Impaired but No Sanction: Thampi v General Medical Council [2026] EWHC 1036 (Admin)

Dr Thampi is a Consultant in Obstetrics and Gynaecology. At her Fitness to Practise hearing, she accepted she had failed to obtain informed consent from Patient A and had communicated inappropriately with her. In finding her impaired, the Tribunal noted:

“The Tribunal did appreciate that the misconduct related to one patient and was an isolated incident that Dr Thampi accepted responsibility for and that it was unlikely to be repeated. However, that had been a serious departure from the relevant sections of GMP and the GMC’s 2008 consent guidance … and it had caused a patient in a vulnerable position to undergo a procedure that she did not want. The Tribunal concluded that a finding of no impairment of Dr Thampi’s fitness to practise would undermine the public interest.”

In coming to this view, it took into account that “psychological harm was caused to Patient A”. Ultimately, it went on to impose a sanction of three months’ suspension.

On appeal, the Appellant argued that this reference to psychological harm was inappropriate. The court agreed:

“Although I accept 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.”

However, the error did not vitiate the finding of impairment, given the seriousness of the findings.

More significantly, the Appellant also attacked the approach taken by the MPT to the sanctions guidance. The guidance noted at paragraph 68 that imposing no sanction was unusual but “there may be exceptional circumstances to justify a tribunal taking no action.” The Tribunal rejected this suggestion, observing “the Tribunal did not consider there to be exceptional circumstances in this case that justified it taking no action to protect the public interest.” On the appeal, the court considered the Tribunal had misconstrued the guidance:

“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. As Ms Barnfather submitted (and I accept), para. 68 simply says that there may be exceptional circumstances which justify no action. Para. 68 reminds a panel that no action is an unusual result following a finding of impairment. Ultimately, the panel must reach its own view on the facts of each case.

…

it appears that the panel have applied a threshold of exceptionality when considering whether to take no action… By placing exceptionality at the forefront of its reasoning, the panel appear to have applied it as a threshold and not as a reminder that such an outcome is unusual following a finding of impairment.”

The Tribunal compounded this mistake by failing to take into account the issue of proportionality. The evidence established that any suspension would result in her immediate termination:

“the panel failed to recognise the clarity of the evidence on the prospect of dismissal should her registration be suspended. It hoped to avoid the consequences of suspension by imposing a relatively brief period but in so doing, the panel effectively ignored the stark reality… Notwithstanding the seriousness of the failings, the loss of her job would be out of all proportion to Dr Thampi’s failings especially given the significant mitigation found by the panel.”

In the circumstances – given the insight, the lack of repetition, her clinical excellence, the issue of proportionality – the court considered no sanction was, in fact, necessary. The case is a welcome reminder that a sanction should not be considered a foregone conclusion following a finding of impairment. This is all the more so at the GMC, where there is no ability to sanction with a warning or caution, and therefore a finding of impairment in the public interest alone would otherwise inevitably result in suspension.