A GMC investigation is opened where a concern about a doctor’s performance, health or conduct raises a possible risk to patient safety or public confidence in the profession, and it proceeds through defined stages set out under the Medical Act 1983 and the GMC’s own Fitness to Practise Rules. Most investigations do not end in a doctor being removed from the register, but the process itself, which can run for many months, carries real professional and personal strain, and GP partners have a direct interest in understanding it, both for their own protection and because a partner under investigation affects the whole practice.
We advise GPs and GP partnerships on regulatory investigations and the practice-level consequences that often follow, including partnership and locum arrangements while a colleague is under investigation. This post sets out the stages a GMC investigation typically follows and what a GP practice needs to think about if a partner or salaried GP is contacted.
Why the GMC Investigates
The GMC’s statutory role, under the Medical Act 1983, is to take action where questions arise about a doctor’s fitness to practise. It investigates where serious concerns are raised about a doctor’s behaviour, health or performance and where those concerns suggest a risk to patient safety or to public confidence in the profession. Concerns can come from patients, employers, colleagues, the police, coroners, or the doctor’s own self-referral, and not every concern raised with the GMC results in a full investigation.
The Stages of an Investigation
The GMC’s own guidance for doctors under investigation is structured around five stages: deciding to investigate a concern, opening an investigation, the investigation process itself, making the decision, and, where relevant, monitoring any sanction that follows.
Initial assessment and opening an investigation
Not every concern raised with the GMC becomes an investigation. Information is first assessed to decide whether it could realistically raise a fitness to practise question at all; concerns that clearly could not are closed at this stage. Where a concern is more borderline, the GMC may carry out a limited provisional enquiry before deciding whether to open a full investigation, which helps it assess risk without committing to a full process unnecessarily.
The investigation itself
Once an investigation is open, the GMC gathers evidence relevant to the concern. This commonly includes medical records, statements from colleagues and witnesses, and the doctor’s own response to the specific allegations put to them. Doctors are given the opportunity to respond formally to the case against them before a decision is made, and the GMC’s guidance is clear that it aims to handle this process fairly and with appropriate support available to the doctor throughout.
Investigations vary enormously in length depending on complexity, the number of allegations, whether external assessments (such as a performance or health assessment) are needed, and how quickly evidence can be gathered. Historically, a proportion of GMC investigations have run well beyond a year; doctors and practices should not assume a quick resolution and should plan accordingly for cover and continuity if a partner is affected.
Reaching a decision
At the conclusion of an investigation, the case is decided by two case examiners, one medically qualified and one not, working from the evidence gathered and the doctor’s response. Possible outcomes include closing the case with no further action, giving private advice, agreeing undertakings (voluntary, agreed restrictions on practice), issuing a formal warning, or referring the case for a hearing before the Medical Practitioners Tribunal Service. Cases resolved by advice, undertakings or a warning conclude at this stage without a tribunal hearing; only cases referred onward proceed to MPTS.
Interim Orders: Restrictions While an Investigation Continues
Where the GMC believes a doctor’s ongoing, unrestricted practice could put patients at risk or seriously undermine public confidence, it can refer the matter to the MPTS for an Interim Orders Tribunal while the underlying investigation continues. This is a separate, faster-moving process from the main investigation and is not a finding of guilt; its purpose is to manage risk during the investigation itself.
An Interim Orders Tribunal panel of three, including at least one registrant member and one lay member, can suspend a doctor’s registration or impose conditions on their practice for up to 18 months. Any such order must be reviewed within six months of being imposed, and at intervals of no more than six months after that, so a restriction is never open-ended without further scrutiny. Hearings are held in private as a default, though a doctor can request a public hearing.
For a GP partnership, an interim order affecting a partner has immediate operational consequences, from patient list cover to NHS contract obligations, and is a scenario every partnership agreement should address explicitly rather than leaving to be worked out under pressure. We cover what a well-drafted partnership agreement should say about a partner’s capacity to practise, including regulatory investigations, in our post on GP partnership agreements and what every partner should know.
Referral to the MPTS and Possible Sanctions
Where a case is referred for a full tribunal hearing, the Medical Practitioners Tribunal Service makes an independent decision on whether the doctor’s fitness to practise is impaired and, if so, what sanction is appropriate. The range of outcomes runs from no action, through warnings and conditions on practice, to suspension, and, in the most serious cases, erasure from the medical register, meaning the doctor can no longer practise in the UK. All GMC and MPTS decisions of this kind are published on the medical register in line with the GMC’s publication and disclosure policy, which is itself a point GP partnerships should be aware of when considering reputational and patient communication issues arising from an investigation.
What This Means for a GP Partnership
Beyond the individual doctor’s own position, a GMC investigation touching a partner or salaried GP raises practical questions for the wider practice: whether NHS England or the integrated care board needs to be notified, whether CQC’s fit and proper persons requirement is engaged, how patient safety is managed in the interim, and how the partnership agreement addresses a partner’s temporary or extended absence. These are exactly the kind of issues that tend to surface alongside a partner’s ill health or incapacity more broadly, which we address in our post on partner ill health and incapacity: the legal issues for GP practices.
What This Means for Your Practice
A GMC investigation is a defined, staged process, not an instant verdict, and most concerns raised with the GMC do not end in erasure. But the process can run for a long time, and both the individual doctor and the wider partnership benefit from understanding, in advance, what an investigation actually involves and what it means operationally if a colleague becomes subject to one.
If you or a partner is facing a GMC investigation, or your practice needs advice on the partnership and governance issues that follow, get in touch with our healthcare team or call us on +44 207 566 1188. You can also reach us at info@gurvelegal.com. Our regulatory compliance team works alongside GPs and practices through regulatory investigations and their practical consequences.
