The Medical Practitioners Tribunal Service (MPTS) has published updated guidance for tribunal panels that clarifies how insight and remediation should be assessed during doctors’ hearings.
The new document, titled Tribunal Guidance for Doctors’ Hearings, introduces a more structured and evidence-based approach, replacing the broader and more advisory tone of previous materials.
Summary of what the new MPTS guidance says about insight and remediation
- Insight: The guidance treats insight as a demonstrable, evolving process rather than a single statement of regret. It focuses on clear evidence that the doctor recognises what went wrong, understands the causes, accepts responsibility, identifies the risk of recurrence, and can explain what they have learnt. Documentary evidence, contemporaneous notes, reflective pieces, and third‑party corroboration are all listed as acceptable forms of proof of insight.
- Remediation: Remediation must be specific, measurable, and appropriate to the regulatory concerns and patient safety risks identified. Remedial steps should show how clinical competence, judgement, or systems‑based failings have been addressed through training, supervised practice, audits, workplace changes, or formal programmes. Evidence of completion, independent verification (supervisors, educators, appraisers), and a plan for how learning will be maintained and embedded in practice are required.
- Link between insight and remediation: Remediation is assessed in light of the depth of insight. Effective remediation both flows from and reinforces insight; where insight is limited, remediation is unlikely to carry weight. The guidance expects a causal chain: identification of error → explanation of cause → tailored remediation → independent evidence of change → ongoing monitoring.
- Assessment approach: Tribunals are instructed to weigh both the quality of evidence and its durability. Short, one‑off courses or unverified attendance are insufficient. Tribunals should consider whether remediation reduces the risk to patients and whether the doctor’s explanations are consistent, believable, and supported by objective indicators. Remediation is not an automatic route to no sanction; it is one factor in a proportionality/risk analysis.
- Practical evidence examples: Supervisor reports, workplace assessments, revalidation/appraisal notes, completed training certificates linked to learning outcomes, reflective case analyses showing cause and effect, audit results demonstrating improved practice, and employer‑lead remediation plans with timelines and monitoring.
How the new guidance differs from the existing MPTS Guidance
- From general to prescriptive: The earlier hearing resources described what insight and remediation are and gave examples and general advice. The new guidance is more prescriptive: it sets out explicit expectations for the form and quality of evidence, the need for independent verification, and minimum characteristics of acceptable remediation.
- Greater emphasis on measurable outcomes: The existing material accepted reflective statements and CPD evidence more broadly. The new guidance demands remediation with measurable, patient‑safety‑linked outcomes and evidence that change has been embedded and sustained.
- Stricter scrutiny of reflective statements: Previously, a well‑worded reflection could be persuasive; the new guidance stresses corroboration. Tribunals are warned to treat unsupported reflections cautiously and to look for external validation.
- Clearer causal chain requirement: The new guidance makes explicit that remediation must directly address the causes identified by the doctor’s insight. Earlier material discussed insight and remediation largely as complementary factors without requiring a tight, evidenced connection.
- Structured examples and templates: The new guidance provides more structured examples of acceptable remediation plans and the kind of supervision/verification statements that carry weight, whereas the older resources were more descriptive and advisory.
- Risk‑focused proportionality: The updated guidance frames both insight and remediation squarely within the tribunal’s statutory task of protecting patients and promoting public confidence, instructing panels to assess whether remediation materially reduces the specific risk identified rather than simply demonstrating contrition.
- Practical implications for presenters and witnesses: The new guidance gives more explicit direction for how evidence should be presented (timelines, independent attestations, specific learning outcomes) compared with the broader tips in the existing materials.
Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.