The MYRO Briefing
Independent Healthcare Intelligence
Consent: a process, not a signature
On 1 May 2026 the High Court handed down judgment in Thampi v General Medical Council [2026] EWHC 1036 (Admin) — a decision that ought to be required reading for any practitioner whose clinical work involves consent decisions of consequence. Dr Premila Thampi, a locum obstetrician, had been found impaired by the Medical Practitioners Tribunal in respect of consent failures during an instrumental delivery. The tribunal accepted that she had proceeded with a Kiwi ventouse device and then with forceps despite the patient's stated objection to forceps, and had failed to offer the option of a caesarean section. A three-week suspension was imposed.
The High Court dismissed the challenge to the finding of impairment: a consent failure of this kind was open to the tribunal on the evidence. But it allowed the challenge to sanction, finding the three-week suspension disproportionate having regard to the isolated nature of the incident, the absence of prior concerns, genuine insight and remorse, substantial remediation, and the passage of approximately nine-and-a-half years without repetition. The suspension was quashed and no further action substituted.
The legal standard is patient-centred, not profession-centred
The Supreme Court in Montgomery v Lanarkshire Health Board [2015] UKSC 11 set aside the Bolam test for the disclosure of risks. A doctor must take reasonable care to ensure that a patient is aware of any material risks in the recommended treatment, and of any reasonable alternative or variant treatments. The test of materiality is whether a reasonable person in the patient's position would be likely to attach significance to the risk — or whether the doctor knows or ought reasonably to know that the particular patient would. The duty is to understand what matters to that patient.
Alternatives must be disclosed — with one important qualification
In McCulloch and others v Forth Valley Health Board [2023] UKSC 26 the Supreme Court clarified that whether an alternative is 'reasonable', and therefore something the doctor must proactively raise, is still assessed against professional opinion. The standard for disclosure of risks is patient-centred; the prior question of which alternatives are on the table is not.
The professional standard is unchanged in substance
The GMC's Decision Making and Consent guidance, in force since 9 November 2020 and extended in December 2024 to physician associates and anaesthesia associates, frames consent as an ongoing dialogue. The seven principles begin with the right to be involved and end with the support owed to patients whose right to consent is affected by law. Good Medical Practice 2024 embeds the duty in Domain 2: patients must be given the information they want or need, in a way they can understand, about the condition, the options (including no action), and the potential benefits, risks and uncertainties.
Capacity is presumed; assess where doubt arises
Principle 5 of the GMC guidance restates the legal presumption of capacity. Where capacity is in doubt, the Mental Capacity Act 2005 (England and Wales) or the Adults with Incapacity (Scotland) Act 2000 applies. CQC Regulation 11 — Need for Consent — requires every registered provider in the independent sector to operate lawful consent procedures that address capacity, information disclosure, and the time the patient needs to decide.
What the appraisal portfolio must show
Consent failures that give rise to significant events or complaints must be declared and reflected upon at appraisal, with learning identified and changes documented. The expectation is not perfection but evidenced engagement: where a consent process has fallen short, the responsible officer is looking for a factual account, a measured reflection, the learning extracted, and the changes that followed. Practitioners should ensure their mandatory training includes a current consent module that reflects Montgomery and McCulloch — the LCS Academy mandatory training bundle includes a dedicated consent module within its nine-course CPD bundle.
Appraisal & Revalidation
Policy, Guidance & Practical Tips
GMC opens first detailed survey of LE and SAS doctors in seven years
The GMC has opened its first comprehensive survey of locally employed (LE) and specialty, associate specialist and specialist (SAS) doctors since 2019, targeting approximately 85,000 doctors across the UK. The survey examines roles, motivations, workplace experiences, and access to training and development. Findings are expected later in 2026 and are likely to inform future revalidation guidance for these cohorts. A significant proportion of doctors in independent cosmetic, fertility and private GP practice hold LE or SAS status — responsible officers in independent designated bodies may wish to encourage participation.
