Meta description: After a criminal charge was dropped, a doctor successfully challenged continued GMC restrictions. What this means for interim order challenges. GMC defence solicitors.

A recent decision of the Court of Session in Scotland provides an important reminder that GMC interim restrictions cannot continue indefinitely without a properly evidenced, proportionate justification.

In Petition of the General Medical Council, [2026] CSOH 75, Lady Tait refused the GMC’s application to extend interim conditional registration restrictions imposed on a doctor after criminal proceedings relating to alleged possession of indecent images of children came to an end.

The judgment does not establish that a dropped or dismissed criminal charge automatically ends a GMC investigation. It does, however, demonstrate that the GMC must identify an evidential basis for continuing restrictions and show why they remain necessary and proportionate.

For doctors facing an Interim Orders Tribunal hearing, or an application to continue existing restrictions, the decision offers practical lessons about evidence, risk assessment and the importance of challenging an order when the underlying circumstances change.

The background to the Scottish case

The doctor had been arrested on suspicion of possessing indecent images of children. He referred himself to the GMC in September 2024, following which the GMC opened a fitness to practise investigation.

The GMC’s Interim Orders Tribunal imposed conditions on his registration. These included additional oversight requirements and restrictions concerning consultations with under-18 patients. The conditions were subsequently maintained at two further interim hearings.

The criminal proceedings later encountered a fundamental evidential difficulty. In January 2026, the Scottish court sustained a plea in bar of trial. The Crown accepted that it would be oppressive to prosecute because there was no conclusive evidence that:

• the doctor had used the device on which the images were found; or
• he could use the specialist software required to access the images.

The criminal proceedings therefore concluded without a trial. The GMC nevertheless sought a further 12-month extension of the interim conditional registration order, taking the restrictions through to April 2027.

The GMC argued that it needed more time to investigate whether the doctor posed a risk to patients. It relied on the proposition that the termination of criminal proceedings does not necessarily mean that there is no ongoing public protection concern.

The doctor opposed the application. He argued that the GMC had identified no clinical risk to patients, had not produced an evidential foundation for its concerns and had failed to progress its own investigation with sufficient focus. He also relied on the serious impact that the restrictions had on his employment and professional life.

What are GMC interim orders?

An interim order is a temporary regulatory measure imposed while a GMC investigation or fitness to practise case is ongoing.

The legal framework is found principally in section 41A of the Medical Act 1983. An interim order may take the form of:

1. Interim suspension : preventing the doctor from practising during the period of the order;
2. Interim conditions : allowing the doctor to practise, but only subject to specified restrictions; or
3. No order : allowing the doctor to practise without interim restrictions.

The purpose of an interim order is not to punish a doctor before the facts have been determined. The focus is whether immediate restrictions are necessary for:

• the protection of patients or members of the public;
• the wider public interest, including confidence in the medical profession; or
• the doctor’s own interests in appropriate cases.

In England and Wales, applications are generally considered by the Medical Practitioners Tribunal Service (MPTS) through an Interim Orders Tribunal. The GMC’s guidance explains more about the interim orders process.

An interim hearing does not determine whether the doctor is guilty of misconduct. It is an assessment of immediate risk and public interest on the evidence available at that stage.

That distinction is important. A serious allegation may justify urgent protective action, but the seriousness of an allegation alone does not remove the need for a reasoned assessment of the individual case.

The test for continuing restrictions

In [2026] CSOH 75, the court emphasised that it had to be satisfied that the proposed extension was:

• necessary for the protection of the public or otherwise in the public interest; and
• proportionate.

The court also made clear that the GMC carried the burden of satisfying it that the statutory criteria were met.

The GMC was right about one general principle: criminal proceedings and regulatory proceedings serve different purposes. The criminal court applies the criminal standard of proof. The GMC’s fitness to practise process is concerned with professional standards, public protection and public confidence, and may involve different evidence and procedures.

Consequently, a decision not to prosecute, a discontinued prosecution or an acquittal does not always prevent the GMC from investigating the underlying conduct.

However, that principle is not a substitute for evidence. The GMC still has to apply the relevant legal test to the doctor’s actual circumstances. It must explain why restrictions remain required and identify the material supporting its assessment of risk.

Lady Tait found that the GMC had not done so. Although the allegation was serious in general terms, the GMC had not adequately addressed the available evidence : or the lack of it : in this particular case. Nor had it realistically explained how the necessary evidence might be obtained after the criminal investigation had failed to establish the relevant evidential link.

The court concluded that there was no current basis for asserting that interim conditional registration was necessary for public protection. It also criticised the lack of urgency and focus in the GMC’s investigation after the criminal proceedings ended.

The petition was refused.

Why the collapse of the criminal case mattered

The judgment should not be read as creating a rule that the GMC must close every investigation after a criminal charge is dropped.

The significance of the criminal outcome was evidential and practical.

