Referrals to local procedures

The GMC is mainly limited to taking action on serious concerns which call into question a doctor's fitness to practise and suitability to retain unrestricted registration.

However, most of the complaints we receive do not fall into that category.

Most are more suitable to be dealt with locally as - even if the allegations are proven - they are not sufficiently serious to warrant action on registration.

In addition, local NHS procedures and the Healthcare Commission - and its equivalents in Scotland, Wales and Northern Ireland - are often best placed to look at the patient's experience and identify any systemic problems.

Since October 2005, the GMC has referred such complaints directly to the relevant NHS Trust or Primary Care Trust (PCT) to take forward under their own complaints procedures.

We ask the employer to confirm receipt and to keep us up to date with the progress of any investigation until the matter has been concluded.

Of course, the employer may refer the case back to the GMC at any stage where information gathered locally indicates that a doctor's fitness to practise may be impaired and that action on registration may be required to protect patients.

When we receive the complaint

All complaints we receive are subject to initial assessment and categorised as Stream 1 and Stream 2.

Stream 1 complaints

These are complaints for which it is immediately clear that we need to investigate.

Stream 2 complaints

These are complaints which could justify action by us if part of a wider pattern of concern about a doctor – but do not justify action by us as isolated incidents.

We refer Stream 2 case to NHS local procedures when the doctor works within the NHS and the incidents that gave rise to the concerns occurred within an NHS environment.

We will not normally investigate ourselves, if a complaint has already been considered locally and enquiries have not identified any concerns about the doctor's fitness to practise.

The GMC will continue to investigate Stream 2 cases where the concerns relate to a doctor's private practice or where the doctor is a peripatetic locum.

The process for referring a case to NHS local procedures

We will begin by asking the complainant for consent to disclose to the doctor and to refer the complaint to the appropriate NHS Trust or PCT.

On receipt of that consent, we will disclose a copy of the complaint to the doctor and ask for details of his or her employers or contracting authority.

We will then refer the complaint to the doctor's employer. We will ask the employer to respond to us immediately to confirm receipt of the letter of referral.

The employer may highlight further issues that suggest that the GMC should undertake a full investigation into the doctor's fitness to practise. These cases will follow our normal investigation process.

The employer may respond by saying that they intend to investigate the case. We will ask to be kept informed of developments and will follow this up with employers at three monthly intervals until the case has been concluded.

For further information please call our dedicated helpline on 0845 357 0022.