Where the GMC (or MPTS) deems there to be evidence of impaired fitness to practise, they will go on to assess whether the doctor poses a risk to public protection that requires action on the part of the GMC (or MPTS).

A look at the criteria the GMC & MPTS decision makers will use to decide if doctors pose a risk to public protection.

Assessment of Risk

GMC decision makers and the MPTS’ assessment of risk includes considering:

  • the seriousness of the concern
  • any relevant context, and
  • how the doctor has responded to the concern

Seriousness of the concern

The seriousness of the concern relates to the extent of the doctor’s departure from the Good Medical Practice and other GMC professional standards and, where relevant, the impact of a health condition on the doctor’s ability to practise safely.

Not every departure from the Good Medical Practice will be considered serious. However, if a doctor does seriously depart from the standards, it can mean they pose a current and ongoing risk to public protection.

GMC decision makers and MPTS tribunals assess how serious a concern is by looking at the extent of the doctor’s departure from the professional standards, along with any specific factors that may impact on seriousness. This includes, if the concern is an isolated incident or has been repeated, whether it was premeditated or persistent, or whether it was an abuse of power.


Context may be relevant to the assessment of risk where it has influenced the doctor’s performance, behaviour or health. Contextual factors include:

  • Working environment
  • Systems factors (the physical working environment the quality of induction, workload issues etc.)
  • Interpersonal factors (relate to the values and interests of the organisation or team within
  • which the doctor is working)
  • Role and experience (their performance or behaviour will be judged against the standards expected of a reasonably competent doctor working within a similar setting and the same role)
  • Likelihood of medical professional continuing in, or returning to, medical practice
  • Personal context

How the doctor has responded to the concern

The extent to which a doctor is able to recognise there is a concern, try to understand how it arose (insight) and steps taken to address the concern and learn from it (remediation) is a relevant consideration when GMC decision makers and MPTS tribunals consider risk.

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According to GMC guidance, for a doctor to take effective steps to reduce the level of any risk they pose to public protection, they must have insight. This means recognising there is a concern, understanding how it arose, and understanding how it can be addressed.

Where the concern relates to a doctor’s poor performance or behaviour, it is crucial that the doctor has insight into what went wrong and appreciates what should have been done differently. They must also show they understand how they should act differently in the future to avoid a similar concern occurring again.

Where the concern relates to a doctor’s health condition, it’s important they’re aware of the impact their condition could have on patient safety. The doctor should only work if it is safe to do so because any impact is being effectively managed. Where the doctor is working, they should be seeking and following treatment and advice and taking steps locally to manage any potential risk to patients.


The same guidance says that remediation is where a doctor actively addresses concerns about their behaviour, performance, or the impact of a health condition. Remediation can take several forms and, where successful, will make it less likely that regulatory action is needed to address any unmitigated risk. For remediation to be successful, it needs to focus on activities that reduce the level of any risk posed to one or more parts of public protection.

When things go wrong, we are here when you need us

GMC decision makers and MPTS tribunals can take action against a doctor’s registration if they find a doctor does pose a risk to public protection.  Action can be taken at any stage of the GMC’s investigation (for example by an Interim Order Tribunal) or as a final step by a MPTS tribunal.  In any case (i.e. IOT or MPTS), suspension, restrictions on practice or erasure are possible.

Legal advice and representation does lead to better outcomes for doctors.  Legal advice will assist doctors with, amongst other things, the right strategies, challenging GMC evidence, responding to the GMC and – importantly – advise on insight and remediation.

Kings View has been advising and representing health care professionals for many years, and we know that despite their best efforts, some things do go wrong.  Through our experience, we know that the circumstances that lead to things going wrong are never straightforward.

It is a well-established fact that healthcare professionals who seek legal advice and representation at an early stage in any fitness to practise process, generally, receive better outcomes and lesser sanctions, if any.  We can advise on the right strategy to take and represent you before a fitness to practise hearing.

Kings View are public access barristers, meaning that you can instruct us directly without having the additional expense of hiring a solicitor first (so we are generally at least one third cheaper).

You can speak to me today for a free, no obligation assessment of your case.

Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.