You should expect to be referred to the GMC

If you are a doctor working in the UK, you should expect to be the subject of a GMC complaint at some point in your career, however most doctors who approach us for legal advice and support have little insight into this process and are ill-prepared for this extremely stressful eventuality.

An ‘occupational hazard’ for doctors

Unfortunately, doctors in the UK should treat investigations by the GMC as an ‘occupational hazard’. 

The GMC receives around 7500 complaints every year.  Based on the number of doctors on the GMC register, there is an approximate 2.2% chance of being subject to a complaint.  Whilst this might not sound a lot, based on a typical 35 year career, you can statistically expect to be the subject of at least one complaint to the GMC within your working lifetime. 

It is worth pointing out though that, of course, not all complaints to the GMC will result in a full, formal investigation.  Nonetheless, GMC investigations are utterly traumatic experiences regardless of the final outcome. 

There is therefore a lot to be said for “avoiding” a GMC referral. 

How to “avoid” a GMC referral

There is probably nothing anyone can do to entirely eliminate the risk of a GMC referral.  However, there are some things you can do to reduce the risk of complaints and referrals.  

Before that though, it is worth understanding what sort of fitness to practise issues most often are referred to the GMC.  Since 2014, the top 5 allegations related to: 

1. Knowledge & experience
2. Acting with honesty/integrity
3. Recording work
4. Partnerships with patients
5. Communicating effectively

GMC Misconduct

Misconduct – a broad category which includes both clinical and non-clinical issues (including misconduct in your personal life) – tops the list of GMC fitness to practise complaints and investigations.

Whilst you cannot entirely eliminate the risk of a GMC complaint, there are some things you can do to lower the risks:

1. Good Medical Practice – The Good Medical Practice (GMP) is the key document the GMC sets out ethical duties for doctors and is a benchmark in virtually all tribunal decisions.
2. Duty of candour – Be open and honest and apologise if something goes wrong.
3. Indemnity insurance – Make sure that you have appropriate insurance arrangements in place.
4. Social media – Be cautious when using social media.
5. Recording keeping – Keep full, accurate and contemporaneous clinical records and resist the temptation of change records following an incident.
6. Professional boundaries – Maintain appropriate professional boundaries with patients and colleagues.
7. Financial interest – Take care with any financial dealings, such as billing patients and particularly work relating to insurance companies.
8. NHS time – Avoid private practice and patients during NHS contracted time.  This might put you at risk of an allegation of fraud and misconduct.
9. Prescribing – Don’t self-prescribe and don’t prescribe for your friends and family.
10. Communication – good communication – with patients and colleagues is essential!

Worth going it alone before the GMC?

 Should you find yourself facing GMC fitness to practise proceedings, it is worth going alone?

Whilst it is technically possible to make it through a GMC investigation and MPTS hearing without legal representation, evidence clearly shows the benefit and value of legal representation.  A 2019 peer-reviewed study published in the journal BMC Medicine found that doctors who lacked legal representation tended to receive more serious outcomes.

The study results showed clearly that both “non-attendance and lack of legal representation” were consistently related to more serious outcomes.”

A similar 2015 study revealed that – of the two outcomes, suspension or erasure – doctors with legal representation at hearings were significantly more likely to merely be suspended (72%), rather than struck off (28%). In contrast, 69% of self-represented doctors were struck off.

Legal representation

The benefits and necessity of legal representation for doctors facing GMC investigation and MPTS hearings are clear. 

Depending on the circumstances, it may be possible for your legal representative to persuade the case examiners that there is no case to answer – effectively stopping your fitness to practise investigation before it reaches the MPTS tribunal stage. 

Even if you cannot stop the case completely at this early stage, it may be possible to significantly reduce the number or severity of allegations you face – therefore reducing the range of sanctions that could be imposed. 

“The GMC’s case against you will be made by a specialist barrister – so it is only appropriate to instruct a specialist yourself.” 

Kings View are public access barristers, meaning that you can instruct us directly without having the additional expense of hiring a solicitor first (so we are generally at least one third cheaper). 

At Kings View, we have experience defending every level of doctor in all tribunals for the last 10 years and our barristers have additional qualifications from the Bar Standards Board, meaning that we can carry out all of the tasks that a solicitor can – including litigation.