Court of Appeal dismisses doctor’s appeal in GMC fitness to practise case in James v GMC

The Court of Appeal has dismissed an appeal by a doctor in proceedings concerning an allegation of assault against a patient, ruling that the allegation could be returned to the medical regulatory process for further consideration.

In James v General Medical Council [2026] EWCA Civ 1338 (20 October 2026), decided on 20 October 2026, the court considered whether the High Court had been wrong to remit the allegation to the Medical Practitioners Tribunal Service (MPTS) after quashing an earlier tribunal finding.

The case arose from an incident in August 2019 involving a patient during the induction of anaesthesia. The patient became distressed and moved unpredictably. The General Medical Council (GMC) subsequently pursued allegations concerning the doctor’s conduct, including an allegation that the doctor had slapped the patient.

The original Medical Practitioners Tribunal found the allegation proved. However, other allegations, including inappropriate language, prescribing excessive analgesia with the intention of causing retrograde amnesia, and attempting to prevent the incident from being reported, were not proved.

The doctor’s conviction for common assault was overturned on appeal in 2022. In subsequent High Court proceedings, the tribunal’s finding that the doctor had slapped the patient was quashed because of deficiencies in its assessment of the evidence and the reasoning supporting its conclusion.

The High Court nevertheless directed that the allegation be returned to the MPTS rather than bringing the regulatory proceedings to an end.

The doctor challenged that decision, citing the time elapsed since the incident, the history of the proceedings, the prospect of witnesses having to give evidence again and the potential prejudice caused by further delay.

The Court of Appeal dismissed the appeal. It considered the principles governing the remittal of regulatory cases, including the seriousness of the allegation, the reasons for quashing the original decision, the fairness and utility of a further hearing, and the competing interests of the professional and the public.

The court concluded that the High Court judge had been entitled to remit the allegation for further consideration.

The decision did not reinstate the original finding or determine whether the allegation was true. Instead, it confirmed that quashing a tribunal’s finding does not automatically require the underlying regulatory proceedings to be terminated. The allegation remains subject to further consideration within the regulatory process.

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