They can and in Dr T’s case they explicitly stated that even though a warning was not a deterrent for him personally, the issues it raised had a more general deterrent effect warranting a Warning being issued.

Dr T had 40 years practice without any serious incident or complaint and an unblemished fitness to practise record.  Comments from colleagues and patients radiated praise.  However, Dr T was referred to the GMC by NHS England following a Care Quality Commission report in 2018.  The GMC directed Dr T to undertake a Performance Assessment in 2019.  Over several days Assessment he was interviewed, 50 of his records were reviewed, he answered 120 knowledge test questions, completed 10 simulated surgery scenarios, 12 clinical based discussions and 12 test clinical examinations.   Clinical Management was found to be unacceptable and three areas were cause for concern (maintaining professional performance, assessment of patients’ conditions and relationships with patients).

The GMC argued his FTP was impaired because he had failed to apply basic concepts, not kept his knowledge up to date and needed time to remediate.  The Dr argued only one area of his practice was unacceptable, he had already begun addressing the concerns in a meaningful way with his clinical supervisor and educational supervisor.

It is arguable that Dr T had a narrower practice compared to most GP’s – he provided cover for a residential care home, was a clinical assistant in cardiology and out of hours service covering home visits.  So for example he scored well above the average on his knowledge test, achieving 80% where the average is 62.4%, but dealing with test situations on domestic violence or drug abuse was less his department of activity.

The Tribunal made a finding there was deficient professional performance because the failings were serious and placed patients at risk of harm.  It is worth mentioning here that ‘deficient professional performance’ is one of the grounds on which a doctor’s FTP can be found to be impaired, the other five grounds are misconduct, criminal conviction or caution, adverse physical or mental health, insufficient language knowledge or another regulatory body decision.    The Tribunal did not find Dr T’s FTP was impaired because of that.  They decided that he had remediated, he had insight and he was taking a series of measures to protect against any risk to his practice.

Notwithstanding the fact Dr T was fit to practice a Warning was issued because there had been a failure to keep clinical knowledge and skills up to date and the areas were significant departures from Good Medical Practice.

The Tribunal stated whilst it “did not consider that a warning was required to act as a deterrent for him specifically …a warning was required to maintain public confidence in the profession and declare proper professional standards”.

Dr T’s case is interesting in that whilst he was a GP it appears his niche practice may have left him open to investigation.  He was assessed as a GP seemingly without allowance being made by the GMC for his narrower practice whereas the MPT looked at matters in context.  If you have any fitness to practise queries please do contact us directly for advice and we can provide advice relevant to you.