MPTS hearing representation: from the notice of hearing to the decision

Notice and case management

The GMC serves a notice of hearing. It sets out the allegation, the date and venue, 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. A legally qualified case manager, independent of both parties, can hold a case review. The case manager can give directions on disclosure, witness statements, expert reports and the timetable. If you need an expert of your own, the case review is where to say so. Our guide to the MPTS hearing from start to finish follows each step.

Who decides

A tribunal of three includes at least one medical member and one lay member. Most hearings have a legally qualified chair who sits as part of the tribunal and advises on the law. Where the chair is not legally qualified, a legal assessor advises on the law. The assessor takes no part in the decision. In-person hearings take place at the MPTS hearing centre at St James's Buildings, 79 Oxford Street, Manchester. Hearings also run by video. The tribunal applies the Guidance for MPTS tribunals in effect from 24 November 2025, although earlier versions still govern hearings that started under them.

Stage one: the facts

First comes any preliminary legal argument. The tribunal then hears the allegation and asks which paragraphs you admit, and it announces admitted facts as proved. For the rest, the GMC calls its witnesses and your representative cross-examines them. The tribunal decides each fact on the civil standard, more likely than not, and the GMC bears the burden of proof. When the GMC's case closes, you may submit that there is no case to answer on any fact. The tribunal must rule on that before you give evidence.

Stage two: impairment

Where the GMC proves facts, the tribunal hears evidence and submissions on whether your fitness to practise is currently impaired. It first decides whether the GMC has shown a legal basis such as misconduct or deficient professional performance. It places the conduct on a spectrum of seriousness and considers the context. Then it examines your insight and remediation and whether you have kept your skills up to date. This stage looks forward, so the evidence gathered since the events does its work here.

Stage three: sanction or warning

If the tribunal finds impairment it hears submissions on sanction. Under section 35D of the Medical Act 1983, it can take no action or take account of undertakings agreed with the GMC. It can also impose conditions, suspend your registration for up to 12 months or erase your name, except in a health case or a language case. Where it finds no impairment it may still issue a warning, which is not a sanction. Of the 160 new hearings in 2025, 124 ended with a finding of impairment. In those cases 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 issued a warning in 11 of those.

£8,000 plus VAT for preparation, then £4,000 plus VAT for each hearing day, counsel included, expert fees quoted separately

After the decision

A sanction usually takes effect 28 days after formal notice unless you appeal. Under section 38, the tribunal can also order immediate suspension or conditions after hearing from both parties. It does so where that is necessary to protect the public, is otherwise in the public interest or is in your own interests. Under section 40, you have 28 days from the date of service of the decision to appeal to the High Court. Where the tribunal imposes conditions or a suspension it usually directs a review hearing before the order ends. A doctor erased from the register can apply for restoration after five years.