A Health Professional's Guide - How to Refer a Doctor to the GMC
This page advises individual doctors, medical directors and clinical governance managers what action to take when they have concerns about a doctor.
If you have concerns about a doctor but are unsure of how to proceed, you can call our helpline to discuss the matter on 0161 923 6402 or by e-mailing us at practise@gmc-uk.org.
You may also find our ethical guidance, Raising concerns about patient safety, helpful.
Contents
When can the GMC take action?
We can take action if we believe that the doctor's fitness to practise is impaired. This may be for a number of reasons:
- misconduct;
- deficient performance;
- a criminal conviction or caution in the British Isles (or elsewhere for an offence which would be a criminal offence if committed in England or Wales);
- physical or mental ill-health;
- a determination (decision) by a regulatory body either in the British Isles or overseas.
If we believe that there is strong evidence which suggest that a doctor's fitness to practise is impaired, we will refer a doctor to the Medical Practitioners Tribunal Service for a fitness to practise panel hearing. A fitness to practise panel can suspend or remove a doctor from the medical register or place conditions on the doctor's registration.
The panel can also issue a warning to a doctor where the doctor's fitness to practise is not impaired but there has been a significant departure from the principles set out in the GMC's guidance for doctors, Good Medical Practice.
What the GMC can't do
Our legal powers enable us to take action where there is evidence which suggests that it may be necessary to remove or restrict the doctor's right to practise. There are other areas where we cannot act. In particular we cannot:
- deal with concerns or complaints about nurses, pharmacists, dentists, opticians, hospital or practise managers or administrative staff, or anyone who is not a registered doctor (many other kinds of healthcare professionals have their own regulatory bodies and complaints procedures);
- provide advice on standards of practice applicable to other healthcare professionals (the regulatory bodies for those professions will be able to help);
- arbitrate in practice or departmental disputes;
- intervene in local disciplinary procedures;
- provide advice and support to doctors whose employers are considering action against them (doctors in this position should consult their medical defence organisation or the British Medical Association);
- make a doctor apologise to a patient or professional colleague;
- order a doctor to provide a patient with the treatment they want;
- pay compensation or fine a doctor.
Our role in context
Our role in registering and licensing doctors to practise and our fitness to practise procedures are one part of a wider system of healthcare regulation within the United Kingdom. We recommend that, in most cases, patients refer their concerns to a doctor’s employer or contracting body before reporting a case to us. Read more about cases that are dealt with via a doctor’s employer or contracting body.
Similarly, if a medical professional has concerns about one of their colleagues we would normally expect them to deal with this at a local level first of all.
We will always consider carefully any concerns regarding a doctor that is are brought to our attention. If we consider that it would be more appropriate for particular concerns to be considered locally, we will normally refer the matter to the doctor's employer.
If we decide to investigate concerns further, we will also contact employers to find out whether there are any wider concerns about the doctor's fitness to practise.
If you're not sure whether the GMC should be involved, please contact us on 0161 923 6402 and we will advise you.
Advice for Trusts
The National Clinical Assessment Service (NCAS) (http://www.ncas.npsa.nhs.uk/) can advise trusts on:
- the handling of concerns;
- the professional performance of individual doctors;
- effective local systems for handling poor performance.
It deals with any performance concern which stops short of fitness to practise issues; it can offer advice and ongoing support, and where necessary it can carry out a full clinical performance assessment to clarify the concerns and recommend actions to help address them.
Referring a doctor
Doctors have a duty to protect patients. If you believe that a doctor's behaviour poses a risk to patients, you should tell us as soon as possible.
If your concerns are less serious, you should follow your employer's procedures, or tell an appropriate person locally – for example, the medical director, chief executive or an officer of the local medical committee.
It is, of course, open to them to refer the matter on to us, if their enquiries identify evidence that the doctor's fitness to practise is impaired.
If you are dissatisfied or worried by action taken under the local procedures, or for any reason you do not feel able to use them, please telephone, write or e-mail us for advice.
Time limits
The GMC will not normally investigate complaints about matters that took place more than five years ago, unless it considers that it is in the public interest for the case to proceed.
How you can help
To help us ensure that all doctors are fit to practise, you should tell us if you think a doctor has behaved in a way that suggests that he or she is not fit to practise. We have taken action where a doctor has:
- made serious or repeated mistakes in diagnosing or treating a patient's condition;
- not examined patients properly or responded to reasonable requests for treatment;
- misused information about patients;
- treated patients without properly obtaining their consent;
- behaved dishonestly in financial matters, or in dealing with patients, or research;
- made sexual advances towards patients;
- misused alcohol or drugs.
These are examples of the kind of cases where we have taken action, but it is not an exhaustive list.
In some of these situations, depending on the severity of the concerns, it may be possible to resolve the issue locally, without the need to refer the matter to the GMC.
Managers will need to consider the issues and the severity of the concerns and whether they can investigate the matter and resolve it locally.
We consider every case carefully, on its own merits. If you believe a doctor's behaviour is, for whatever reason, putting patients or anyone else at risk of serious harm, you should let us know straight away.
Before you refer a doctor to us you may wish to discuss your concerns with a member of our Investigation Team. You can contact the team by calling our helpline on 0161 923 6402 or by e-mailing us at practise@gmc-uk.org.
We can tell you if we are the right organisation to deal with the matters you have raised. If we are not the best place to start, we can advise you on who else to contact. This may reduce delays and help to ensure that doctors who are not safe are dealt with quickly and effectively.
What will happen if you refer a doctor to us?
Ideally we will need the following information in writing, so that we can begin an investigation:
- the doctor's full name, or surname, initials and reference number;
- the doctor's address, or the address of the hospital/practice where they work;
- a full account of the events or incidents that concern you, with dates, if possible;
- copies of any relevant papers and/or any other evidence you have;
- details of any action you have taken already – for example, if you have spoken to the doctor, or made a complaint to the doctor's employer;
- details of anyone else who will support your complaint.
If you are concerned that by providing information you may be breaching patient confidentiality you may wish to take advice from the GMC, your defence organisation or union.
If we decide to act on your concerns, we may ask you for permission to show the doctor your letter or statement. If the case is referred to the Medical Practitioners Tribunal Service for , you might be asked to attend as a witness. We will pay your expenses for attending the hearing.