What Is GMC Fitness to Practise?
The General Medical Council (GMC) investigates concerns about a doctor’s conduct, performance, or health that may impact patient safety or public confidence in the profession. The fitness to practise process ensures doctors meet the standards expected in UK medical practice.
How Are Concerns Raised?
- Employers or colleagues
- Patients or their families
- Other regulatory bodies
- The doctor themselves
The GMC’s aim is to protect patients and maintain trust in the medical profession.
Initial Assessment and Triage
When a referral is received, the GMC assesses if the concern falls within its remit and if there is a realistic prospect of finding a doctor’s fitness to practise impaired. If not, the case is closed at this stage.
What Should You Do?
- Gather qualifications, employment history, and any previous regulatory action details
- Document your current role and responsibilities, including sole practitioner status
- Seek early support from your employer or a medical defence organisation
Preliminary Response to Allegations
If a formal investigation is opened, you will receive a Rule 4 letter. Allegations may not be fully detailed at this stage.
- Request as much information as possible about the concerns
- Consider external or mitigating factors affecting performance
- Collect references and testimonials demonstrating insight and remediation
GMC Investigation Process
- Gathering documentation (medical records, rotas, policies)
- Taking witness statements
- Commissioning expert reports
At the Rule 7 stage, you will receive draft allegations and evidence. This is your opportunity to:
- Provide factual responses
- Submit evidence of remediation and insight (reflective statements, CPD certificates, testimonials)
- Argue the seriousness of the concern, context, and whether your fitness to practise is currently impaired
Interim Orders Tribunal
If there is an immediate risk to patient safety or public confidence, the GMC may refer your case to the Medical Practitioners Tribunal Service (MPTS) for an Interim Orders Tribunal. This tribunal can impose interim conditions or suspension.
Key Considerations:
- Prepare financial information to show the impact of an interim order
- Submit up-to-date health information if relevant
- Provide employer references and evidence of support
- Propose workable conditions to mitigate risk
Case Examiner Decision
- Close the case (no case to answer)
- Offer undertakings (agreed restrictions)
- Refer the case to a fitness to practise hearing before the MPTS
Making Effective Submissions
- The facts (admitting or disputing allegations)
- Whether the conduct amounts to misconduct or deficient performance (referencing Good Medical Practice)
- Whether your fitness to practise is currently impaired, with evidence of remediation and insight
- The proportionality and necessity of any interim or substantive restrictions
Fitness to Practise Hearing (MPTS Tribunal)
If referred to a hearing, your case will be managed by the MPTS. The hearing panel includes a legally qualified chair, a lay member, and a medical member.
Hearing Process:
- The GMC presents its case
- You can present evidence, call witnesses, and make submissions
- The tribunal decides:
- Whether the allegations are proven
- Whether your fitness to practise is currently impaired
- What, if any, sanction should be imposed
Possible Outcomes:
| Outcome | Description |
|---|---|
| No Further Action | No impairment found or no action needed |
| Warning | Serious misconduct found, but no current impairment |
| Conditions | Practice is restricted and monitored for a defined period; compliance is reviewed regularly |
| Suspension | Registration suspended for up to 12 months; review before return to practice |
| Erasure | Name removed from the register; reserved for the most serious cases (e.g., dishonesty) |
Remediation and Insight
Demonstrating remediation and insight is crucial. This may include:
- Reflective statements about the events
- Evidence of relevant CPD, training, or supervision
- Testimonials and references from employers and colleagues
- Documentation of any health or personal issues that have been addressed
Appeals and Reviews
Both you and the GMC can appeal the outcome of a fitness to practise hearing. If conditions or suspension are imposed, your case will be reviewed periodically before any return to unrestricted practice.
Expert GMC Representation for Doctors
Regulation Resolution specialises in representing doctors in GMC fitness to practise proceedings. Our team provides expert guidance at every stage, from initial referral to hearings and appeals, ensuring your rights and career are protected.
Contact Regulation Resolution today for a free, no-obligation quote and expert advice on your GMC case.