How we assess and respond to fitness to practise concerns

When assessing fitness to practise concerns, and to reach a decision on whether a doctor poses any risk to public protection, we consider:

The seriousness of the concern

This includes looking at how far a doctor has departed from the professional standards set out in Good medical practice. Or if relevant, it includes considering if a health condition is having an impact on their ability to practise safely.

We also take into account any specific factors that may impact on the seriousness of the concern. For example, if the behaviour was an isolated incident, whether it was premeditated or persistent, or whether it was an abuse of power.

Any relevant context

We consider any relevant context that we’re aware of. By ‘context’ we mean the specific setting or circumstances that surround a concern.

There are different types of relevant context. One example is a doctor’s working environment, including issues related to workload, and interpersonal factors such as the culture of the organisation they’re practising in.

How the doctor has responded to the concern

We examine the evidence available to establish if the doctor has:

  • insight into their own practice and behaviour
  • taken steps to remediate any issues, such as participating in training, supervision, coaching or mentoring relevant to the concern raised
  • kept their knowledge and skills up to date
  • been working within their area of competence.

Our information document, What we mean by fitness to practise provides further detail on the decisions made about fitness to practise, how we assess if a medical professional poses any current and ongoing risk, and sets out what may amount to a fitness to practise concern and why, in cases involving sexual misconduct, dishonesty and lack of integrity, violent or abusive behaviour, discrimination, clinical concerns, impact of a health condition insufficient knowledge of English language, and convictions, cautions and determinations.

If we decide that a doctor does not pose any current and ongoing risk to one or more of the three parts of public protection, but has significantly departed from the professional standards, we may need to issue them with a warning. This is a formal way of indicating to the doctor that their behaviour or performance has significantly departed from the professional standards and should not be repeated.

If we decide that a doctor poses a current and ongoing risk to one or more of the three parts of public protection, we may need to restrict their registration. This may be through agreeing undertakings or putting in place conditions or a suspension. The purpose of this type of action is to protect the public until the doctor no longer poses any risk, and can return to unrestricted practice.

In a very small number of cases, we may remove a doctor’s registration. This type of action is rare and is reserved for the most serious cases.