Doctors become unwell like everyone else. Most health conditions never involve the GMC at all, and the GMC's own agreement with NHS Practitioner Health says so. Where a condition, or its management, raises a question about patient safety, the GMC can investigate. A GMC health case then differs in important ways from a conduct case. Knowing those differences helps you decide what to disclose, to whom and when.
When health becomes a regulatory matter
Section 35C of the Medical Act 1983 lists adverse physical or mental health as one of the grounds on which a doctor's fitness to practise can be regarded as impaired. The ground is about current risk, not diagnosis.
The memorandum of understanding between the GMC and NHS Practitioner Health, signed on 23 August 2022, puts the threshold in practical terms. It records that most health conditions are suitable for local management. The GMC needs to know about a condition only where it poses a risk to patients or may contribute to clinical or conduct concerns. In health only cases, it says, the GMC generally makes provisional enquiries rather than opening a full investigation. It may also pause a case so that a doctor can complete treatment for an acute illness. The memorandum was signed for 36 months, so check with Practitioner Health whether a renewed version is in place.
Good medical practice (2024) frames your own duty at paragraph 78. You should try to take care of your own health and wellbeing and recognise when you may not be fit for work. You should also seek independent professional advice about your fitness for work rather than relying on your own assessment. Consider a doctor who has a GP, follows occupational health advice and adjusts work to match that advice. That doctor is in a strong position if anyone ever raises a concern.
How a concern reaches the GMC
The GMC's guidance for registrants under investigation says it may receive concerns about your health in three ways. You may refer yourself, your employer may refer you, or the concern may arise during an investigation into something else. Health can also lie behind a conduct allegation. That happens, for example, where alcohol explains a missed shift or a mental health crisis explains an outburst. Raising that context early, with medical evidence, gives the GMC the information it needs to consider a health route.
The health assessment
If the GMC believes your health may adversely affect your ability to practise safely, it may ask you to take a health assessment. Its guidance is direct about refusal. If you do not take one, it may affect your registration status. In some cases you may no longer be able to practise or hold registration.
One or two GMC appointed examiners examine you. Where the concern is mental health you talk with two, normally general psychiatrists. They take a full history, including family and personal history. Where the concern relates to drugs or alcohol you will usually need to give a testing sample. An independent testing provider then contacts you to arrange the collection. The GMC asks you to send any recent reports from occupational health, your GP or your treating doctor in advance. It also encourages you to be open with the examiners. The GMC mainly arranges assessments remotely and can hold them in person. But where you need testing, you must attend the assessment and the testing in the UK.
Each examiner writes an independent report. It covers a diagnosis using ICD-10 or DSM-5, and whether you are fit to practise generally, on a limited basis or not at all. It also makes recommendations, such as a medical supervisor or a support group. If you disagree with the reports, you can obtain your own and submit it as evidence.
What follows the reports
Two senior GMC decision makers, one medical and one non-medical, then decide how to proceed. The options are to close the case with no further action, agree undertakings with you, or refer you to a Medical Practitioners Tribunal. A warning is not available where the issue relates solely to your health.
The memorandum with Practitioner Health covers what happens where the GMC finds a health only impairment. In that event the GMC will seek to resolve the investigation as swiftly as possible by consent, through health undertakings. The memorandum adds that referral to a tribunal may on occasion be necessary. That applies where the doctor lacks insight, fails to comply with measures needed to protect patients, or faces serious misconduct concerns.
If a case does reach a tribunal, the Medical Act limits the outcome. Under section 35D a tribunal cannot direct erasure from the register in what the Act calls a health case. It can suspend or impose conditions. In a health case, after a suspension of at least two years, it can extend the suspension indefinitely.
Living with undertakings
With health undertakings the GMC assigns you a medical supervisor, usually a consultant psychiatrist. You meet them at least every three months. The supervisor reports to the GMC. They gather feedback from an agreed contact at your employer, usually your workplace reporter, and from anyone else you agree to. Tell your supervisor promptly if your condition changes.
Confidentiality
The GMC says the assessment reports are confidential and that it does not share them with your employers. If a tribunal uses them, it sits in private for the parts of the hearing that relate to your health. Published decisions also leave out health information. The GMC publishes only non-health undertakings and conditions. It says it will not disclose health information to your employer, workplace supervisor or responsible officer without discussing it with you first.
Within the NHS, Part V of Maintaining High Professional Standards routes employers' concerns about a practitioner's health through the occupational health service. Your employer's route and the GMC's are separate, so keep what you tell each of them consistent.
Other healthcare professionals
Removal from the register is not available before any regulator where the case is about your health alone. The GDC, the GPhC and the GOC cannot erase or remove in a case that rests solely on health, and the HCPC and the NMC may strike off for health only after two years of continuous suspension or conditions. The GDC, the GOsC and the GCC send health allegations to a Health Committee, and the HCPC to a Health Panel. See our pages for each profession.
Eloquia acts for doctors in GMC investigations on fixed fees by stage, each stated plus VAT, with a specialist barrister from the outset. Our fees and funding page sets out each stage.
If the GMC has asked you to attend a health assessment, gather your recent GP, occupational health and specialist reports now. Send them to your GMC officer before the appointment, and take advice before you reply to any proposal for undertakings.
Sources
- Medical Act 1983, section 35C: Functions of the Investigation Committee
- Medical Act 1983, section 35D: Functions of a Medical Practitioners Tribunal
- NHS Practitioner Health, Memorandum of understanding with the GMC (signed 23 August 2022)
- GMC, Good medical practice (2024), Domain 3: Colleagues, culture and safety, paragraph 78
- GMC, Health assessments: guidance for registrants under investigation
- GMC, What does the health assessment involve
- GMC, What happens after the health assessment
- GMC, Monitoring health undertakings and conditions
- Maintaining High Professional Standards in the Modern NHS, Part V: Handling concerns about a practitioner's health (copy hosted by East London NHS Foundation Trust)
- GDC: Fitness to Practise, Guidance for the practice committees, version 1.0, 6 January 2026
- GPhC: Good decision making, fitness to practise hearings and outcomes guidance, March 2024
- Opticians Act 1989, section 13F (powers of the Fitness to Practise Committee)
- Health Professions Order 2001, article 29 (orders and appeals)
- Nursing and Midwifery Order 2001, article 29 (orders and appeals)
- Osteopaths Act 1993, section 20 (allegations and the Investigating Committee)
- Chiropractors Act 1994, section 20 (allegations and the Investigating Committee)
- HCPC: Hearings
