Sanctions
Warnings
Where the GMC threshold for a full investigation has not been met, namely your fitness to practise is not impaired, it is still open to the GMC to issue a warning if they believe there has been a significant departure from Good Medical Practice or a significant concern following a GMC assessment. A Tribunal may also issue a warning where the facts relevant to an allegation referred to it have been proved and they apply the same test as the GMC. The GMC or MPTS must consider your interests and those of patients in deciding whether it is proportionate to issue a warning.
What is a Warning?
A warning is formal warning issued by the GMC or MPTS. It would usually record the allegation and established facts regarding the allegation. It will ordinarily state that there has been a breach of some standard and it should not be repeated.
A warning is not action on your registration (in the way that conditions or undertakings are) because it does not restrict your medical practice. It is a formal response to mark a lapse. They are published on the medical register. A warning stays on the register for two years after which time they are removed and no longer disclosed to general enquirers.
The GMC will retain the record and will disclose them to employers. The GMC retain them to monitor whether there has been a repetition and they would be considered if another fitness to practise issue arose in the future.
The GMC’s Guidance on Warnings provides that there are a range of factors to take into account in deciding whether a Warning is appropriate.
The level of insight into the failing; a genuine expression of regret/apology; previous good history; whether the incident was isolated or whether there has been any repetition; any indicators as to the likelihood of the concerns being repeated; any rehabilitative/ corrective steps being taken; relevant and appropriate references and testimonials.
In reality it is often worth pointing out to a Tribunal that a warning would serve no purpose and so should not be issued.
We can give you advice on your case and any sanction. Each matter turns on its own facts and there will be those cases where a Warning or any sanction should be strenuously challenged and others where it would may be desirable to spare the risk of the case and any alternative sanction escalating.
An example of a relatively recent case issuing a warning involved numerous clinical failings allegations in respect of one patient relating to taking patient history, adequate examination, record keeping and though there were clinical errors ultimately the patient was not harmed. There were also systemic failures at the Trust as a background to the incidents. The Tribunal found misconduct but not fitness to practise impairment. Taking into account an unblemished career history, sincere apologies, sufficient remediation, sufficient but not complete insight, and that whilst the errors related to one patient they were multiple, it was found a warning was the proportionate sanction for Dr V.
In the case of Dr G a warning was imposed and the Tribunal explicitly accepted that warnings have a deterrent effect and highlight to the wider profession certain behaviours are unacceptable. The case concerned a one-off incident in respect of giving a patient full information, fitness to practise was not impaired and Dr G worked in a difficult environment.