Before the criminal case concluded, the GMC had been able to rely on an ongoing police investigation and the unresolved nature of the allegations when seeking interim restrictions. Once the proceedings ended because of a fundamental lack of evidence, the GMC needed to reassess its position.

That reassessment had to consider questions such as:

• What evidence remains available to the GMC?
• Does that evidence establish a continuing risk to patients?
• Is there any clinical or professional connection between the alleged conduct and the doctor’s practice?
• Can conditions manage any identifiable risk?
• Why is an interim order still required while the GMC investigates?
• What steps has the GMC taken, and when is the investigation likely to progress?

The court was not prepared to treat the original allegation as a continuing justification in itself. The evidential position had changed, and the legal assessment had to change with it.

What does this mean for doctors facing an interim order application?

The decision is particularly relevant where a doctor’s practice is restricted following an arrest, charge or police investigation.

A doctor should not assume that an interim order is inevitable, even where the allegation is serious. Equally, a doctor should not assume that a criminal dismissal will automatically resolve the regulatory position.

Each stage requires a separate, evidence-based response.

1. Obtain the evidence behind the application

The GMC’s application should be examined carefully. It is important to identify whether the concerns are based on:

• a conviction or formal finding;
• a charge or arrest only;
• information supplied by the police;
• witness evidence;
• clinical concerns;
• alleged dishonesty or non-disclosure; or
• a broader public confidence argument.

The distinction between suspicion, charge and proven fact should be kept clear. The tribunal is entitled to take allegations seriously, but it must still decide whether restrictions are justified on the evidence before it.

2. Challenge the link to patient risk

Where the allegations do not involve clinical practice, the GMC may rely heavily on public interest and public confidence. Those issues can be important, but they should not be treated as automatic answers.

A robust response should address whether there is any identifiable risk to patients, particularly in the doctor’s proposed role. It may be possible to distinguish between:

• direct clinical risk;
• risk associated with particular patient groups;
• workplace or safeguarding concerns; and
• reputational arguments that do not justify the breadth or duration of the proposed restrictions.

3. Offer proportionate alternatives

If some form of interim protection is considered necessary, the appropriate response may be to propose narrower conditions rather than simply opposing every restriction.

Depending on the facts, alternatives may include:

• supervision by an approved colleague;
• restrictions on particular duties;
• limits on contact with specified patient groups;
• a chaperone requirement;
• occupational health support; or
• regular review of the conditions.

Conditions must be workable, clear and capable of being monitored. Vague or excessive restrictions may be challenged as disproportionate.

4. Revisit the order when circumstances change

Interim orders should not be treated as permanent findings. A material change in circumstances may justify variation or termination.

Examples include:

• criminal charges being withdrawn or dismissed;
• an acquittal;
• new evidence undermining the original concern;
• the police investigation ending;
• the doctor complying with all requirements;
• an expert report addressing risk; or
• significant delay by the GMC in progressing the investigation.

The [2026] CSOH 75 decision shows why the point at which the criminal case ends may be critical. The doctor’s representatives should ask the GMC to explain what independent evidential basis now supports the restrictions.

5. Preserve evidence of professional impact

The practical effect of conditions should be documented. This may include:

• loss of employment or clinical sessions;
• inability to undertake ordinary duties;
• restrictions on training or career progression;
• financial loss;
• impact on professional registration in another jurisdiction; and
• reputational or personal consequences.

These matters will not automatically outweigh public protection, but they are relevant to proportionality. A restriction that has a severe professional impact requires a correspondingly clear justification.

Important limits of the decision

The Scottish case is fact-sensitive and arose in the Court of Session’s jurisdiction. It is not a guarantee that an English or Welsh tribunal or court will reach the same outcome in every case.

The GMC may still investigate conduct after criminal proceedings have ended. It may also rely on evidence that was not sufficient to support a criminal prosecution but is relevant to professional regulation.

In addition, allegations involving indecent images of children are treated as exceptionally serious by the GMC and MPTS. Where the facts are established, the potential regulatory consequences can include suspension or erasure from the medical register.

The decision’s importance lies elsewhere: interim restrictions must be justified by the evidence and the statutory test at the time they are sought or continued. The GMC cannot rely indefinitely on the seriousness of an allegation while failing to demonstrate current risk, public interest or proportionality.

Get advice before an interim order hearing

Doctors who receive notice of an Interim Orders Tribunal hearing should obtain specialist advice immediately. The initial response may influence whether the tribunal imposes suspension, conditions or no order. A later change in the criminal or evidential position may also provide grounds to seek variation or termination.

Tyndel Solicitors represents doctors in GMC investigations, Interim Orders Tribunal proceedings, fitness to practise hearings and appeals. Our GMC defence solicitors and medical licence defence solicitors can advise on the evidence, the applicable legal test and the most effective way to challenge unnecessary or disproportionate restrictions.

This article is for general information only and does not constitute legal advice. Every GMC case depends on its facts, evidence and procedural history.