[DAYS_LEFT] days left of your Medeconomics free trial

Subscribe now

Your free trial has expired

Subscribe now to access Medeconomics

Medico-legal - Being under the GMC's scrutiny

Help is at hand if your fitness to practise is probed.

Be aware that any concern over probity, honesty or health, as well as clinical practice, could trigger a GMC fitness to practise investigation (Photograph: Istock)
Be aware that any concern over probity, honesty or health, as well as clinical practice, could trigger a GMC fitness to practise investigation (Photograph: Istock)

Facing a GMC investigation can be very daunting and we have all seen the mileage the press can get out of 'doctors under fire'.

The process involved in a GMC investigation was covered in last week's GP. Here we look at how your defence body can help you get through the ordeal.

Getting support
An investigation can be very stressful, so it is important to have the right level of support. Start by contacting your defence body, which will provide you with invaluable advice.

Understandably, doctors feel there is a stigma surrounding a GMC investigation, and often try to keep the details of the investigation to themselves. However, it is sensible to tell your colleagues, family and friends, who will be able to rally round you. You can do this without breaching patient confidentiality.

It is also advisable to tell your employer (practice and/or primary care organisation). This also applies if you are a contractor GP or locum GP. They are likely to find out, and it is better that they hear it from you first.

When you are first made aware that you are the subject of a GMC investigation, you should get advice from your defence body immediately, get the relevant medical records and draft a detailed factual report. If there is a time limit to providing a response, it may be possible to get an extension.

You should not ignore the correspondence, respond without getting advice or alter (or falsify) the medical records or other evidence.

Meeting your advisers
There is work to do in preparing to respond to the investigation. The meeting would generally involve a lawyer and a medico-legal adviser (a doctor with legal training) who can assist with the legal and clinical aspects of your case.

Your advisers will explain the process of the investigation and collect and assess the evidence. They will listen to your account and look at your notes, home visit and message book and at patient's appointments relating to the incident. As well as identifying witnesses such as practice staff, they will give you an assessment of how they think that the process will go, based on their experience of similar cases.

Sometimes this can be done in correspondence and over the phone, but often a face-to-face meeting is the best way.

Proactive action and education
The ability of your advisers to give the best advice depends on the quality and quantity of information you provide. Be open, honest and candid from the outset to avoid problems escalating.

If the GMC has identified potential deficiencies or shortcomings in your practice, there are valuable actions you can take to mitigate their impact on its assessment of your fitness to practise (FtP).

Insight and acknowledgement of areas for improvement will have a much more positive effect than a blanket rebuttal. Identifying and undertaking appropriate training, refresher courses or CPD is wise, especially if you are preparing for a hearing.

At the GMC
FtP hearings are conducted with the formality of a legal tribunal. They are normally open to the public, and can be intimidating if there is a large media presence.

You will be expected to give evidence, which involves being questioned by your barrister, the GMC's barrister and the panel. It is important to:

  • Ensure you have understood the question.
  • Answer the question.
  • Be consistent in your answers.
  • Look at and direct your responses to the panel.
  • Retain your professional composure - do not allow yourself to be provoked.
  • Demonstrate your knowledge and competence.

Some GMC hearings attract high-profile national coverage. If you receive any media calls regarding your hearing, generally your defence body can advise and manage your individual situation, including preparing and issuing agreed statements on your behalf.

It is important to remember your duty to respect patients' rights of confidentiality, and to follow GMC guidance on dealing with media enquiries.

Career at stake
The GMC has control over your registration and your ability to practise. It is important to take a GMC investigation seriously and to project a professional demeanour at all times - this includes what you wear, how you speak and introduce yourself, and being punctual.

Do get professional advice early and look after your own health, especially as the stress of an investigation can adversely affect your FtP.

The GMC will be consulting on reforming the FtP procedures and has acknowledged the 'public humiliation' experienced by doctors at hearings.

  • Dr Stephanie Bown is director of policy and communications, and Sarah Whitehouse is a staff writer at the Medical Protection Society, www.medicalprotection.org/uk
  • Services discussed here are based on what the MPS provides.
What the GMC can investigate

You may be surprised at the range of issues that may be investigated by the GMC as raising a question over your FtP:

  • An investigation is not necessarily confined to clinical practice.
  • Any question over a doctor's probity, honesty or health could be investigated.
  • GMC statistics show that in 2009 more than 25 per cent of (less serious) 'stream 1' allegations related to probity and more than 10 per cent involved inappropriate relationships with patients.


Dr P had a domestic dispute with his wife who called the police. He accepted a caution and thought nothing more of it until he received a letter from the GMC saying that the matter called his FtP into question and it would be investigating.

He was furious and sent a terse letter to the GMC stating it was a private matter and none of its business. The tone of his correspondence unfortunately compounded the GMC's concerns. Dr P subsequently took advice from his defence body which explained the breadth of issues that could legitimately raise a question about a doctor's FtP.

The matter was eventually concluded after lengthy correspondence, but was undoubtedly protracted by the tone and content of the first response.

Have you registered with us yet?

Register now to enjoy more articles
and free email bulletins.

Sign up now
Already registered?
Sign in

Would you like to post a comment?

Please Sign in or register.

Database of GP Fees

Latest Jobs