GMC Appeal Rights: The Consultation Returns

The government has confirmed that it will launch a fresh supplementary consultation on the General Medical Council’s (GMC) right to appeal fitness to practise decisions. The consultation is expected in September 2026 and reopens an issue that appeared to have been settled earlier this year.

For doctors, this is more than a technical dispute about regulatory legislation. A GMC appeal can require a doctor who has already succeeded before a tribunal to defend that outcome in the High Court, with further legal costs, delay and uncertainty.

This article explains what has changed, what remains the law, and what doctors should consider if the GMC appeals a Medical Practitioners Tribunal Service (MPTS) decision.

What did the draft General Medical Council Order 2026 propose?

The government published the draft General Medical Council Order 2026 consultation in March 2026.

The draft proposed a major restructuring of the GMC’s legislative framework, including reforms to registration, fitness to practise, interim measures and appeals.

On appeal rights, the draft proposed:

• retaining the GMC’s existing right to appeal certain MPTS decisions;
• allowing the GMC to appeal specified interim registration measure decisions;
• giving the Professional Standards Authority (PSA) corresponding powers in relation to certain interim decisions;
• creating new appeal rights for applicants, current registrants and former registrants; and
• establishing a GMC appeal panel for certain decisions made by the Registrar or case examiners.

The government’s proposal to retain the GMC’s existing appeal power is particularly controversial because previous policy had moved towards removing it.

Under the current law, section 40A of the Medical Act 1983 allows the GMC to appeal certain MPTS decisions where it considers that the outcome is insufficient for public protection. This can include a finding of no impairment, a decision to take no action, or a sanction that the GMC considers too lenient.

The draft Order would preserve that power and extend the appeal framework to certain interim registration decisions.

Why has the government decided to re-consult?

In July 2026, the government confirmed that it would re-consult specifically on the GMC’s appeal rights.

The decision followed concerns that the original consultation process did not accurately represent the recommendations of the Mann Review. The British Medical Association (BMA) has argued that the consultation presented retention of the GMC’s appeal right as though it were required by the review, when the review’s recommendations and reasoning required more careful consideration.

The timing has also been criticised. The March consultation opened before the Mann Review was published in full. This created concern that consultees could not properly assess the material said to support the government’s change of policy.

The supplementary consultation is therefore expected to focus specifically on:

• whether the GMC should retain its section 40A appeal right;
• whether that right should be extended to interim registration decisions;
• how the GMC’s appeal role should interact with the PSA’s oversight role; and
• whether the proposed framework provides a fair balance between public protection and the independence of tribunal decision-making.

A significant procedural point is that responses on appeal rights submitted during the first consultation will not be considered for the new exercise. Those who want their views taken into account will need to respond again.

The draft Order has not been made. It must still pass through the required legislative process, including further consultation and parliamentary approval.

What is the BMA challenging?

The BMA has begun legal action against the government. Its challenge concerns the way the government consulted on the retention and expansion of the GMC’s appeal powers.

The BMA’s position is that the consultation was materially misleading. It argues, among other things, that:

1. the government relied on the Mann Review before consultees could properly assess it;
2. the consultation overstated what the review recommended;
3. retaining the GMC’s appeal power reverses previous government policy; and
4. allowing both the GMC and PSA to challenge decisions risks duplication and undermines confidence in the MPTS.

The BMA wants the government to reconsider the policy and consult lawfully on any proposed changes. It has also opposed extending the GMC’s power to interim registration measures.

This is separate from the question of whether an individual doctor can defend an appeal. Even if the political and legal challenge continues, the current section 40A regime remains in force.

What is the GMC’s position?

The GMC has not taken a straightforward position that its appeal right must be retained at all costs. However, it has warned against creating unnecessary regulatory overlap between the GMC and the MPTS.

The MPTS exists to provide a degree of separation between the GMC’s investigative function and the tribunal’s adjudicative role. The concern is that allowing the regulator to appeal its own tribunal’s decisions may weaken the perception of independence.

The government’s counterargument is that an appeal right provides an additional safeguard where a tribunal decision is not sufficient to protect the public. The draft consultation also points to the GMC’s record of using the power relatively infrequently and to changes intended to make the process more transparent.

That disagreement is likely to remain central to the supplementary consultation.

Why does this matter to doctors?

When the GMC appeals an MPTS decision, the doctor is usually the respondent to the appeal, even if the doctor won at tribunal.

That can be difficult to understand. A doctor may have faced a lengthy investigation, prepared for a hearing, given evidence and received a decision in their favour. If the GMC then appeals, the doctor must defend that outcome in further proceedings.

