GMC v Anjum: what the case means for doctors facing Fitness to Practise allegations

General Medical Council (GMC) appeals to the High Court against decisions of the Medical Practitioners Tribunal Service (MPT) are rare. In 2025, the GMC only appealed five cases, all involving allegations of sexual misconduct. Appeals are generally reserved for cases where the GMC contends that a decision made by the MPT panel is wrong and/or unjust because of a serious irregularity.

This Keynote summarises GMC v Anjum, in which Healthcare Litigation partner Tracy Sell-Peters and senior associate Sharon Buckham successfully opposed a GMC appeal, and why input from specialist lawyers at the outset is so important.

Background: MPTS decision and GMC’s appeal to the High Court

The client, a consultant anaesthetist, faced an MPT Fitness to Practise hearing. He admitted that he had left an anaesthetised patient in theatre to go to the bathroom but then engaged in sexual activity whilst absent from theatre.

The tribunal found serious professional misconduct but concluded that the doctor’s fitness to practise was not impaired. They imposed a warning.

The GMC appealed the decision to the High Court under s40 Medical Act 1983. The GMC’s submissions were that the tribunal’s decision was wrong and/or unjust because of a serious irregularity, including that the tribunal:

• attached excessive weight to the doctor’s remediation and insight; and
• failed properly to address in its reasoning (a) the seriousness of the misconduct or (b) the impact of making no finding of impairment on (i) public confidence in the medical profession and/or (ii) proper professional standards and conduct.

The GMC asked the High Court to quash the tribunal’s decision, and either substitute its own decision on impairment or remit it to the MPT to reconsider impairment, and for the MPT to determine sanction.

The Honourable Mrs Justice Foster dismissed the appeal. In doing so, she emphasised that the tribunal had acknowledged the seriousness of the allegations. She did not accept that the allegations should be characterised as sexual misconduct, describing his conduct instead as a doctor putting his own needs above that of his patient.

Why is this important?

1. Serious misconduct does not automatically mean current impairment

This case is a reminder of a fundamental distinction in medical regulation: the seriousness of conduct versus the doctor’s current fitness to practise – or whether that conduct means the doctor poses a current and ongoing risk.

The impairment analysis considers current risk and the public interest, including the extent to which the doctor has demonstrated:

• genuine insight (acceptance, understanding, learning);
• credible remediation (practical steps taken, sustained over time); and
• a reduced risk of repetition, supported by objective evidence.

2. Remediation and insight are crucial, not optional

When a case goes to hearing, panels look for evidence of remediation and insight that is:

• early and consistent;
• targeted on the concerns;
• evidenced with documents such as training and supervision records addressing the issues, and testimonials.

This is particularly important where allegations include matters that the regulator deems to be most serious, such as sexual misconduct and dishonesty.

3. Early legal input is vital

Referral to the GMC is inevitable in a case like this, making early legal input crucial, because much of what happens at the initial hospital investigation stage will be considered later on by the GMC and MPT. Sometimes doctors find the initial hospital investigation extremely stressful, or, conversely, they fail to grasp the gravity of the situation, treating it almost flippantly. For these reasons and more, it is rare for an unrepresented doctor to be able to give accurate, clear, and complete factual evidence, as well as to demonstrate the appropriate insight and remediation. The doctor’s stated position in the initial hospital investigation can be very hard to shift later on, and errors in the factual evidence can be interpreted as dishonesty. But with specialist legal input, even with allegations at the most serious end of the spectrum (as here), the doctor has a considerably better chance of giving factual evidence that will remain correct and consistent however many stages follow the hospital investigation, and of demonstrating early and thorough remediation and insight.

What does this mean for doctors and their indemnifiers?

If a hospital opens an investigation into a GMC registrant where there are allegations which could be considered serious misconduct, particularly any sexual misconduct or dishonesty, specialist lawyers should be appointed immediately. The new MPT sanctions guidance and bandings (in effect since 24 November 2025, which are clearly influenced by criminal sentencing guidelines) make this even more important.

An unrepresented doctor in a hospital investigation can inadvertently damage their position in ways that can be difficult, if not impossible, to undo. For example:

• Inconsistent accounts may exist across different investigation processes, harming the doctor’s credibility, particularly in a hearing where they will be cross-examined;
• Evidence of remediation may be absent or weak; and
• Opportunities to demonstrate insight and improved practice may have been missed.

This can increase the risk of referral to the GMC, or of the referral being wider in scope. This increases the cost for the indemnifier and the risk and reputational damage for the doctor.

A registrant’s ability to demonstrate meaningful reflection, learning, and sustained changes to practice (supported by objective evidence) can be central to how a hospital, the GMC, or a MPT panel assesses current risk, impairment, and the appropriate outcome.

Done properly, it helps the practitioner address the concerns, demonstrate insight, and provide assurance that there is no risk of repetition, supporting safe practice and protecting patients. In a healthcare sector that is often under strain, it is particularly worthwhile when appropriate remediation enables a doctor to return to practice safely, rather than leaving medicine altogether – benefitting the profession as a whole and, ultimately, the patients who rely on it.

If you are a doctor, or other healthcare professional, and you are facing a Fitness to Practise allegation, please contact Tracy Sell-Peters. Tracy and her team provide specialist advice and case strategy and can act from the earliest stages of an investigation, right through to proceedings.

If you are an insurer or indemnifier who arranges and funds doctors’ representation in hospital and GMC investigations into professional conduct allegations, please contact Tracy Sell-Peters.

Tracy and Sharon Buckham were appointed to act for the doctor when the Trust started a disciplinary investigation and continued to act throughout the GMC investigation, MPT hearing, and the High Court appeal.