Interim Orders Tribunal and Interim Measures Tribunal (Advocacy Services)

Section 41A of the Medical Act 1983 (as amended) provides the power for an Interim Order Tribunal (IOT) of the Medical Practitioners Tribunal Service (MPTS) to impose an interim order of suspension or conditions on a doctor’s registration where such an order is necessary for the protection of members of the public or is otherwise in the public interest, or is in the interests of the practitioner.

Similarly, Article 11 of the Anaesthesia Associates and Physician Associates Order 2024 provides the power for an Interim Measures Tribunal (IMT) of the MPTS to impose an interim order of suspension or conditions on an anaesthesia associate’s or physician associate’s registration where such an order is necessary for the protection of members of the public or is otherwise in the public interest, or is in the interests of the associate.

Under both an IOT and IMT an interim order/measure, for an initial period of up to 18 months, may be imposed. At the end of the initial period, the interim order/measure may be extended by the High Court, on application by the GMC. Any extension is for a maximum of 12 months, although there is no limit on the number of extensions that may be sought.

The legislation requires that once an interim order/measure has been imposed, it is reviewed at regular intervals (normally every 6 months), both before and after any extension authorised by the High Court.

The GMC are currently engaged in regulatory reform and at some point (probably not within the duration of this contract) the legislation which currently governs IOT’s may become more aligned (including in terms of naming convention) with IMT’s. None of that on-going regulatory reform is expected to impact on this contract.

The only point of note relevant to this contract is that the MPTS currently elect to empanel an IMT separately from an IOT. It is possible that the MPTS may at some point during the term of this contract choose to ask an empaneled IOT to sit as an IMT. Because IMT hearings are so infrequent (see below) the current MPTS approach means that if an advocate is instructed in an IMT they are likely to only have one case allocated to their list that day.

Interim Orders Tribunal (IOT) Sessions

During 2024 there were 272 IOT hearing sessions. Although no guarantees of future volumes can be given, on the basis of current volumes we would anticipate the need to plan for a minimum of 1 IOT session per working day and a maximum of 2 on some occasions. In 2024 there were 2 IOT sessions on 37 days.

From time to time sessions are removed from the list. In 2024, 17 hearing sessions were cancelled. The GMC would expect to always be able to provide at least 7 days’ notice of cancellation of a session and in those circumstances would not expect to pay a cancellation fee.

IOT sessions vary in length. A typical IOT session will include 3-5 cases, commence at 9:30am and can last for anything between a couple of hours and the entire working day. The vast majority conclude no later than 4:30pm.

The GMC’s in-house legal team is responsible for preparing cases both for initial and review hearings at the IOT.

The vast majority of IOT sit remotely using MS Teams. If the IOT do sit in person that is at that MPTS Hearing Centre in Manchester. An IOT will normally only sit in person at the request of the doctor and when a public hearing is requested. That has only happened on a few occasions in 2025 and the GMC anticipate the same during the term of this contract. Tenderers should presume that at least 95% of hearings will be serviced remotely via MS Teams.

Interim Measures Tribunal (IMT) Session

IMT sessions are currently very rare. There has been 1 in 2025 which sat remotely via MS Teams. There is expected to be an increase in these numbers, but not to a materially significant extent.

Currently the MPTS lists IMT sessions as a separate additional tribunal. This could be subject to review in future.

Scope of requirement

This Tender relates to the provision of all advocacy before the Interim Orders Tribunal (IOT) and Interim Measures Tribunal (IMT). In relation to IOT’s the advocate can expect a mix of new and review hearings to be listed on one day. In relation to IMT’s, (unless the MPTS choose in the future to incorporate the case within at IOT list) the advocate can expect one case to be listed (either a new or review). All cases are prepared for hearing by a specialist team within the in-house legal team and the advocates role is limited to presenting our case at hearing and feeding back on outcome.

This Tender does not include advocacy services in relation to applications for extension orders in the High Court or for defending challenges issued in the High Court.

Counsel/Advocate Requirements

The successful tenderer will be required to deliver high quality specialist advocacy services on behalf of the GMC in respect of all cases heard before the IOT and IMT throughout the period of the contract. This will involve provision of specialist Counsel/Advocates who are approved by the GMC and meet minimum requirements (as defined by the GMC from time to time), in relation to level of experience, expertise and relevant training.

Current GMC minimum requirements for Counsel/Advocates are:

• No less than five years call
• Significant advocacy experience of regulatory or similar proceedings (e.g. crime)
• Completion of GMC delivered training, including GMC Connect training if required (see Operational Requirements)
• Pre-commencement shadowing of Counsel currently conducting IOT hearings by all Counsel/Advocates
• Successful completion of a probationary period during which Counsel/Advocates will be shadowed at IOT.

Given the data referred to above the successful tenderer will need to guarantee availability of two Counsel / Advocates each working day should that be required.

Operational Requirements

Counsel/Advocates will receive access to the IOT/IMT case bundles from the GMC’s in-house legal team, with brief covering Instructions to Counsel via GMC Connect, a secure electronic delivery system no later than 5 days prior to the hearing;

Counsel/Advocates will receive confirmation from the GMC’s in-house legal team no later than 48 hours before the hearing as to which Order (Conditions or Suspension) should be sought by Counsel;

Counsel/Advocates are responsible for reviewing all case papers ahead of the hearing and identifying to their instructing legal preparation assistant no later than 24 hours before the hearing whether there appear to be any issues with the case, the sanction submission, proof of service or any other documentation included within the case papers;

Counsel/Advocates will join a pre-arranged Microsoft Teams video call with the GMC legal preparation adviser by 09:00am on the day of the IOT/IMT session, prior to the session commencing at 09:30am;

In the rare event parties apply and MPTS Case Management direct an in person hearing at St James Building, Manchester: Counsel / Advocates to arrive at the MPTS Hearing Centre no later than 9am on any given hearing date.

Counsel/Advocates will seek clarification of any instructions required on the day of the hearing from the GMC in-house legal team as instructed. The GMC will ensure that Counsel/ Advocates are in a position to obtain instructions at all times;

The GMC operate a paperless hearing process. Counsel/Advocates are required to present the case remotely via a Microsoft Teams video call using their own secure device which is linked with GMC Connect;

Counsel/Advocates to provide post hearing analysis to the GMC within 48 hours of the hearing. This is in accordance with GMC guidance on a pro forma attendance note provided by the GMC.

Client Care Requirements

The successful tenderer will be required to deliver high quality client care (as defined by the GMC from time to time).

Current GMC minimum requirements for client care are:

• An account manager who will be responsible for overall contract provision
• The account manager to meet regularly (virtually or in person) with the contract managers at the GMC (no less than once every quarter)
• To respond to any reasonable requests; such reasonable requests to include demonstrating ED&I considerations in the list of Advocates advanced to undertake the work, the provision of management information and the removal of any Counsel/Advocate who the GMC assess as unsuccessful at probation (or subsequently) from their IOT list of Advocates
• A designated individual who will be responsible for all operational management and be the first point of contact for the GMC in relation to day to day matter, including assurance that instructions have been received from the GMC in good time ahead of IOT/IMT sessions
• If requested, to prepare and deliver occasional complimentary training to the GMC in-house legal team in relation to matters pertaining to interim orders
• At contract end to assist the GMC in the provision of a smooth transition of advocacy services to any new supplier.