During the second stage of the MPT hearing, the Tribunal will need to decide whether or not a doctor’s fitness to practice is currently impaired; this is called the impairment stage. The Tribunal is often assisted by evidence presented by the doctor under investigation, which includes testimonials and references from colleagues, patients and other relevant individuals.
Paragraph 34 of the GMC’s Sanction Guidance provides ‘doctors may present references and testimonials to support their good standing in the community or profession’.
This evidence allows the doctor to provide feedback about their clinical practice and character from selected individuals. This could include a statement from individuals that are aware of the concerns about the doctor and who, where appropriate, can comment on the extent to which the doctor has reflected on the concerns and remediated. This feedback will assist the Tribunal with their decision at this stage of the process.
Who can provide a testimonial?
Any individual who knows the doctor in a professional or personal capacity is allowed to provide a testimonial.
- If the author has had significant contact with the doctor in a setting where they are likely to have in-depth knowledge of the doctor’s conduct, performance or health is likely to be useful to a Tribunal.
- The testimonial is less likely to be of assistance to the Tribunal if the author is a distant contact of the doctor, or does not have real knowledge relevant to the matters being considered by the Tribunal.
- It may assist the Tribunal to receive testimonials from friends and family that can demonstrate the doctor’s good character.
The Tribunal will consider any comments made in the testimonial and whether the author is qualified to make those comments. To do this, the Tribunal will want to understand the relationship between the author and the doctor. For example, if the author has recently supervised the doctor, the Tribunal is likely to place more reliance on the information they provide about the doctor’s medical competence. However, if the testimonial is from a friend or family member who is not medically qualified, yet the testimonial comments upon the doctor’s clinical practice, then the Tribunal are less likely to attach the same amount of weight to this.
Conflict of Interest
There are occasions where the testimonial author’s relationship to the doctor creates a conflict of interest. For example, if the author is supervised by the doctor under investigation. Or, if the author is the spouse of the doctor under investigation. In these situations, if the Tribunal considers that the author has any conflicts of interest in relation to the doctor, this could impact how the Tribunal views the testimonial. It is important that the author considers whether they have a conflict of interest, and if so, states this clearly in their statement.
There are strict guidelines setting out how testimonials are obtained at all stages of a GMC investigation, whether at Rule 7 stage or in preparation for an IOT or MPT hearing. We are obligated to disclose the allegations against a doctor to all individuals that we contact for a testimonial. The author of the testimonial must be made aware of the allegations so the GMC is satisfied they are able to provide a balanced and informed opinion. This applies to all cases, except where the allegations relate to the health of a doctor, as matters related to health are treated as confidential.
There is no limit to how many testimonials you submit at each stage, but it is always helpful to a doctor’s case to obtain as many testimonials as possible.