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Performance Review - GMC 2017/18

21 Jun 2019
  • 2018
  • Performance Reviews

Key facts & figures:

Regulates the practice of doctors in the United Kingdom
298,011 (as at 30 September 2018)
£390 fee for registration with a licence to practise or £140 for registration without a licence to practise

Standards of good regulation met:

Guidance & Standards:

4 out of 4

Education & Training:

4 out of 4


6 out of 6

Fitness to Practise:

10 out of 10


The GMC has met all of our 24 Standards of Good Regulation this year.

Education and Training: standards are linked to standards for registrants

In June 2018 the GMC published an updated document setting out the knowledge and skills that all graduates from UK medical schools must have. This followed a programme of engagement with key stakeholders. The updated document emphasises the links between the standards for graduates and those for registrants. The GMC also published accompanying guidance for medical schools, which specifies the guidance for GMC registrants with which graduates should be familiar.

Registration: information about registrants is easily accessible

The GMC has made some changes to how it publishes information about fitness to practise sanctions. It updated its publication policy in February 2018. The new policy changes the time limit for which some information about sanctions is published, and confirms that the GMC will continue to disclose relevant information to current employers on request. The GMC has also made changes to make it easier for people to find information in cases where the GMC has agreed undertakings with a registrant, or where the case examiners decide to issue a warning to a registrant.

Fitness to Practise: anybody can raise a concern

We carried out a targeted review and audit of the GMC’s use of provisional enquiries. These are enquiries the GMC carries out at the initial stage of a case to determine whether a full investigation is necessary. We obtained information from the GMC which showed that its use of provisional enquiries remained consistent with the previous year, and that it has measures in place to assure the quality of decisions. The GMC also told us about the steps it is taking to review and develop its use of provisional enquiries. We wanted to see how provisional enquiries were working in practice. We reviewed 40 cases. We found:
  • the rationale for carrying out a provisional enquiry was consistent with the relevant GMC guidance
  • the further information sought by the GMC was consistent with the reasons given for carrying out a provisional enquiry
  • the GMC obtained enough information through the provisional enquiry to make a reasonable decision
  • the GMC applied the appropriate test in making decisions about the outcome of provisional enquiries: that is, whether the information received amounted to an allegation of impaired fitness to practise.

Overall, we considered that the outcomes of provisional enquiries were reasonable and appropriate. The evidence we gathered in our audit did not indicate that the GMC’s use of provisional enquiries makes it harder for people to raise concerns.

Fitness to Practise: the process is transparent, fair and proportionate

The GMC has been taking action to implement the recommendations of the Williams Review, an independent review commissioned by the Government to look into issues in relation to gross negligence manslaughter and professional regulation. We saw that the GMC has reviewed how it decides whether to exercise its power of appeal against final fitness to practise decisions. It has introduced a decision-making panel, and we understand that the panel’s decisions will be published. This is appropriate, to promote transparency in decision-making. The GMC has also been taking other action to promote fairness in its fitness to practise process. It has commissioned an independent research project to understand the reasons for the pattern of complaints it receives from employers and healthcare providers. The GMC wants to understand what constitutes good practice in decision-making about making referrals to the GMC, and ‘to work more closely with clinical leaders to properly develop supportive, open and fair workplaces’. 


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