Roomi, R (on the application of) v General Medical Council

A professional disciplinary tribunal must determine only the allegations and facts particularised in the notice of hearing. It may consider additional matters only if the notice is amended under the applicable procedural rules and the practitioner has a fair opportunity to respond and adduce evidence. A tribunal cannot rely on unnotified concerns when deciding impairment. The legal assessor must independently advise the tribunal about the limits of its powers and the requirements of fairness. Where the notified allegations have been remedied, the appellate court may allow the appeal without remitting the matter, particularly where substantial delay has occurred and further proceedings would be unreasonable.

The claimant, a registered medical practitioner, appealed against a Fitness to Practise Panel decision finding that his fitness to practise was impaired by deficient professional performance and imposing conditions on his registration for 12 months.

The notified case concerned deficiencies identified in practical tests of surgical skills. At the hearing, the Panel accepted that those deficiencies had been remedied, but nevertheless found continuing impairment based on alleged failures concerning audit, appraisal, education and continuing professional development. Those matters had not formed part of the allegation as presented and the notice had not been amended. The central issue was whether the Panel could rely on them.

1. Appeal allowed. The Panel’s finding of impairment and the conditions imposed on the claimant’s registration were quashed.
2. Under rule 15 of the General Medical Council (Fitness to Practise) Rules Order of Council 2004, the notice of hearing must particularise the allegation and the facts on which it is based. Read with rule 17(3)(a), the practitioner faces only the allegation contained in the notice unless it is properly amended.
3. The Panel had accepted that the deficiencies identified in the notified practical skills assessment had been remedied. It nevertheless relied on alleged failures in audit, appraisal, education and continuing professional development. The hearing had been conducted on the basis that practical surgical skill was the only issue. The Panel neither amended the notice nor gave the claimant a proper opportunity to meet the additional case. That breached the rules and natural justice.
4. A tribunal may raise concerns about matters outside the notice, but it must not rely on them adversely unless the allegation is amended in accordance with the rules and the practitioner has a fair opportunity to respond, including by calling further evidence.
5. The legal assessor is independent. The assessor must explain what the Panel may and may not properly do, even where that advice is unwelcome. Failure to give such advice may result in an otherwise lengthy hearing being rendered unfair.
6. Remittal was inappropriate. Any new allegations would have to be pursued through the proper procedure, but the history, the claimant’s remedial steps and the approximately ten-year delay made further pursuit unreasonable. Finality was required, absent serious grounds to consider that the claimant posed a risk to the public. The registration conditions were removed and costs were awarded to the claimant, subject to detailed assessment if not agreed.

• High Court (Administrative Court): allowed the appeal against the Fitness to Practise Panel’s decision of 20 March 2009. The finding of impairment was quashed, the registration conditions were removed, and costs were awarded to the claimant.