A successful challenge to the High Court against a 3 week suspension resulting in “no action” for the Doctor

Dr Thampi is a Consultant in Obstetrics and Gynaecology of considerable experience. She was referred to the GMC by her former employer, Milton Keynes University Hospital, following an investigation into concerns arising from the instrumental delivery of a baby in October 2016. The original concerns related to the clinical advice and treatment that Dr Thampi had provided as well as her communication with the patient.

Following a protracted GMC investigation, in May 2025, a Medical Practitioners Tribunal (“MPT”) found allegations proved that essentially amounted to failures in communication and consenting.  

The MPT went on to find that Dr Thampi’s fitness to practise was impaired on the grounds of public confidence and maintaining professional standards but not on public protection grounds. In June 2025, the MPT made its determination on sanction, imposing an order of suspension for a period of 3 weeks. The MPT did not order a review hearing or consider an immediate order to be necessary.  

Whilst 3 weeks may seem a very short period of suspension, the impact of a suspension of any length on a doctor’s reputation and career should not be underestimated.

Dr Thampi appealed to the High Court, challenging the MPT’s finding of impairment and, in the alternative, the sanction imposed.   

Impairment

In respect of impairment, it was submitted that the MPT’s decision was flawed because it had considered and placed weight upon a finding of “psychological harm” suffered by the patient.  This had not been the subject of an allegation brought by the GMC.

The Court found that:

“… the MPT was entitled to take into account the impact on Patient A of the proven failings, nonetheless the panel erred when it concluded that Patient A had suffered “psychological harm” as a result of those failings. There was no such allegation before the MPT; there was no expert evidence or relevant reasoning to support the conclusion and Dr Thampi was unfairly denied the opportunity to respond in evidence and submissions.” (para 46)

However, the Court did not consider that this vitiated the MPT’s overall conclusion on impairment.

It was further submitted that the MPT failed to properly weigh up the factors in Dr Thampi’s favour in reaching its decision on impairment. The Court found that the MPT had considered the factors required and was entitled to find that those factors were outweighed by the seriousness of the failings that had been found proved.

Sanction

Turning to sanction, it was submitted on behalf of Dr Thampi that the MPT had failed to appropriately assess the public interest, that the wrong approach had been applied to the necessity for exceptional circumstances when considering taking no action and that there was a failure to adequately consider proportionality.

With regard to exceptional circumstances, it was argued that the MPT had made its decision on sanction on the basis that only exceptional circumstances could justify it making a finding of “no action” where impairment had been found at the previous stage. This requirement is not found in the Medical Act 1983 or the GMC (Fitness to Practise) Rules 2004.  

The Court considered the GMC’s Sanctions Guidance (February 2024), including how paragraphs 20 and 68 of that guidance relate to each other.  

The Court ruled that the guidance “is not prescriptive but indicative”, further stating that: “para. 68 does not prescribe a threshold of exceptional circumstances to justify a decision not to take action against a practitioner whose fitness to practise has been found to be impaired.” (para 70)

The Court found that the MPT had applied exceptional circumstances as a “threshold”, rather than “guidance”. Dr Thampi’s appeal was therefore successful on this ground.

It was further submitted that the MPT failed to properly consider proportionality in reaching its sanction decision. The unopposed evidence before the MPT was that Dr Thampi’s locum post would be terminated if her registration was suspended. The MPT was found to have “failed to grasp the clarity of that evidence”, instead hoping that this consequence could be avoided. 

In also allowing this ground of appeal, the Court ruled:

“Ms Barnfather neatly encapsulated the point thus: by placing insufficient weight on the evidence and hoping that Dr Thampi would not be dismissed, proportionality was weighed against a hypothetical, not an actual, situation. Notwithstanding the seriousness of the failings, the loss of her job would be out of all proportion to Dr Thampi’s failings.” (para 78)

Conclusion 

The Court therefore maintained the finding of impairment but substituted the sanction of suspension with “no action” due to the wrong approach being taken to the sanctions guidance and a failure to have regard to the overarching principle of proportionality.

This will be a very helpful Judgment for defence practitioners and registrants alike, highlighting the following key points:

• The principles from R (El- Baroudy) v. General Medical Council [2013] EWHC 2894 (Admin), that the MPT cannot make causative findings where no allegation is pleaded, are reinforced by paragraph 46 of this judgment.
• Although this case considered the GMC’s 2024 Sanctions Guidance which has now been replaced with the November 2025 guidance, it nevertheless reinforces that guidance is only guidance. There is no threshold of exceptional circumstances in order for MPT panels to reach conclusions of “no action”. This should apply equally to panels applying the new 2025 guidance.   
• The case serves as a reminder that a finding of impairment is a significant finding and a marker in itself, even without the imposition of a sanction.

Matthew Barlow of Clyde & Co and Lydia Barnfather of QEB Hollis Whiteman represented Dr Thampi throughout the MPT and High Court proceedings.