Approved practice settings

What are approved practice settings?

Approved practice settings:

  • provide doctors with appropriate supervision and regular appraisal
  • support the provision of relevant training and continuing professional development
  • identify and act upon concerns about doctor’s fitness to practise
  • provide regulatory assurance.

All designated bodies are recognised as approved practice settings. A designated body is a UK organisation that has established clinical governance processes including appraisal systems that support doctors with their revalidation and promote and protect the interests of patients.

Do I need to work in an approved practice setting?

All UK and international medical graduates joining the Register for the first time must work in an approved practice setting unless they also join the GP or Specialist Register at the same time.

When the GMC revalidates a doctor or they join the GP or Specialist Register, the approved practice setting restriction will be lifted from their registration.

The approved practice setting restriction does not apply to EEA or Swiss medical graduates joining the Register for the first time, however we strongly advise that they connect to a designated body.

In the case of restoration of your registration, the following applies:

  • If you had an approved practice setting restriction at the time your registration ceased then the restriction will be reapplied to your restored registration until you revalidate
  • If you did not have an approved practice setting restriction at the time your registration ceased, then depending on how long it has been since you held registration in the UK:
    • 0-24 months – usually there is no approved practice setting restriction applied to your restored registration
    • 24 months to 5 years – you may have a new approved practice setting restriction applied to your restored registration (case dependent)
    • More than 5 years – usually a new approved practice setting restriction will be applied to your restored registration.

Your record on our List of Registered Medical Practitioners will show whether your registration is currently subject to an approved practice setting restriction. Click the link ‘View information for employers’ in the ‘More details’ section to see if it mentions an approved practice setting.

If approved practice settings apply to me, what steps do I need to take?

If you have an approved practice setting restriction on your registration, you must only practise in the UK if you have a connection to a designated body. You must keep this information up to date in your GMC account.

If you don’t comply with this restriction you could be subject to our fitness to practise procedures. 

Connection to a designated body means you:

  • meet the approved practice setting restriction 
  • are supported with appraisal and revalidation
  • are monitored and supported in delivering quality care.

Find your designated body
Update your designated body

If you no longer have a connection to a designated body, you should cease practise in the UK until you make a connection to a new designated body.

Where can I work under approved practice setting restrictions?

You can work in any organisation as long as you have a connection with a designated body.

If you're a doctor on a UK training programme and you want to practise outside your formal training (for example as a locum doctor) you may do so. But, you must make sure your educational supervisor is aware of this and comply with any reporting requirements set by your responsible officer or training body.

Can I practise with a connection to a suitable person?

No, unless you're based in Jersey, Guernsey, Isle of Man or Gibraltar and you maintain a connection to a suitable person there.

Outside these jurisdictions you can’t connect to a suitable person until the approved practice setting restriction is lifted from your registration after your revalidation.