The General Medical Council is responsible to regulating doctors ensuring that doctors are fit to practise.  It can act if a doctor’s fitness to practise is impaired.  How does the GMC define fitness to practise? 

The GMC’s statement of policy on fitness to practise for doctors state: 

“To practise safely, doctors must be competent in what they do. They must establish and maintain effective relationships with patients, respect patients’ autonomy and act responsibly and appropriately if they or a colleague fall ill and their performance suffers. 

“But these attributes, while essential, are not enough. Doctors have a respected position in society and their work gives them privileged access to patients, some of whom may be very vulnerable. A doctor whose conduct has shown that he cannot justify the trust placed in him should not continue in unrestricted practice while that remains the case.”

GMC principles of “Good medical practice”

  1. Knowledge, skills and performance – doctors must develop and maintain their professional performance, must apply their knowledge and experience and practise within the limits of their competence and must record their work clearly, accurately and legibly. They must have the necessary knowledge of the English language to provide a good standard of practice and care in the UK.
  1. Safety and quality – doctors must contribute to and comply with systems to protect patients, respond to risks safely and protect patients and colleagues from any risk posed by their own health.
  1. Communication, partnership and teamwork – doctors must communicate effectively with patients and establish and maintain partnerships with them. They must work collaboratively with colleagues, be willing to contribute to teaching, training, supporting and assessing and must contribute to the continuity and coordination of care for patients transferring between providers.
  1. Maintaining trust – doctors must show respect for patients, treat patients and colleagues fairly and without discrimination and must act with honesty and integrity.

When a fitness to practise is likely to arise

The GMC accepts that accidents happen and is of the view that isolated incidents would not normally result in a fitness to practise investigation or action.  Fitness to practise proceedings will be necessary in cases of ‘Serious or persistent failures to follow this guidance will put your registration at risk’.

A question of fitness to practise is likely to arise if:

  1. A doctor’s performance has harmed patients or put patients at risk of harm – A risk of harm will usually be demonstrated by a series of incidents that cause concern locally. These incidents will indicate persistent technical failings or other repeated departures from good practice which are not being, or cannot be, safely managed locally or local management has been tried and has failed.
  1. A doctor has shown a deliberate or reckless disregard of clinical responsibilities towards patients – An isolated lapse from high standards of conduct – such as an atypical rude outburst– would not in itself suggest that the doctor’s fitness to practise was in question. But the sort of misconduct, whether criminal or not, which indicates a lack of integrity on the part of the doctor, an unwillingness to practise ethically or responsibly or a serious lack of insight into obvious problems of poor practice will bring a doctor’s registration into question.
  1. A doctor’s health is compromising patient safety – The GMC does not need to be involved merely because a doctor is unwell, even if the illness is serious. However, a doctor’s fitness to practise is brought into question if it appears that the doctor has a serious medical condition (including an addiction to drugs or alcohol); AND the doctor does not appear to be following appropriate medical advice about modifying his or her practice as necessary in order to minimise the risk to patients.
  1. A doctor has abused a patient’s trust or violated a patient’s autonomy or other fundamental rights – Conduct which shows that a doctor has acted without regard for patients’ rights or feelings, or has abused their professional position as a doctor, will usually give rise to questions about a doctor’s fitness to practise.
  1. A doctor has behaved dishonestly, fraudulently or in a way designed to mislead or harm others – The doctor’s behaviour was such that public confidence in doctors generally might be undermined if the GMC did not take action.

Stephen McCaffrey

I am a GMC Defence Barrister who has represented large number of medical professionals before their regulatory bodies in either first instance proceedings or appeals.  I can help with all matters relating to GMC Fitness to Practise Referrals issues including:

  • GMC fitness to practise referrals
  • GMC fitness to practise hearings
  • Appeals against a MPTS Tribunal determination
  • MPTS Interim Order hearings
  • Appeals against a MPTS Interim Orders Tribunal determination
  • Preparing your case before the Case Examiners
  • Help with the decision of the Case Examiners
  • Help with voluntary removal
  • Registration advice
  • Appeal against refusal of registration
  • Restoration to the Register
  • Investigation and disciplinary hearings at work
  • Criminal investigation and proceedings
  • Police cautions
  • DBS [Disclosure and Barring Service] issues


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