Read the GMC announcement →Complaints handling and reflection — what the portfolio must show
Every appraisal cycle, the question recurs: how should a complaint be presented in the portfolio? The professional duty is settled, but the practical expectations are often less clear. The starting point is Good Medical Practice 2024, Domain 2: respond promptly, fully and honestly, and do not allow a patient's complaint to affect the care subsequently provided. The duty is express, unqualified, and applies regardless of sector.
The independent sector has its own particular obligation. CQC Regulation 16 requires every registered provider to operate an accessible and effective complaints system, to investigate every complaint received, and to take necessary and proportionate action. The absence of a working complaints procedure is itself a registrable failing.
The GMC's Compliments and Complaints guidance for revalidation is clear: all formal complaints must be declared at appraisal, and reflection should cover informally resolved complaints and any complaints investigated by regulators or ombudsmen. The discussion at appraisal should focus on the learning and the changes made, not on a rehearsal of the facts.
Practical checklist — what the portfolio should contain for each formal complaint: (1) a brief factual account, not a full case reconstruction; (2) reflection on what happened — communication, system, clinical, or expectation; (3) learning identified; (4) concrete changes made to practice or process; (5) evidence, where possible, that changes have been embedded; (6) the outcome for the patient; (7) any regulator or ombudsman involvement.
The Reflective Practitioner guidance (GMC, Academy of Medical Royal Colleges, COPMeD, Medical Schools Council, January 2021) is explicit: reflective notes should focus on insight gained and action taken, not on a full factual reconstruction. The Parliamentary and Health Service Ombudsman's Principles of Good Complaint Handling provide the benchmark against which any escalated complaint will be assessed.
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GMC Watch
Regulatory Updates
UK health and social care regulators commit to nine anti-racism principles
The GMC, the CQC, the NMC and other UK health and social care regulators have jointly committed to nine shared anti-racism principles — Advancing Workforce Race Equity in Health and Social Care — building on the NHS Race and Health Observatory's Seven Principles of Anti-Racism. Commitments include embedding anti-racism in governance, workforce and inspection processes across all signatory bodies. The direction is clear: anti-racism review is being embedded into the inspection and regulatory framework rather than treated as a separate initiative.
Read the GMC release →DHSC consultation on the GMC Order 2026 — closing date approaches
The Department of Health and Social Care's consultation on the draft General Medical Council Order 2026, opened on 24 March 2026, remains open. As at the date of this issue the page records no amendments and no early close. Responses from designated bodies and connected practitioners — particularly on how the proposed flexibilities would affect revalidation arrangements — should be submitted before the deadline.
Read the consultation →DHSC opens consultation on commercial sunbeds regulation in England
DHSC opened a new consultation on 22 May 2026 under the Sunbeds Act, seeking views on proposals to strengthen safeguards for commercial sunbed use in England — focusing on enforcement against under-18 access and on protecting vulnerable users from UV-related harm. It closes on 14 August 2026. Not directed at medical providers, but relevant to aesthetic clinic operators offering or operating adjacent UV services, and a signal of continued government appetite for tightening regulation of non-surgical aesthetic-adjacent services.
Read the consultation →
MPTS Cases — Cautions & Warnings
Fitness to Practise Outcomes
Dr Eren Battaloglu — Erasure
Outcome: ERASURE
The tribunal found proved a course of serious misconduct directed towards a vulnerable patient — Ms A, who was pregnant — including the formation of an improper personal relationship, the provision of money, attendance at her home and consumption of alcohol with her, the provision of dangerous information about methods of terminating a late-stage pregnancy, and the encouragement to take illegal drugs. NHS England referred the matter to the GMC after Ms A attended the British Pregnancy Advisory Service. Ms A was treated as a vulnerable witness and gave her evidence by video link via an intermediary.
The tribunal concluded that the misconduct was persistent and fundamentally incompatible with continued registration. Erasure was determined as the only sanction sufficient to protect the public and maintain confidence in the profession. The case illustrates the consequences of exploiting a doctor–patient relationship for personal purposes where the patient is vulnerable, and how concerns from third parties — here, the BPAS attendance and NHS England's referral function — can reach the GMC where no colleague reports initially.
