Interim orders: are they wrong in principle?

Interim orders exist to protect patients, but when fitness to practise cases take years to conclude, are they becoming a punishment before the facts have even been tested? Jonathan Meadows weighs up the ethics.

I used to be the one asking for the order.

As a solicitor for the GDC and former head of prosecutions, my team’s role, amongst others, was to argue that a dental professional should not be working while the allegations against them were resolved. These days I sit on the other side of the room, defending them, and the view from that chair is very different.

Recent discussion of the impact of fitness to practise delays landed with me harder than most. Because the stress of proceedings, real as it is, is only half the story. The compound effect is starker: for many dentists, the career is effectively over long before a single factual allegation is ever decided.

Here is how it happens. A complaint is made about you. The GDC opens an investigation. You cooperate, you carry on treating patients, and nothing further happens. Then, perhaps within weeks, months, or even years later, you are called to an interim order hearing, where the GDC argues you pose a risk so immediate that you cannot be allowed to work while the case is resolved.

Nothing has been proved. Nothing may ever be proved. But from that day, everything changes. And the GDC’s new Fitness to Practise Statistical Report 2025 lets us put numbers on just how much changes and for how long. It raises a question the profession asks quietly all the time, and deserves to have answered out loud: is it ever right to restrict a professional before anything has been proved against them? Are interim orders wrong in principle?

What is the case for interim orders?

Let’s be fair to the orders first, because the case for them is real.

Regulation exists to protect patients, and some risks cannot wait for a final hearing. A dentist alleged to be practising while seriously impaired, or facing credible allegations of deliberate harm, presents a problem that a hearing years away does not solve. In principle, a holding measure for the genuinely urgent case is not just defensible; it would be negligent not to have one.

And the legal design reflects that narrow purpose. An interim order, whether a suspension or conditions on your practice, is not a finding and not a sanction. The committee that imposes one makes no findings of fact at all. The order can only be made where it is necessary: to protect the public, otherwise in the public interest, or in the registrant’s own interests. Necessary. Not convenient, not reassuring, not ‘the allegation sounds serious’.

So the honest answer to the headline question is no: interim orders are not wrong in principle. A narrow emergency power, strictly policed, is something every serious regulatory system needs.

But that answer assumes the order is what the law says it is: a short-term measure, bridging a brief gap until the facts are tested. The GDC’s own data shows it is nothing of the kind.

How long is ‘interim’ exactly?

Follow a case through the GDC’s 2025 report, using the regulator’s own average timescales at each stage.

A concern arrives. The assessment stage, the investigation itself, averages 78 working weeks from the concern being received to a final assessment decision. If the case is referred on, the case examiner stage adds an average of 36 working weeks. And if the case examiners refer it to a hearing, the wait from that decision to the initial committee hearing averages roughly another year: 54 working weeks on the GDC’s own figures.

Add it up. On the GDC’s own published stage averages, a case that goes the distance takes 168 working weeks, well over three years, from the concern arriving to the hearing that first tests whether any of it is true.

Now set one more number beside that. The average time from a referral to the Interim Orders Committee to the hearing taking place: 19 working days.

That is the machinery in full view. Restriction moves in days. Vindication moves in years. And in 2025 the machinery of restriction was busy: 149 registrants referred to the IOC, more than in any of the previous three years, with 70% of initial hearings resulting in an order, up sharply from 62% the year before. In all, 104 dental professionals were restricted before any allegation against them was proved.

What does delay compound?

This is where the word compound earns its place. Delay does not merely extend an interim order. It multiplies its effects at every stage.

It compounds the financial damage. A suspension stops you earning from day one, but a three-year process turns a bridging measure into the loss of a career’s worth of income. Associates lose list numbers, practice owners face locum costs and, eventually, questions about the practice’s survival. Conditions compound too: a supervision requirement that a practice can absorb for six months becomes unemployability over three years.

It compounds beyond the order itself. The law allows an initial interim order for up to 18 months. On the GDC’s average timeline, the process simply outlasts it, so the order must be extended, and often extended again, each renewal restarting the clock on a restriction that was sold as temporary. The register entry, published against your name and attached to untested allegations, sits there for the duration.

It compounds into permanence. Here is the cruellest arithmetic. Three years out of clinical practice means deskilling, and deskilling then becomes its own reason for restriction, whatever the outcome on the facts. A vindicated dentist returns, if at all, to a practice that no longer exists, patients who have gone elsewhere, and skills a panel may now say need supervised rebuilding. The order was interim; its consequences are not. That is what it means to say the career is over before the allegations are decided.

And, on the courts’ reasoning, it compounds the evidence the other way.

What happens at the end of interim orders?

Just 18 dental professionals were erased in 2025, unchanged from 2024, and 0.01% of all registrants. And of the 110 initial Professional Conduct Committee (PCC) hearings held, more than a third (38) ended with no sanction at all.

Which raises the question the report cannot answer, because no regulator routinely publishes it: of the registrants placed under an interim order, how many were never subsequently found impaired? How many carried a restriction through that three-year pipeline and then walked out of their final hearing with nothing found against them?