The practical consequences may include:

• additional solicitor and barrister costs;
• court fees and other expenses;
• time away from clinical work;
• continued professional and reputational uncertainty;
• stress for the doctor and their family; and
• a delay before the case is finally resolved.

September 2026 reporting has again highlighted the financial burden that prolonged regulatory proceedings can place on doctors. The issue is particularly serious where a doctor’s defence organisation does not cover every stage of an appeal, or where the doctor must consider potential adverse costs orders.

A successful tribunal outcome does not always mean that the matter has ended.

How does a GMC section 40A appeal work?

A section 40A appeal is not normally a complete rehearing of the original case.

The GMC must identify why it says the tribunal’s decision was insufficient for the protection of the public. The court considers the statutory objectives, including:

• protecting public health, safety and wellbeing;
• maintaining confidence in the medical profession; and
• maintaining proper professional standards and conduct.

The court generally conducts a review rather than hearing all the evidence again. It will give appropriate weight to the tribunal’s factual findings, particularly findings based on witness credibility and evidence heard directly by the tribunal.

However, the court may intervene where there has been:

• an error of law;
• a material misdirection;
• an irrational or unsustainable evaluation;
• inadequate reasoning; or
• a sanction that does not adequately protect the public.

The court may dismiss the GMC’s appeal, allow it and quash the tribunal’s decision, substitute another decision that the tribunal could have made, or remit the case for reconsideration.

Section 40A appeal versus a doctor’s own appeal

The route matters.

A GMC section 40A appeal is brought by the GMC against an MPTS decision. The doctor is the respondent and must defend the tribunal’s decision.

A doctor’s own appeal, generally brought under the separate statutory appeal framework, challenges an adverse decision affecting the doctor. In that situation, the doctor is the appellant and must identify why the decision should be overturned or reconsidered.

The legal tests, procedure and strategic considerations are not identical. A doctor should not assume that preparing a defence to a GMC appeal is the same as appealing a sanction or finding personally.

Any notification from the GMC or court should be sent immediately to specialist GMC defence solicitors. The 28-day time limit applying to GMC appeals is strict, and early advice is essential.

What should a doctor do if the GMC appeals?

A doctor who receives notice of a GMC appeal should:

1. Obtain the sealed appeal documents and grounds. These will identify exactly what the GMC is challenging.
2. Check the deadline. Do not wait until the hearing date before taking advice.
3. Notify your medical defence organisation or insurer. Confirm what representation and costs are covered.
4. Preserve the tribunal record. This includes the evidence, written submissions, witness statements, transcripts and exhibits.
5. Review the tribunal’s reasoning carefully. The strength of the defence will often depend on the recorded findings and the logic supporting them.
6. Avoid informal commentary. Do not discuss the appeal publicly or on social media.
7. Obtain specialist representation. A solicitor experienced in medical regulatory appeals can assess the grounds, evidence and prospects of resisting the appeal.

The tribunal record is especially important. A decision that clearly identifies the issues, explains the factual findings and gives coherent reasons is better placed to withstand appellate scrutiny.

What is the position now?

For now, nothing has changed legally.

The GMC retains its existing section 40A right of appeal. The draft General Medical Council Order 2026 has not been made, and no new appeal regime is currently in force.

Doctors should not assume that the right will be removed, expanded or otherwise changed imminently. The supplementary consultation may influence the final policy, but further legislative steps will still be required.

Tyndel Solicitors represents doctors in GMC investigations, MPTS proceedings and appeals. If you have received notice that the GMC is challenging a tribunal decision, contact our doctors’ defence team promptly.

Frequently asked questions

Can the GMC appeal a decision where a doctor was found not impaired?

Yes. Section 40A can apply to certain decisions where the MPTS finds no impairment or takes no action, if the GMC considers the outcome insufficient for public protection.

Am I the respondent if the GMC appeals?

Usually, yes. The GMC is the appellant and the doctor whose case is being challenged is the respondent.

Is a section 40A appeal a full rehearing?

Generally, no. The court reviews whether the decision was wrong or insufficient for public protection, although the scope of review depends on the grounds and the issues raised.

Has the GMC’s appeal right been removed?

No. It remains in force. The government has confirmed a fresh consultation, but the draft Order has not yet become law.

Do I need specialist representation?

It is strongly advisable. GMC appeals involve specialist statutory provisions, strict deadlines, appellate procedure and potential costs exposure. Early advice can help protect your position.

This article is for general information only and does not constitute legal advice. The law and government proposals may change. Doctors should obtain advice on their individual circumstances.