Interim Orders Tribunal (IOT) – A Brief Overview 

The General Medical Council (GMC) may decide to refer a case to an Interim Orders Tribunal (IOT) at any point during its investigation of allegations regarding a doctor’s fitness to practise. The GMC’s decision to refer a case to an IOT hearing will depend on whether the information gathered during an investigation means that the GMC believes an interim order is needed.

The allegations leading to referral to interim orders tribunal will fall within one or
more of the following categories:

  • Misconduct
  • Deficient professional performance
  • Conviction/caution
  • Adverse physical or mental health
  • Not having the necessary knowledge of English
  • Determination by another regulatory authority

The IOT will not make findings of fact about the allegations, and will not decide whether your fitness to practise is impaired. Instead, the IOT will assess the risk posed if your practise remains unrestricted during the GMC’s investigation.

If the IOT considers it necessary to do so, it may make an Interim Order, either placing conditions on or suspending your registration.  The IOT will decide the length of the Order, up to a maximum of 18 months. The Interim Order may be extended beyond the initial length of the Order by Order of the High Court. 


If the GMC chooses to refer a doctor to an Interim Orders Tribunal, it will write to inform them of this and the reasons for the referral.  The GMC letter will also include a copy of any documents they intend to present to the IOT.

You will also receive a written Notice of Hearing from the MPTS at least seven days before your hearing, which will:

  • Give the date, time and venue of the hearing
  • Confirm that you have the right to attend the hearing and be represented
  • Confirm that the hearing can proceed in your absence if the interim orders tribunal is satisfied that you have been given notice of the hearing
  • Explain the interim orders tribunal’s powers.

There is no requirement for a doctor to attend an IOT however a hearing may go ahead despite the doctor’s absence particularly if the tribunal is satisfied that the doctor has been given notice of the hearing and it is appropriate to proceed in your absence.  In limited circumstances, a short postponement might be agreed. 

Doctors have a right to be represented.  In fact, the MPTS guidance makes clear that a doctor should “as soon as you receive notice that the GMC” take “urgent action to decide how you will be represented at that hearing”.

Review of Appeal? 

A decision to impose an Interim Order takes effect immediately. Where an Interim Order has been imposed, a doctor can appeal the Order to the High Court.  

However, in some circumstances, it may be more effective for a doctor to consider an early review of their Interim Order.  Under normal circumstances, if an IOT decides to impose an Interim Order, the Order must be reviewed within the first six months of it coming into force and then at intervals of at least every six months. 

However, the MPTS has the discretion to consider an early review of an Interim Order when new evidence, relevant to the current Interim Order becomes available, which could mean the current Order is no longer appropriate.  Both the GMC and a doctor can apply to the MTPS for an early review of an interim order. 

The GMC may refer a case to an Interim Orders Tribunal at any point during its investigation.  This may mean that an Interim Order is sought at an early stage in the GMC’s investigation, before it may have had sight of all the relevant facts and/or information.  Therefore, if the IOT did not see all the evidence that might have persuaded them to come to a different conclusion, or there is new evidence, an early review may be more appropriate. 

Furthermore, it might become apparent during the GMC’s investigation that there is no case to answer or that a doctor has demonstrated sufficient insight and remediation to close the investigation.  Under these circumstances, an early review of an Interim Order may also be appropriate. 

In certain circumstances, a review of an interim order can take place without the need to attend a hearing.  For a review ‘on papers’ to go ahead, cases must meet the following conditions.

  • The doctor and the GMC must agree on a proposed outcome (such as where there is no case to answer or a doctor has demonstrated remediation);
  • There must be enough time to prepare for a review; and if applicable
  • A doctor must have supply evidence that they have complied with existing conditions.

Legal Representation

Whether to appeal or to consider an early review of an Interim Order will depend on the individual circumstances of your case.  It is strongly advisable that you seek specialist legal advice when considering your options.  A specialist fitness to practise barrister will assess your case and be able to provide you with advice on the strength of your case for an early review. 

An expert legal advisor will also give an opinion on whether the IOT panel came to a decision that was wrong or disproportionate, in which case you may consider an appeal to the High Court.

In either case, you should seek legal advice at the earliest possible opportunity.  In doing so, you will have the benefit of clear advice and approach from the outset of your case and allow your legal representation sufficient time to review your case and prepare your response without any unnecessary delay.  This is particularly important if an early review of your Interim Order is appropriate.

Kings View Chambers have a proven track record of success, acting for a range of health and care professionals facing fitness to practise issues.  You can read more about our case success, our excellent reviews and contact us for a free, no obligation case assessment.