The omission is more conspicuous than ever, because this is the report in which the GDC proclaims its ongoing commitment to increasing transparency. The foreword announces expanded analysis for every stage of the process. Every stage, it seems, except the join between restriction and outcome. The courts already accept it happens in Northover v Social Work England (2020), the High Court acknowledged that interim restrictions will sometimes ‘turn out to have been unjustified because the allegations are not found proved’, calling that ‘a great misfortune’. A misfortune of unknown frequency, compounded over a three-year timeline, is not something a regulator should decline to count.

Does the law offer any protection?

More than many dentists realise, because the courts have been tightening the test. In NMC versus Persand (2023), the High Court demanded an ‘intense focus’ on precisely how and why the evidence shows patients are at risk and held that a vague sense of public unease is not enough; if it were, it would justify suspension in almost every serious case.

To its credit, the GDC’s foreword concedes the underlying problem: investigations can take too long and feel overly complex, breeding mistrust, unfairness and fear of the process itself, with consequences for mental health and wellbeing. That candour is welcome. But candour about delay, combined with a rising rate of restriction imposed at the front of that delay, is exactly the combination the principle cannot bear.

So what’s the fix?

Not abolition: triage. An interim order is the regulator’s own declaration that a case sits in its most serious category, and that declaration should carry consequences for the case, not just the registrant. The moment an order is imposed, the case should leave the general queue: evidence fast-tracked, disclosure prioritised, the matter listed before a final committee in the shortest time the process will bear.

And who pays for triage? On the current model, the money is already being spent – on the wrong thing.

Every interim order that outlives its 18-month lifespan forces the GDC to the High Court for an extension: counsel instructed, an application drafted, a hearing listed, and often the exercise repeated a year later. On the GDC’s own averages, a restricted case cannot conclude inside 18 months, so extension litigation is not an occasional overhead. It is a structural cost, built into the timeline, recurring by design. The effect is that money is spent each year certifying the delay rather than curing it.

Redirecting funds

Now run the money the other way. Fast-track every restricted case to a final hearing within the 18-month window and the extension applications largely disappear: no counsel’s fees, no court fees, no case-management time spent justifying to a judge why the matter still isn’t ready. That saving alone funds a substantial part of a front-loaded evidence team whose sole task is to get restricted cases hearing-ready first.

The second dividend is larger and less obvious. Roughly a hundred registrants a year are restricted at the IOC. Under the current model, those cases then re-enter the general queue and consume the same post-case-examiner investigative resource as everything else, over a timescale of years. Pull them out, resolve them in months, and that is a hundred-plus cases a year lifted off the standard pipeline. This is not new work requiring new lawyers, but the same work done earlier by staff redeployed from the queue those cases would otherwise have clogged. The caseload doesn’t grow; it re-sequences.

Which is the point custody time limits made decades ago in criminal cases: obliging the state to hurry when it restricts someone isn’t just fairer. It’s cheaper than paying, year after year, for permission to be slow. Triage isn’t a spending commitment. It’s the redirection of money currently spent prolonging the very orders the system should be racing to test.

What’s the takeaway on interim orders?

Here is where I land. Interim orders are right in principle, and the principle is being dismantled by arithmetic. A measure that is protective at 19 days becomes punitive at three years, because everything it does to a professional compounds over time while the justification for it, on Pestano, weakens over the same period. The slower the system, the higher the true cost of every order, and the harder the necessity test should bite, with committees holding full knowledge of what an order now actually means: not 18 months, but a multi-year restriction on the GDC’s own averages, unless and until restricted cases are prioritised as they should be.

If you walk into an interim order hearing planning to prove your innocence, you have misunderstood the hearing. It is not a trial. The committee will not resolve disputed facts or hear from the complainant; the allegations are usually taken at or near their highest. The registrant who spends the hearing insisting they did not do it is answering a question the committee is not asking.

The committee is asking three things. Does the evidence hang together, or is it assertion stacked on assertion? Can the risk be managed through conditions, supervision or an informed practice, without stopping you working? And is any order truly necessary at all?

What can we learn?

That is where the timeline belongs. Put the GDC’s own averages in front of the committee: an order imposed today is not a short bridge but, in practice, a multi-year restriction, and proportionality must be judged against that reality. Gather the evidence early: appraisals, audits, training records, patient feedback, a statement from your practice. Keep gathering it, because at every review and extension, each further month of safe practice strengthens the case that the order is not necessary. And be clear-eyed: blanket denial with no engagement on risk reads as a lack of insight, which inflates perceived risk, the very thing being measured. Defend the allegations at the final hearing; that is what it is for.

An interim order hearing is decided on risk, not truth. The order is temporary in law. On the GDC’s own numbers, its effects are anything but. And until the regulator publishes how often those effects fall on people against whom nothing is ever proved, every registrant should treat that half-day hearing as what it is: the moment the compound interest starts running on their career.

Please note: this is a commentary on legal principle, not legal advice. Every case turns on its own facts. Statistics and average timescales are taken from the GDC’s Fitness to Practise Statistical Report 2025; the aggregate timeline is the sum of the GDC’s published stage averages; case references are to the judgments cited.

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