Doctors are understandably concerned by GMC investigations because they have the potential to affect your registration. In cases where there has been a serious breach of standards the regulator can stop you from practising either temporarily or permanently.
Fortunately, a GMC investigation is relatively unusual for most doctors and being suspended or stopped from practising happens only in a minority of cases.
In 2020, the GMC considered 8,468 fitness to practise enquiries about doctors. However, there were only 1,043 full investigations. While the pandemic has reduced the number of investigations being undertaken it may still be reassuring to note that in 2020, given the 337,717 doctors on the register there were only 104 erasures or suspensions. Over 80% of complaints in 2020 were closed at an early triage stage, a slight increase on the previous year.
In addition, for the cases that reach a more formal process, the GMC introduced the use of virtual hearings during the pandemic, relieving some of the stress for those involved.
Here are six steps to take if you receive a letter from the GMC informing you of an investigation:
1. Contact your medical defence organisation as soon as possible
If you are a member of a medical defence organisation (MDO), contact them immediately to request advice and support.
The MDU advises that you do not provide any comments to the GMC about the concern raised until you have discussed the case with us.
It is helpful to write some notes about the case for the benefit of your MDO adviser as soon as you can, while events are fresh in your mind. Your adviser will assess your case, advise you on the best way to respond to the GMC and arrange legal representation if you need it.
Always be open and honest with your medico-legal adviser so that they can help you get the best outcome. Let them know if there are any other issues that you think might be relevant, such as health problems.
2. Co-operate fully with the GMC process and the requirements of your employer
You will need to inform your employer (if you are not a GP partner), as well as NHS England or your health board. Performers’ list regulations require GPs to do so in writing, within seven days. It is also a good idea to contact your medical director.
In addition, the GMC requires you to complete and return a work details form within seven days.
3. Don’t let the complaint affect patient care
Surprisingly, many patients wish to continue seeing the doctor they have complained about. It is understandable that if a patient refers you to the GMC, it can make you feel uncomfortable about seeing and caring for that particular patient in future.
You may feel that you wish to end your professional relationship with the patient who complained, however, the GMC makes it clear in Good Medical Practice that ‘you must not allow a patient’s complaint to adversely affect the care or treatment you provide or arrange’.
If possible, you should continue to see and care for the patient as before, although you can end your professional relationship with the patient ‘when the breakdown of trust between you and the patient means you cannot provide good clinical care to the patient’.
Seek advice about this from your medico-legal adviser before taking such action.
4. Review the concerns raised and see what you can learn
The GMC is concerned about whether a doctor’s fitness to practice may be impaired, rather than investigating the complaint itself. The GMC will consider, among other things, whether a doctor could be a risk to patients in the future.
Doctors who are able to demonstrate insight, for example, by apologising and remediating, are considered to be lower risk.
Review the case with a trusted senior colleague, asking for their honest feedback and advice regarding any learning points that you can take forward for future practice. You may wish to list the case for discussion at your practice or departmental significant event meeting and at your next appraisal. Document such discussions carefully.
Add any learning points to your personal development plan and provide certificates from relevant courses or online learning as part of your defence to the GMC.
5. Be prepared for a virtual hearing
Only a small minority of cases reach a regulatory hearing and the pandemic has led to some positive changes in this area. Virtual hearings can be more convenient and less stressful, as you can take part from your home or workplace, rather than attending a hearing in person.
They can work well in certain cases where the facts are agreed or where a health concern has been raised, for example. However, we still advise doctors to behave as they would when appearing in person (see tips below).
MDU tips for doctors appearing at virtual hearings
- Make sure you have all the documentation about the case to hand and have downloaded the app necessary to take part.
- Log on in plenty of time and ensure you are familiar with the technology, such as how to mute and unmute your microphone.
- Use a work device to take part, rather than a personal one, and make sure it is fully charged.
- Ensure there is a suitable background and preferably choose somewhere quiet where you won't be interrupted.
- Dress smartly including below the desk in case you need to stand up.
- Be aware of your posture and body language. Behave in the same way as if you were appearing in a court room in person.
- Have a glass of water on hand and have a comfort break before you start.
- Speak clearly while looking at the camera. If you have to look away to your notes, explain that's what you are doing.
6. Ask for support
GMC investigations can be very stressful and protracted, sometimes taking several years to conclude. Some doctors feel ashamed when under investigation, and try to hide it from their family and colleagues. Don’t underestimate the effect an investigation can have on your health and wellbeing, and make sure you confide in someone.
As well as discussing your concerns with your medico-legal adviser, you can discuss the investigation with family members, trusted colleague or friend, ensuring you protect the patient’s confidentiality at all times.
MDU members who need support through a GMC case, or some other investigation process can access our peer support network to talk with fellow members who have been in their shoes. Find out more about this and other sources of support at www.themdu.com/wellbeing.
The GMC has a confidential support service in conjunction with the BMA which is open to all doctors who have had a complaint made about them to the GMC. Doctors in England suffering mental ill health and addiction can also get support from NHS Practitioner Health.
In summary
It can be difficult not to take a GMC complaint personally but obtaining advice from those used to dealing with such cases and support from family, friends and colleagues can help to maintain your confidence and protect your health.
This article was first published in January 2018 and updated in February 2022.
