Periodic Review - General Chiropractic Council 2025/26

We have published our 2025/26 performance review for the General Chiropractic Council (GCC). For this period it is one of our longer, more detailed periodic reviews. The report covers the period 1 July 2025 to 30 June 2026.

Key statistics

• The GCC regulates chiropractors in the UK
• There were 4,158 professionals on its register (as at 30 June 2026)

Key findings and areas for improvement

Standard 3 on Equality, Diversity and Inclusion

The GCC continues to perform well in several areas. It has made some changes to its EDI governance arrangements, but they remain clear and appropriate for embedding EDI. It has made progress in updating its fitness to practise (FTP) guidance documents to ensure they address racist or other discriminatory behaviour – a gap we identified in 2023/24. It continues to use data and research to inform its work and, although it has not identified evidence of unfairness, it continues to look for, and take steps to reduce, risks of bias or unfairness (both actual and perceived) in its regulatory decisions. The GCC’s data shows that male registrants are disproportionately represented in FTP referrals. It is implementing measures to reduce the underlying drivers of disparity rather than solely targeting the gender disparity. We welcome these plans but encourage the GCC to remain curious about what its data may be showing to assure itself there are no issues of unfairness. We have also suggested that it consider systematically collecting data on student progression and outcomes, in the same (or similar) way that it collects data on student admissions. We will continue monitoring its work on EDI and how it responds to our suggestions. 

The Code of Professional Practice

The GCC’s new Code of Professional Practice came into effect on 1 January 2026. To support registrants through the change, the GCC issued extensive communications around the time of its launch, created a new hub with videos and guidance on the changes and published new guidance on professional boundaries. This activity and supporting materials were generally well-received by stakeholders.

Accuracy of the Register

We identified two errors in the GCC’s register this year. This was despite corrective action taken following a similar error we identified in 2023/24. The GCC holds a small number of final hearings each year and only three resulted in a sanction this year, so errors occurred on a high proportion of cases. The GCC corrected the errors and is taking steps to strengthen its assurance framework. While this response is positive, the evidence shows there were insufficient controls in place during the review period. We concluded Standard 10 is not met.

Fitness to Practise (FTP)

The GCC met four out five FTP Standards this year.

We audited all cases closed by the GCC between 1 July 2025 and 31 October 2025 at the earlier stages of its process. This helped us assess its closure decisions, quality of investigations, risk management and timeliness. Our audit also provided insight into the support the GCC provided to people involved with FTP investigations. Our findings provided assurance that, by and large, the GCC:

• made reasonable and appropriate closure decisions 
• conducted robust investigations, gathering relevant information and seeking clinical advice or expert opinions where appropriate
• identified and managed risks, although it continues to take a risk-averse approach which may create challenges when identifying high priority cases
• supported parties by providing detailed process information, professional and sensitive case handling and regular updates.

We saw some delays in case progression but only one occurred during the review period, with the rest occurring before. The GCC proactively progressed multiple cases without delay by giving deadlines for responses, chasing promptly when responses weren’t received and acting promptly on information received. The timeliness data shows improvement at the earlier stages of the FTP process and we welcome this progress. However, the end-to-end timeframe from referral to final hearing remains similar to last year, when the GCC did not meet this Standard because of timeliness. The caseload data also shows an increase in cases awaiting a final hearing and in open cases over 52 weeks old, which could indicate a backlog developing. We concluded that Standard 15 is not met again this year.

This was the third consecutive year that the GCC did not meet Standard 15 because of the timeliness of its FTP investigations. We therefore considered whether to escalate our concerns about the GCC’s performance, in accordance with our escalation policy. The GCC is taking action to address our concerns and there are some early signs of improvement, so the issues do not currently appear intractable. However, end-to-end timeliness has not significantly improved in the last three years and there has been a significant increase in the number of older cases. We therefore decided to escalate our concerns by writing to the Chair of the GCC’s Council. We will continue to monitor the GCC’s progress in improving its timeliness.