period, so check which version applies to yours.

Stage one: the facts

Rule 17 sets the order of proceedings. After any preliminary legal arguments, the hearing turns to the allegation. Once it has been read, the chair asks whether you admit any of it. The tribunal then announces admitted facts as proved. For the rest, the GMC opens its case and calls its witnesses, who face cross-examination on your behalf. The GMC bears the burden of proof and the standard is the civil one. So the tribunal decides whether each fact is more likely than not to have happened.

When the GMC's case closes, you can submit that it has not produced enough evidence to find a fact proved or to support a finding of impairment. The tribunal must rule on that submission before you present your own case. You then give evidence if you choose to and call your witnesses. Finally, the tribunal retires and announces its findings of fact with reasons.

Admissions deserve care. An early admission of facts you accept spares witnesses from giving evidence and can support evidence of insight later. But once made, it is hard to withdraw. Take advice on each paragraph of the allegation separately.

Stage two: impairment

If any facts are proved, the tribunal hears further evidence and submissions on whether your fitness to practise is currently impaired. The MPTS guidance sets out the steps. The tribunal first decides whether there is a legal basis, such as misconduct or deficient professional performance. It then places the allegation on a spectrum of seriousness and considers any relevant context about you and your working environment. Next it examines how you have responded. That includes your insight, your remediation and whether you have kept your knowledge and skills up to date. From those conclusions it decides whether you pose a current and ongoing risk to the public, and it gives reasons for its finding.

This stage looks forward. The question concerns risk today. That is why the evidence you have gathered since the events does its work here, from your reflective statement to your supervisor's reports.

Stage three: sanction or warning

If the tribunal finds impairment, it hears submissions on sanction. It can take no action, take account of undertakings agreed with the GMC, impose conditions, suspend your registration or erase your name. Any sanction must be proportionate. The guidance includes sanction bandings for specific case types, such as dishonesty. If the tribunal finds no impairment, it can still issue a warning. A warning is not a sanction and does not restrict your practice.

Of the 160 hearings in 2025, 124 ended with a finding of impairment. Tribunals erased 48 doctors, suspended 68, imposed conditions on 7 and took no further action in 1. In 34 cases they found no impairment, and they issued a warning in 11 of those. Two further doctors received voluntary erasure.

After the decision

A sanction usually takes effect 28 days after you receive formal notice of it, unless you appeal. Under section 38 of the Medical Act 1983, the tribunal can also order immediate suspension or conditions. It may do so where that is necessary to protect the public, is otherwise in the public interest or is in your own best interests. Rule 17 requires it to hear from both parties first. You have 28 days to appeal to the High Court under section 40. A High Court appeal runs through a regulated law firm Eloquia works with, because conducting litigation is a reserved legal activity. Where a tribunal imposes conditions or a suspension, it will usually direct a review hearing before the order ends. At that review a fresh tribunal decides whether your fitness to practise is still impaired. A doctor erased from the register can apply for restoration after five years.

If you are a nurse, dentist, pharmacist or other healthcare professional, your regulator's committee runs its hearing under its own rules, set out on our pages for each profession. Our MPTS hearings page covers a doctor's hearing and the fee.

Eloquia can act for you from the GMC's first letter to the tribunal's decision, because representation before the GMC and the MPTS is not a reserved legal activity. For a tribunal we prepare the evidence, witness statements and expert evidence, prepare you to give evidence and present your case at the hearing. A specialist barrister works with us from the outset. Our fixed fees by stage include counsel's work and are stated plus VAT, with expert fees quoted separately.

Sources

  1. General Medical Council, Concerns about fitness to practise: Annual statistical report 2025 (published 30 July 2026)
  2. General Medical Council, GMC publishes fitness to practise data for doctors (30 July 2026)
  3. The General Medical Council (Fitness to Practise) Rules Order of Council 2004, SI 2004/2608, Schedule (legislation.gov.uk, text as made)
  4. MPTS, How to attend a hearing
  5. MPTS, How a hearing works for doctors: medical practitioners tribunals
  6. MPTS, Guidance for tribunals: medical practitioners tribunal hearings
  7. Medical Practitioners Tribunal Service, Guidance for MPTS tribunals (published 30 September 2025, in effect from 24 November 2025)
  8. General Medical Council, Our fitness to practise processes: a guide for doctors (published October 2014, updated January 2025)
  9. Medical Act 1983, section 38 (legislation.gov.uk)
  10. Medical Act 1983, section 40 (legislation.gov.uk)
  11. General Medical Council, How we investigate concerns: how we monitor sanctions
  12. Medical Act 1983, section 41 (legislation.gov.uk)