How we make decisions about a doctor’s fitness to practise
Our decision makers use a range of guidance to help them reach decisions in cases where concerns have been raised about a doctor’s fitness to practise. You can find the guidance our decision makers use below along with other key policies.
Page last updated: 30/03/2026
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An introduction to fitness to practise for doctors
- What we mean by fitness to practise (Doctors)
Describes what decisions are made about a doctor’s fitness to practise, how we assess fitness to practise and what might be a concern and why. - Decision-making principles in fitness to practise (Doctors)
Describes our legal role to protect the public and explains the principles of being proportionate, transparent and fair when making decisions about a doctor’s fitness to practice.
Deciding whether GMC action is required
- Deciding whether to refer a matter to the GMC (Doctors) - Guidance for Responsible Officers
Supports responsible officers to decide whether fitness to practise concerns about a doctor need to be referred and to make accurate referrals when appropriate. - Deciding whether to refer a matter to the GMC (Doctors) - Guidance for Employers
Supports employers to decide whether fitness to practise concerns about a doctor need to be referred and to make accurate referrals when appropriate. - Supplementary guidance on matters relating to a doctor’s failure to have appropriate and adequate insurance and indemnity
Supports decision-making on whether a doctor poses any current and ongoing risk to public protection where information has been received relating to their failure to have adequate insurance and indemnity. - Decision on whether regulatory action is required (Doctors)
Supports decision-making on whether there’s a legal basis for considering a doctor’s fitness to practise and whether they pose any current and ongoing risk to public protection. - Supplementary guidance for decision makers when violence and dishonesty may represent a lower risk to public protection (Doctors)
Supports decision-making on whether a doctor poses any current and ongoing risk to public protection where information has been received relating to their alleged violent or dishonest behaviour. - Supplementary guidance on assessing the risk to public protection posed by a doctor where the information relates to their practice during the COVID-19 pandemic
Supports decision-making on whether a doctor poses any current and ongoing risk to public protection where information has been received relating to their practice during the COVID-19 pandemic. - Supplementary guidance on assessing concerns about a doctor’s involvement in encouraging or assisting a person to end their own life
Supports decision-making on whether a doctor poses any current and ongoing risk to public protection where information has been received about their involvement in encouraging or assisting a person to end their own life.
Deciding whether to investigate information received about a doctor
- Deciding whether to open an investigation (Doctors)
Supports decision-making on whether we can, and should, proceed to carry out an investigation of matters relating to a doctor’s fitness to practise. - Supplementary guidance to support decisions on applying the five-year rule (Doctors)
Supports decision-making on whether a matter that came to our attention more than five years after the most recent events occurred should be investigated.
Decisions made during an investigation
- Deciding how to approach evidence collection (Doctors)
Supports decision-making on how to approach evidence collection when considering a doctor’s fitness to practise. - Deciding whether to refer a matter for a non-compliance hearing (Doctors)
Supports decision-making on whether a doctor has failed to comply with an assessment or requirement to supply information and where they have, how to respond.
Deciding what happens at the end of an investigation
- Deciding the outcome of an investigation (Doctors)
Supports decision-making on whether the doctor poses any current and ongoing risk to public protection requiring restrictive action on registration, and what the proportionate outcome is at the end of an investigation. - Supplementary guidance on assessing concerns based on police cases resulting in acquittal or a decision not to proceed to trial (Doctors)
Supports decision-making on whether the doctor poses any current and ongoing risk to public protection requiring restrictive action on registration where a police case resulted in acquittal or did not proceed to trial. - Supplementary guidance on assessing the impact of a doctor’s health on their behaviour or performance
Supports decision-making on the proportionate response when there are concerns about the impact of a doctor’s health condition and concerns about their behaviour or performance. - Decisions by the Investigation Committee (Doctors)
Supports decision-making on matters referred to the Investigation Committee to decide at the end of an investigation and on procedural matters relating to oral hearings. - Decision on whether a warning is required (doctors)
Supports decision-making on when it is appropriate to impose a warning following a decision that a doctor’s fitness to practise is not impaired. - Decisions on undertakings (Doctors)
Supports decision-making on agreeing undertakings at the end of an investigation and sets out the considerations relating to varying or revoking undertakings.
MPTS tribunals have their own guidance to support decision-making in relation to doctors. This is published on the hearing resources for doctors page on the MPTS website.
Interim orders
- Decisions on interim orders (Doctors)
Supports decision-making on whether it may be necessary to restrict a doctor’s registration on an interim basis.
Other guidance and policies to be used throughout the fitness to practise process for doctors
- Policy on publication and disclosure of fitness to practise information for doctors
Sets out our general policy on the publication and disclosure of information relating to a doctor’s fitness to practise. - Using personal information in the fitness to practise process for doctors
Sets out the guiding principles informing our approach to using personal information in the fitness to practise process and supports decision-making about disclosing or obtaining personal information in specific circumstances. - Drafting allegations guidance (Doctors)
Operational guidance for GMC staff and legal representatives on the approach to take to drafting allegations of impaired fitness to practise.
Monitoring and reviewing restrictions
- Decisions where undertakings, conditions or suspension are being monitored (Doctors)
Supports decision-making when monitoring cases where a doctor’s registration is subject to restrictive action of undertakings, conditions or suspension.
Voluntary and administrative erasure where there is a fitness to practise concern
- Deciding voluntary erasure applications and advising on administrative erasure where there is an unresolved concern (Doctors)
Supports decision-making on whether to grant or refuse an application for voluntary erasure, or advise that administrative erasure can proceed, where there are unresolved concerns about a doctor’s fitness to practise. - Restoration decisions following voluntary or administrative erasure
Supports decision-making on whether to grant or refuse an application for restoration following voluntary or administrative erasure where there is an unresolved fitness to practise concern.
Decisions made following referral to a tribunal hearing
- Decisions on section 40a appeals
Supports decision-making by the Executive Panel on whether to appeal a relevant decision by a medical practitioners tribunal because it is not sufficient for the protection of the public.
Working with other relevant organisations where a concern has been raised
- Guidance on referral to Disclosure Scotland
Explains the relevant legal framework, approach we take and criteria we apply when deciding whether to refer a doctor to Disclosure Scotland. - Guidance on referral to the DBS
Explains the relevant legal framework, approach we take and criteria we apply when deciding whether to refer a doctor to the DBS. - Guidance on disclosure to DS and DBS
Explains the relevant legal framework, approach we take and criteria we apply when deciding whether to make a disclosure about a doctor to DS and the DBS. - Decisions on sharing information related to a doctor with the police
Helps GMC staff identify information that may amount to criminal conduct and need to be shared with the police and supports decision-making on whether that information should be shared. - Decisions on sharing information related to a doctor with the police – supplementary guidance for decision-makers
Supplementary guidance to help GMC staff identify information that may amount to criminal conduct and need to be shared with the police and supports decision-making on whether that information should be shared. - Sharing information with Social Services – supplementary guidance for decision makers
Helps GMC staff identify information that may need to be shared with social services and supports decision-making on whether that information should be shared.