Read the MPTS decision →Dr Kausik Ray SUSPENSION 12 MONTHS
Remittal hearing following the High Court's earlier decision in GMC v Ray, in which the 2024 tribunal's sanction had been found insufficient for public protection. Dr Ray had been convicted of sexually assaulting a female colleague and placed on the Sex Offenders Register for five years. Applying the High Court's direction that a doctor remaining on the Sex Offenders Register should not have unrestricted registration, the remittal tribunal imposed a 12-month suspension. Significant remediation and insight moved the tribunal away from erasure but were insufficient to support conditions or no action given continuing statutory registration. The principle is clear: a doctor who remains on the Sex Offenders Register cannot hold unrestricted registration.
Read the MPTS decision →Dr Colin Winter SUSPENSION 12 MONTHS
Dr Winter completed an online application to Holt Doctors, a locum agency, in November 2023 in which he agreed to a declaration whilst knowing he was the subject of an MHPS investigation by the Southern Health and Social Care Trust. He failed to notify Holt Doctors of the investigation in a timely manner, and subsequently failed to disclose the outcome letter to Shrewsbury and Telford Hospital NHS Trust. The tribunal found his conduct dishonest and imposed a 12-month suspension. The case is directly relevant to every designated body engaging locum or agency practitioners: onboarding declarations should ask express questions about active MHPS and GMC matters, and the duty of candour extends to those declarations.
Read the MPTS decision →Dr Vijay Gaikwad ERASURE
Dr Gaikwad, a family GP, was convicted of three counts of sexual assault against patients and sentenced to six years' imprisonment at Bolton Crown Court. The tribunal determined erasure as the only sanction commensurate with the conviction.
Read the MPTS decision →Industry Intelligence
Independent Healthcare Sector
HIW cautions unregistered aesthetic laser clinic — 13 months of unregistered class 3B/4 practice in Flintshire
Healthcare Inspectorate Wales has issued a formal caution under the Care Standards Act 2000 to a provider operating an aesthetic laser clinic in Flintshire offering Class 3B/4 laser and IPL treatments without registration as an independent hospital — a period of unregistered practice of approximately 13 months between June 2024 and July 2025. HIW has confirmed that any service providing laser or IPL aesthetic treatments in Wales must be registered as an independent hospital and that failure to register is a criminal matter.
Read the caution notice →
Clinic 45, Clydebank — nine requirements, twelve recommendations
HIS published its report on Clinic 45 in Clydebank following an announced inspection in January and February 2026. The inspection resulted in nine requirements and twelve recommendations — a notably high number of findings — with an action plan published alongside. For an independent clinic operating within HIS's regulatory ambit, that volume of findings represents a significant compliance challenge and a calibration point for the sector.
Read the report →
Unity Aesthetics, Newtonhill — a clean inspection outcome
In contrast, HIS published a clean-outcome report on Unity Aesthetics in Newtonhill, an independent aesthetics provider in Aberdeenshire. No requirements and no recommendations is a strong outcome and useful evidence that aesthetics-specific inspection findings depend on the operator, not the sector.
Read the report →
Bodyvie Medi-Clinic, Richmond — from inadequate to good
The CQC raised the rating for Bodyvie Medi-Clinic in Richmond — an independent women's health and cosmetic provider — from inadequate to good across all five domains, and lifted special measures, following a February 2026 inspection. Conditions previously placed on its registration have been removed. The CQC noted material improvements in safe recruitment, training, care planning, complaint management, and leadership transparency.
Read the CQC release →
Independent sector reaches record CQC ratings — 94% Good or Outstanding
The Independent Healthcare Providers Network's 2026 quality and safety audit finds that 94% of IHPN members and 92% of independent sector hospitals are now rated Good or Outstanding by the CQC — up from around 70% in 2018. Diagnostic imaging services achieved 87% good or outstanding; community healthcare locations 92%. The trajectory is striking, and the implication for those below the threshold is straightforward.
Read the IHPN report →Subscribe to The MYRO Briefing
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