The MYRO Briefing

GMC v Tripathi: sanction, sexual motivation and the current Sanctions Guidance test

On 2 July 2026 the High Court handed down judgment in GMC v Tripathi [2026] EWHC 1653 (Admin). A locum GP had been found by an MPT to have carried out an unjustified, sexually motivated breast examination without consent, in the presence of the patient's seven-year-old son. The tribunal suspended him for ten months. The GMC appealed under section 40A of the Medical Act 1983 on the basis that the sanction was too lenient. The Court allowed the appeal on three of four grounds, quashed the suspension, and remitted the case to a freshly constituted tribunal for sanction.

The judgment matters not for the facts alone but for what it says about how tribunals apply the current Sanctions Guidance. The Court held that the tribunal had applied a superseded version of the guidance and failed to weigh properly the gravity of repetition. The correct question, the Court confirmed, is whether the misconduct is "difficult to remediate" — not the older "fundamentally incompatible with continued registration" formulation.

Chaperoning in cosmetic and aesthetic settings — the practical framework

The GMC's guidance on intimate examinations and chaperones remains in force and applies to all settings. In an NHS setting, a chaperone is routinely available and the clinical workflow assumes their presence. In an independent cosmetic or aesthetic setting — particularly a single-clinician clinic — chaperone provision is often weaker. That is not, in itself, an excuse; the professional standard is the same.

The GMC's expectation is that an intimate examination is preceded by an explanation of what the examination will involve and why it is clinically necessary, an offer of a chaperone with a record of the offer and its acceptance or decline, and a documented record of the examination and its indication. Where the clinic cannot provide a trained chaperone, the doctor must consider whether the examination can be deferred until one is available.

What "difficult to remediate" now means for sanction

Tripathi confirms that the current Sanctions Guidance test, whether misconduct is difficult to remediate, is more searching than the previous formulation. Where sexual motivation is found and the conduct occurred in a clinical setting with a vulnerable patient, insight and remediation must be substantial and evidenced — not a paper exercise. The High Court will intervene where a tribunal's sanction is out of step with the seriousness of the underlying conduct, particularly where the applicable guidance has been misapplied.

For designated bodies supporting a connected doctor through an FTP referral involving allegations of this kind, the practical implication is that the evidence of remediation the doctor brings to tribunal will be scrutinised against a higher threshold than it might have been under earlier guidance. Responsible officers should ensure that support offered is directed at genuine, evidenced behavioural change — reflection, formal training on boundaries, occupational-health engagement, supervised practice where appropriate — rather than paperwork.

The chaperone protocol every independent clinic should be able to produce

For designated bodies, three concrete points to check with connected doctors and their clinics. First, does the clinic have a written chaperone policy that reflects current GMC guidance and CQC Regulation 12, and is it dated and signed? Second, is there a mechanism by which the offer of a chaperone is recorded in the notes — including where the patient declines? Third, where a chaperone is not available on the day, what is the clinic's protocol — deferral, or documented risk assessment, or an alternative arrangement — and is it being followed?

The Tripathi judgment is a reminder that when things go wrong in this area, the tribunal, and now the High Court, will look closely at the framework the doctor was working within. A designated body cannot immunise a connected doctor from that scrutiny, but it can ensure that the framework in place is defensible.

Read GMC v Tripathi [2026] EWHC 1653 (Admin) →