Thread by @tribunaltweets

Quick reminder about representation, GMC’s barrister is Mr Ryan Donoghue (RD) and Dr Adrian Harrop’s barrister is MrGiles Powell(GP).

We are waiting to restart soon for today's session covering AH's fitness to practice

Handed ddown in private session 25 mins ago but fitness to practice IS impaired

Going into private session until 1.30pm to determine any sanctions

An abridged version of the decision will be provided to the public soon - it is under preparation - and we will post this when we receive it

AH heard the full decision about 30 minutes ago in a private session. He is now meeting with his legal team to discuss further and for the tribunal to decide on whether any sanction should be imposed. And if so, what it should be.

This details the meaning of Fitness to Practice
gmc-uk.org/-/media/docume…

Thanks @STILLTish

This is the Sanctions Guidance the tribunal will be using in their determination:
gmc-uk.org/-/media/docume…

We're still waiting to go in

Confirm received 2 docs . One of 12 pages from GMC and one from GP. Independent decision starting from the lowest possible. Panel don't have any Qs of the QCs

RP Based on para 4 the importance of the objective to maintain profess standards and good regard of the public. Reputation of the profess is the most importnat. GMC accepts mitigating factors. accept AH has some insight

His insight is very recent, and incomplete say the GMC. The Vice article and didn't engage. Valued at GP practice and no evidence of poor clinical work

Warnings not heeded are an aggravating factor in this case which AH repeatedly failed to do. Letter in 2018, meetings in 2018 that covered SM where he was given guidance

No action isn't a possibility acc to GMC.
Re conditions is usually dealing w health issues or poor knowledge. So GMC feel these aren't approp for AH
Public interest isn't served by conditions

GMC want suspension in AHs case. Discussing paragraphs in the nos 90s of the GMC Sanctions here, eg para 92 & 93. Para 97 is also appropriate

GMC saying multiple departures from expected practice, failure to remediate were unsuccessful altho GMC accepts that insight has moved on since then, at least partly

Erasure - GP doesn't feel this is appropriate and GMC doesn't want to move for this. Again the public profile of the case is important, time to develop his refelective process to be remediated. Suspension is the least

restrictive way forward. Repeated there are no issues with patient safety.
Chair discussion re availabilities. What restrictions have been put on AH? None and we think none were requested. RP needs to check

GP We accepted he was guilty of misconduct. You've seen my submissions. Real issue is the central issue. You've paid no attention to the lack of investigation throughout this process. Context is everything. No fair investigation to contextualise whats happened. Only some context

But not enough understanding of context. Public trust is important but what is the most proportinate way of dealing w this. This is unlikely to be repeated by AH and he's learning. Suspension doesn't remediate but leaves him in the cold

His incomplete understanding can improve
INCAS re remediation in the past was a move awau from the 3 wise men model as it deskills. AH will be deskilled by a suspension, and none of this improves your central concerns of conduct

GP cont... A workable solution wld be a PDP reviewed in 6-12 months requiring reflection. On public confidence: public findings here, AHs acknowledgement and future sanctions ensure this improves confidence

Deterrent effect is important but his actions haven't been that serious to warrant a suspension. There is no patient safety issue as this is only about SM events in 2018-19 (one event in 2020)

Is a suspension therefore reasonable here? For something so long ago. A more focussed remedial approach would be better here
All aggravated charges are from 2018

There's been a paradigm shift in attitude according to Dr Exley recently. GP is not averse to mentorship at all.
Looking at the features when considering a suspension but AH has none of these

Chair Regulation 28 and being removed from the performance list if he's suspended. AH wld have to reapply and it cld take several months to be registered again. So even a very short suspension means he's unable to work for many months more due to the delay

This was GP again and below: He could do non-clinical work, or tertiary care or secondary care but he couldn't work as a GP. And would deskill

RP asked to discuss the implications of a suspension. RP Yes, but it's not what the decision should be based upon. Sanctions simply have to occur. Effect on the profession can supercede the impact on an individual Dr

GP: Without being on the performance list he cannot work as a GP. If out of practice for more than 6 months you need some retraining within GP. So is a Q of proportionality

SM in covered within the wider practice of patient confidence
This is an ideal case where focussed input would work.
With mentorship.
Can I underscore the lack of context and woeful examination by the case

Chair - reread the determination please GP
GP - You don't understand the context when looking at sanctions and you need to understand it

Chair - going into private session now. Can people be available at 2pm tomorrow. This is the earliest we'll reconvene

Public session covering the submissions put forward by both parties to take into consideration regarding possible sanctions is closed at 2.20pm

We will post the redacted Determination of Impairment soon but at the moment it's only visible on my phone white text on a black ground which isn't suitable to post (not easy on the eye!)

Actually, I'm lifting these from a fellow observer who has
a better phone than me!

https://twitter.com/selfcommit2othe/status/1465311954583568385?s=20