MPTS Rules & Case Management Directions – Advice for doctors

Doctors who do not comply with MPTS Rules and case management directions risk increased adverse outcomes and costs awarded against them.

MPTS Rules & Case Management Directions – What are they?

Where the General Medical Council (GMC) refers a fitness to practise case for a full hearing, the Medical Practitioner’s Tribunal Service (MPTS) will notify the doctor in writing of the date of their Medical Practitioner’s Tribunal (MPT) hearing.  Included in this correspondence will be, for example, instructions, known as case management directions, to comply with.  Under Rule 16(7A), a case management direction is binding on the parties and on any subsequent MPT considering the case.

What is case management for?

In essence, MPTS Rules and case management directions requires all parties (the doctor and GMC) to prepare their cases and to cooperate with each other to keep delays to a minimum.  Case management directions should facilitate an effective MPTS hearing, so to minimise the stress on doctors (and on witnesses).  Case management directions also seek to serve to facilitate agreement about a number of key issues in the case.

Consequences for failure to comply with Rules or case management directions

Whilst the above might appear simple enough, doctors must be aware that MPTS and case management rules are comprehensive, complex and prescriptive.  There are potentially serious consequences for doctors who do not comply with MPTS Rules and/or case management directions.

The MPT can take the following actions where doctors have not complied with the Rules or directions:

• draw an adverse inference;
• refuse to admit evidence; and/or
• award costs.

What does adverse inference mean?

In this context, to draw an adverse inference means that the MPT may draw a negative conclusion from a doctor’s failure to comply with a Rule or case management direction.  A negative conclusion will not assist a doctor in their hearing and/or defence. 

What does refusal to admit evidence mean?

A refusal to admit evidence means that the MPT may refuse to receive evidence (e.g. witness statements or other documents) that the doctor wish to rely on in their defence or to challenge evidence submitted by the GMC. 

Factors that the MPT may consider when deciding on the admissibility of evidence will include:

• when the evidence was obtained;
• the relevance of the evidence to the issues in the case;
• any reasonable excuse given for the failure to produce the evidence in accordance with the Rule or case management direction; and/or
• whether there is any other mechanism, other than excluding the evidence, that would allow the hearing to proceed fairly.

Failure to admit evidence can be devastating for a doctor and their defence.  It will leave the doctor’s case vulnerable and may serve to strengthen the GMC’s case against them. 

Conversely, doctors have a right to apply to the MPT to draw an adverse inference or refuse to admit evidence.  This might apply in cases where the GMC have not complied with the MPTS’ Rules or directions.  There are separate rules and procedures for this.  In certain cases, a doctor may benefit greatly from making such an application but, again, a clear and thorough understanding of the process and procedures is key – which is where the value of legal advice and representation is clear. 

It is worthwhile for doctors to remember that MPTS hearings are overseen and managed by Legally Qualified Chairs.  These chairs are chosen from a pool of very experienced legal practitioners – defined as “a barrister, chartered legal executive or solicitor in England and Wales; an advocate or solicitor in Scotland; or a member of the Bar of Northern Ireland or solicitor of the Supreme Court of Northern Ireland”. 

Costs awards

A costs award is an order made by an MPT that one party (either the doctor or the GMC) must pay some of the other party’s costs. The MPT may consider making a costs award either if one party makes an application for costs, or of its own initiative.  

The MPT’s decision on costs is separate from its decision on the fitness to practise proceedings. This means that even if the MPT finds that your fitness to practise is not impaired, the GMC could still make an application for costs against you. Equally, you can still make an application for costs, even if your fitness to practise is found impaired.

Better outcomes for doctors

Understanding the MPTS’s rules and directions are key to meaningful engagement, which, in turn, is key to better outcomes for doctors.  Legal advice and representation is critical in aiding doctors to understand these rules and directions.

We regularly advise doctors and understand the significance and impact complaints can have on the reputation and career of a doctor. A well-prepared case is essential to ensure the best outcome for you, your career and professional reputation. It is imperative that you seek legal advice from someone who specialises in GMC defence work. 

What we do:

• GMC fitness to practise referrals
• GMC fitness to practise hearings
• Appeals against a MPTS Tribunal determination
• MPTS Interim Order hearings
• Appeals against a MPTS Interim Orders Tribunal determination
• Preparing your case before the Case Examiners
• Help with the decision of the Case Examiners
• Help with voluntary removal
• Registration advice
• Appeal against refusal of registration
• Restoration to the Register
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• Police cautions
• DBS [Disclosure and Barring Service] issues