The effects of having restrictions on practice or warnings

What were the key findings?

  • While it's not always the case, being given a warning by the GMC can have a significant long-term negative impact on a doctor, particularly in terms of their employment.

  • Doctors often attributed positive behavioural change to the original event that resulted in our investigation or to the investigation itself rather than to the warning.

  • Employers do not seem to respond to warnings in a consistent way.

  • Doctors and employers believe that warnings should be more flexible. They questioned the time they remain on a doctor’s registration, five years, and also the term ‘warning’ itself, as it suggested significant risk.

  • In practice, conditions (which are imposed) and undertakings (which are voluntarily agreed to) were often seen as equivalent. Doctors often only agreed to undertakings to halt our proceedings.

  • While some doctors who were given restrictions on their practice or accepted undertakings were able to remediate, this was not the case for many.

  • Restrictions or undertakings seemed to work better in health cases, with both doctors and employers being more likely to work together to ensure a successful outcome.

  • Employers did not always believe that remediation was possible for doctors who had restrictions or undertakings, and this made it difficult to access appropriate support.

  • Improved communication between the GMC, employers and individual doctors and tailoring of restrictions or undertakings to individual circumstances could help more doctors remediate.

Why did we commission this research?

This research is part of an ongoing programme of work undertaken by the GMC to ensure that our fitness to practise procedures are fair, consistent and robust. We identified that we have limited evidence about how ‘warnings’ or restrictions on a doctor’s registration affect a doctor’s practice. Warnings and restrictions play an important role in ensuring that we balance considerations of public safety with appropriate opportunities for doctors to remediate.

What did the research involve?

Doctors who had been given a warning, undertaking or condition between 2006 and 2013 were invited to participate in an interview and/or a survey. A range of employers were also invited to participate in an interview. The final sample was relatively small and self-selecting and it is likely that doctors were more inclined to take part if they had an experience which they were particularly motivated to share. However much of the feedback was consistent.

Read the full report

The effects of having restrictions on practice or warnings full report