Most doctors will have dealings with the General Medical Council (GMC) at some point in their career. It can be stressful to learn you are the subject of a complaint, or that your medical licence could be at risk. However, most complaints are resolved without serious issue, leaving you able to continue to practice. And there are many sources of support available during an investigation.
What triggers a GMC investigation?
There are a number of ways that a GMC investigation can be initiated.
Firstly, a patient may have made a complaint about your professional conduct – either directly to the GMC, or to your employer, who may then pass it on to the GMC. The GMC would assess the complaint using their usual processes, and would communicate with you if they felt it raised a question of fitness to practice.
The concern could also have been raised by an employer or contracting body, for example after an incident that risked patient safety. They would investigate the incident, and if they felt it raised fitness to practice issues, they would refer it to the GMC.
The other common route is self-referral, which usually happens for health reasons. If you are struggling with your physical or mental health and feel it is affecting your fitness to practice, you can (and you should) inform the GMC about this.
If there is a court hearing or criminal investigation that results in a doctor being charged or convicted, this is automatically referred to the GMC. The GMC can also choose to investigate a situation of its own volition, e.g. if an issue is raised in the press or in parliament.
What are the possible outcomes of a GMC investigation?
The most common adverse outcomes involve warnings, undertakings or conditions, which may be recorded against your registration. The GMC can order interim conditions or suspensions, to protect the public, while a full assessment is carried out. This step is not a conclusion on the facts, but a holding protective position.
A warning is a formal indication that your conduct or behaviour has fallen below the standard expected. It does not place any restrictions on your licence, but would be relevant e.g. if you were to repeat the same errors in future.
Undertakings are actions that you resolve to take, when there has been a question of fitness to practice, to show you are remediating the issues in question. Undertakings will usually be proposed by the GMC for you to accept, and there are a wide variety of possible undertakings. Some will be visible on the public record, but health-related ones will usually be kept confidential.
Conditions are like undertakings, but instead of being voluntary, they are imposed by the GMC, and you must follow them. Breaching these conditions would count as an act of misconduct in its own right.
In serious cases which are referred to the Medical Practitioners Tribunal Service (MPTS), your licence may be suspended. This is for a set period, during which you are not allowed to practice. Suspensions are regularly reviewed, at least once a year. The suspension will be removed at the end of the period, or modified if necessary.
In very serious cases, you may be erased from the medical register. After five years, you can re-apply, though it can be very difficult to achieve the necessary proof of remediation and re-training.
How the RMBF can help
The RMBF can consider financial support for doctors who are on a reduced income and unable to support themselves financially due to physical or mental health issues, injury, or bereavement.
That includes:
- doctors under GMC investigation
- doctors who have had their licence suspended
- doctors with warnings, conditions or undertakings on their licence
as long as you also meet all of our eligibility criteria.
Please note that we will not be able to consider assistance if you are suspended or have conditions on your licence, unless you are also unable to work in any capacity. We also cannot offer financial support to doctors whose names have been erased from the GMC register.
The RMBF is fully independent from the GMC, and if you make an enquiry or apply for support, we don’t pass on any of your personal details. All applications are treated in confidence.
We recognise that the worry of dealing with a complaint or an investigation can make an already-stressful situation more difficult. We offer a free online Wellbeing Resource for doctors, and there are articles on our Advice Hub covering related issues, including stress and burnout, moral injury, and dealing with the death of a patient.
Protecting yourself
Most doctors will join a medical defence organisation (MDO) at the start of their careers. This is probably the single biggest thing you can do to protect yourself from any difficult consequences of a complaint or investigation.
Simon Dinnick is a senior healthcare lawyer with over 30 years’ experience, and a former RMBF Trustee and Grants & Awards Committee chair. “Without a doubt, I would recommend joining an MDO,” he says. “In all my years of dealing with doctors in difficulty, the most serious situations have always been made more difficult when a doctor hasn’t joined an MDO.
“Some doctors can’t see the point – they think it’ll never happen to them. They might assume their employer will look after them, or the BMA. Those can certainly be a help, but I would still recommend having an MDO. You should understand that they are based on discretionary indemnity, so there are cases where they may not be able to help – but these are rare. Usually, almost without exception, they will be able to help with a GMC case.”
First steps
If you find out that you have been the subject of a complaint or investigation, it’s important to stay calm and not to rush into a response, says Simon.
“Firstly, don’t panic. Try to maintain a sense of perspective. It’s a professional risk these days for virtually anybody – very few doctors go their whole career without some form of engagement with the regulatory process. It doesn’t mean that the world has come to an end.
“The second thing to do is to seek advice, as soon as possible. If you’re with an MDO, then go to them. If you aren’t with an MDO, go to a trusted friend or colleague – someone sensible who can give impartial advice.
“Next, familiarise yourself with the professional obligations relevant to the issue you’ve been informed about. You should be familiar with Good Medical Practice, as well as the supporting materials on the GMC website. And make sure you know how the GMC procedures work, so you’re not taken by surprise during the process.”
All of these things should be done before you begin crafting any kind of formal response, advises Simon. “If the GMC writes to notify you of a complaint, read that letter carefully. It’ll say you have a period of time to provide a comment.”
Crafting a response
Both the tone and content of your response will be important, says Simon. The main task is to demonstrate your insight about the situation, showing self-reflection and self-awareness.
“If there have been errors of judgement, the GMC want to see that that these are going to be remediated and steps are going to be taken – by going on a course, for example.
“A responsible doctor needs to be self-aware. If they feel they’ve done something wrong, they may want to modify their practice. They might say to their employer: I’d rather not do this procedure for a while until I get some further training, because I’m not getting it right. It’s difficult to be self-aware when you’re under that kind of anxiety, but it is vital.”
Avoid the temptation to be defensive or to dismiss concerns out of hand.
“If you write things which are derogatory of someone who’s made a complaint, that makes it worse. You may feel that they’ve not been fair to you, and you can disagree with them, but to say this person is malign in their intentions would not be sensible.”
Finally, try to remain professional in your response to the GMC, leaving your emotions about the situation aside.
“At the end of the day, the GMC’s statutory duty is to investigate. Treat them as a source of information, who can explain to you what’s going to happen, and how it’s going to happen. But don’t treat the GMC as someone to confide in. There are other people and services who can provide that listening ear.”
Health Committee procedures
Simon also advises that when the investigation involves health issues, you may need to be resilient and patient, as this can be a lengthy process.
“The Health Committee assessment procedure involves the GMC appointing examiners to determine if you are fit to practice, with or without conditions or controls. Those reports are complicated and can be slow to obtain, as they involve medical examination. It may take a while for the GMC to suggest a course of action, and you will be invited to agree to that course of action.
“The whole process can last a number of months or even years. It will include regular reviews, because the GMC have to see whether you are getting better, and whether you are doing what was agreed in terms of training, insight, remediation, health, et cetera. There will be problems along the road, and you’ve got to show patience.”
Sources of support
The RMBF has been able to help many doctors who are dealing with a GMC investigation while they have been too unwell to work. If you are in financial hardship due to ill health, find out whether you may be eligible for support by using our eligibility checker tool.
Our online Wellbeing Resource and Advice Hub can help you deal with practical or emotional difficulties you may be facing during an investigation.
The BMA offers confidential emotional support for doctors going through fitness to practise procedures with the GMC, or at risk of having their licence withdrawn.
The GMC website hosts a lot of resources and information for doctors who are under investigation, as well as information about the required professional standards that you may need to review.
