Doctors under investigation - undertakings

This page provides information about 'undertakings' in the context of the GMC's Fitness to Practise procedures.

What are 'undertakings'?

Undertakings are an agreement between the GMC and the doctor about the doctor's future practice.

Such undertakings might include

  • restrictions on the practitioner's practice
  • restrictions to the practitioner's behaviour
  • commitments to practise under medical supervision
  • commitments to undergo re-training.

Undertakings allow the GMC to deal effectively with certain types of case without having to refer the matter for a medical practitioners tribunal hearing with the Medical Practitioners Tribunal Service (MPTS). Read our information for doctors who have undertakings or conditions that affect their practice.

How are undertakings applied?

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 for a medical practitioners tribunal (MPT) hearing with the MPTS;
  • agree undertakings, for example to retrain or work under supervision.

Undertakings will only be agreed with a doctor when both the medical and non-medical case examiners are satisfied that they are sufficient to protect patients and the public, and are an effective way of addressing the concerns about the doctor.

The GMC will not offer undertakings where there is a realistic prospect that a medical practitioners tribunal might erase the doctor from the register if the case was referred forward for a full hearing.

The doctor will be given 28 days to indicate whether he/she will agree to the undertakings.

Undertakings and confidentiality

We will inform the doctor's employers of any undertakings that have been agreed. Undertakings that relate solely to a doctor's health are confidential.

All other undertakings, such as restrictions on practice, will be disclosed to any enquirer in the same way as conditions or restrictions on a doctor's registration.

To protect the public, we share action that has been taken to protect patients and uphold confidence in doctors with a wide range of regulators around the world. We are also legally required to inform European medical regulators about restrictions on a doctor’s registration including doctors who have undertakings that affect their practice. We may provide further information about the case in response to specific requests from any regulator. If we disclose further information, we will let you know.

Undertakings agreed by the doctor will be reviewed regularly to consider whether the undertakings should be varied or, where there are no longer concerns about the doctor’s fitness to practise, whether they should be lifted. These reviews may also be requested by the medical supervisor or even the doctor themselves.

Doctors with undertakings as a result of deficient performance (i.e not health) are likely to be required to undergo a performance assessment before they are discharged from any undertakings.

Failure to comply with undertakings

If the doctor does not agree to the undertakings, or if the doctor subsequently fails to comply with the undertakings, the case will be referred to the MPTS for a medical practitioners tribunal hearing.

Similarly, where a doctor's health or performance has deteriorated, or where the GMC receives information giving rise to further concern regarding the doctor's fitness to practise, the case will be referred to a medical practitioners tribunal to decide whether to take action to erase or suspend the doctor or to impose conditions or restrictions on his/her registration.

Where a doctor with undertakings relinquishes their licence they will continue to be subject to undertakings which attach to their registration.  Relinquishing their licence may make it more difficult to improve deficient performance and may in the future lead to further action on their registration or put their registration at risk.