Investigating concerns
Contents
Introduction
Our procedures are divided into two separate stages: 'Investigation' and 'Adjudication'.
In the investigation stage we investigate cases to assess whether we need to refer them for adjudication.
The adjudication stage consists of a hearing of those cases we have referred to a Fitness to Practise (FTP) panel.
Whether to investigate
At an early stage we will decide whether there are issues which we need to investigate further, and if so, what form the investigation should take.
In some cases, it will be clear from the start that it is not appropriate for us to investigate (for example, because it is not about a doctor or because the case clearly falls outside our criteria for taking action against a doctor).
If the issues raised in the complaint do not themselves raise questions about the doctor's fitness to practise, the action we take will depend on where the doctor is employed;
- if the doctor is employed within the NHS, we will normally refer the matter to the doctor's employer, so that they can take what action they consider appropriate under their local procedures and report back to us if there are matters which may require us to take action to protect patients;
- if the doctor works as a locum, or in a private setting, we will contact the doctor's employers to establish whether there are any other concerns about the doctor, before we decide whether we can conclude the case or whether we need to carry out other enquiries.
Starting our investigation – permissions and disclosures
Where the concerns potentially raise questions about the doctor's fitness to practise, we will start our investigation.
Whenever we investigate concerns further, we will disclose the complaint to the doctor and his/her employer/sponsoring body.
This ensures that we have a complete overview of the doctor's practice. This exchange also makes our information available to those responsible for local clinical governance.
When we begin to investigate a complaint, we will normally need to obtain further information from the complainant. We will also need their consent to disclose the complaint to the doctor.
We will disclose the complaint to the doctor and ask him/her to provide details of his or her employer/s or sponsoring body. The doctor will have an opportunity to comment on the complaint.
What happens during an investigation?
Our investigation will depend very much on the nature of the concerns raised with us. Our investigation staff will decide on the most effective forms of investigation for the case. An investigation may include:
- obtaining further documentary evidence from employers, the complainant or other parties;
- obtaining witness statements;
- obtaining expert reports on clinical matters, etc;
- an assessment of the doctor's performance;
- an assessment of the doctor's health.
At the end of the investigation - Case Examiners
At the end of the investigation by the GMC of allegations against a doctor, the case will be considered by two senior GMC staff known as case examiners (one medical and one non-medical). They can:
- conclude the case with no further action;
- issue a warning;
- refer the case to a Fitness to Practise (FTP) Panel;
- agree undertakings.
No case can be concluded or referred to a FTP panel without the agreement of both a medical and non-medical case examiner. If they fail to agree, the matter will be considered by the Investigation Committee, a statutory committee of the GMC.
We will inform both the doctor and the complainant of the case examiners' decision and their reasons.
Warnings
If the case examiners or the Investigation Committee decide that the doctor's fitness to practise is not impaired, they may issue a warning.
A warning will be appropriate where the concerns indicate a significant departure from the standards set out in the GMC's guidance for doctors, Good Medical Practice , or if there is a significant cause for concern following assessment
The Investigation Committee will also meet to consider those cases where the case examiners decide to issue a warning, but where the doctor has disputed the facts, or requested that the matter be considered at a hearing of the Investigation Committee. The hearing will take place in public.
Read our section When we decide a warning is appropriate.
Interim Orders Panel
At any stage of the investigation we may refer the doctor to an Interim Orders Panel (IOP). An IOP can suspend or restrict a doctor's practice while the investigation continues.
