Medical Council Publishes New Sanctions Guidance

On 28 May 2024, the Medical Council (the "Council") published new guidance (the "Guidance") on the imposition of sanctions upon the conclusion of fitness to practise Inquiries.

The revised document provides insight and transparency surrounding the factors to be considered and the approach taken by the Council when deciding on sanctions.

In addition, the guidance also outlines mitigating and aggravating factors that may affect the level of sanction to be imposed on a medical practitioner. Mitigating factors may reduce or dilute the severity of the sanctions to be imposed and include; remediation, co-operation, adherence to the principles of good practice and insight. Aggravating factors may increase the severity of sanctions to be imposed and these include; criminal convictions, previous findings made against them by the Council or another regulator and a lack of insight into the subject matter of the complaint against them.

It is important to note that it will be determined by the Council what weight, if any, will be given to both the mitigating and aggravating factors. In doing so, the Council will consider the relevance of each mitigating or aggravating factor based on the circumstances of each case and will balance any mitigating or aggravating factors against the findings of the Fitness to Practise Committee ("FTPC"), the rights of the practitioner and the Council's objective to act in the public interest.

As outlined in the guidance, the Council's primary objective relating to the imposition of sanctions is to act in the public interest. This includes; protecting the public, promoting and maintain public confidence in the profession and the regulatory process and promoting and upholding professional standards and conduct.

The guidance has also outlined the 9 step approach used by the Council prior to the imposition of sanctions. These are as follows;

1. Receive Report - The Council must impose a sanction following the receipt of a report from the FTPC where findings have been made against the medical practitioner on one or more of the grounds of complaint
2. Consider Recommendation - The Council will consider the sanctions, if any, recommended by the FTPC.
3. Consider Alternatives - The Council is not bound by the sanctions, if any, recommended by the FTPC, and will consider all the available sanctions.
4. Proportionality - In determining which sanctions to impose, the Council will have regard to the principle of proportionality. The Council will balance its objective to act in the public interest and the rights of the medical practitioner.
5. Leniency - The Council must also afford the medical practitioner with as much leniency as possible in the circumstances, whilst simultaneously ensuring that it acts in the public interest.
6. All the Factors - Taking all the above factors into account, and any mitigating or aggravating factors the Council will consider which sanction or combination of sanctions is necessary to act in the public interest in light of the findings of the FTPC.
7. Step Approach - The Council will begin its consideration with the least severe sanction and will consider whether it is sufficient to address the public interest. If the sanction is not sufficient, it will consider the next serious sanction. The Council will repeat this process until it has determined the appropriate sanction(s) required in the circumstances.
8. Imposition - Once the Council has decided on the appropriate sanction(s), it must impose such sanction(s), even if it may lead to hardship for the medical practitioner.
9. Reasons - The Council will provide clear and cogent reasons for the sanctions it decides to impose, to include the weight it has given to any mitigating and aggravating factors it has taken into account, including where the Council does not consider the factors to be relevant or mitigating or aggravating.

The guidance also outlines the types of sanctions that the Council may impose which are found at Section 71 of the Medical Practitioners Act 2007¹ (the "Act") and range from advice or admonishment, censure, attachment of conditions to the practitioner's registration, temporary suspension or cancellation.

Once a sanction has been imposed on a medical practitioner, they may appeal the decision of the Council to the High Court, not later than 21 days after receipt of the written notice of the Council's decision. The Court, on hearing the appeal, can confirm the Council's decision, or cancel the decision and replace it with such other decision that the Court considers appropriate.

It is clear that the arrival of this new guidance will assist those engaging with the Council to better understand their role and function in the Fitness to Practice process.

Footnote

1 Section 71 of the Medical Practitioner's Act 2007

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