Doctor wins appeal against GMC dishonesty findings over retrospective patient entries

The Appellant doctor has successfully overturned findings of dishonesty and a three-month suspension imposed by the Medical Practitioners Tribunal, following a High Court ruling that identified serious flaws in the tribunal’s reasoning and approach to evidence.

Background to the case

The appeal in Alam v General Medical Council [2025] EWHC 2907 (Admin) concerned retrospective entries made by the Appellant doctor over the Easter weekend in 2018 at her GP practice in Blackburn. These entries related to whether patients with chronic diseases had been invited for annual reviews, a key metric under the NHS Quality Outcomes Framework (QOF), which affects practice remuneration.

The Medical Practitioners Tribunal had found that the Appellant doctor acted dishonestly in making retrospective entries for 14 patients, concluding she could not have genuinely believed that certain staff had issued verbal invitations. Her fitness to practise was deemed impaired, and she was suspended for three months.

Grounds of appeal

The Appellant doctor appealed under section 40 of the Medical Act 1983 on two grounds:

1. Logical inconsistency in dishonesty findings – The Tribunal failed to take an overall view of its findings, which included both honest and dishonest entries made within minutes of each other, undermining the coherence of its conclusions.
2. Misapplication of the burden of proof – The Tribunal was said to have inferred dishonesty from an absence of evidence, rather than requiring the GMC to prove it on the balance of probabilities.

High Court judgment

HHJ Jarman KC allowed the appeal, quashing the dishonesty findings and the resulting suspension. He found that:

• The Tribunal failed to take an overview of the case, particularly the improbability that the Appellant doctor would switch between honest and dishonest entries in rapid succession. This undermined the credibility of the dishonesty findings.
• The Appellant doctor’s good character was not properly considered, despite extensive testimonials attesting to her integrity. The judge concluded that the Tribunal likely overlooked this factor during its 15-day deliberation.
• The Tribunal’s reasoning suggested a reversal of the burden of proof, particularly in passages where it assessed whether the Appellant doctor could be “confident” that invites had been issued, rather than whether she genuinely believed they had.

The judge noted that while the Tribunal was entitled to evaluate evidence, its failure to consider inherent improbabilities and character evidence amounted to errors of principle. He concluded: “Mistake is more likely than mischief” in the Appellant doctor’s case.

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