Most doctors learn about a GMC concern in one of two ways. A patient or colleague says that a complaint is on its way, or the GMC itself makes contact. Either way, the first stage of the GMC investigation process is the same. The GMC calls it triage. In 2025 it made 13,465 triage decisions about doctors, a rise of 25 per cent on the 10,769 it made in 2024, its annual statistical report shows. The GMC published that report on 30 July 2026.

The most useful figure in that report belongs at the top of this guide. Of those 13,465 concerns, the GMC closed 12,146 at triage because they did not meet the threshold for a full investigation. A further 291 went to the doctor's employer or responsible officer to consider locally. Only 997 became formal investigations. While a concern sits at triage, the GMC does not tell the doctor or the employer about it. As a result, many doctors whose concerns close there never hear of them. The GMC's own advice covers the doctor who hears that someone is going to complain. If you then hear nothing, it says, you can assume that the GMC closed any concern it received.

What the GMC looks at first

Triage begins with the Registrar's initial consideration under rule 4 of the General Medical Council (Fitness to Practise) Rules 2004. At this point the GMC is not deciding whether you did anything wrong. Instead, its guidance, Deciding whether to open an investigation (Doctors), sets four questions. Is the information about a doctor on the GMC register? Is there a legal basis for assessing fitness to practise? If proven, would the information be serious enough to raise a question of impaired fitness to practise? Finally, is there any reason not to open an investigation?

The legal basis means one of six grounds of impairment. They are misconduct, deficient professional performance, a conviction or caution, adverse physical or mental health, not having the necessary knowledge of English, or a determination by another regulator. A complaint about a missed appointment will often fall outside these grounds or below the seriousness threshold. A billing dispute with a private clinic is often in the same position, and such a complaint closes at that point.

The guidance describes the seriousness threshold as relatively low. The GMC asks whether you may pose a current and ongoing risk to patient safety, to public confidence in the profession or to professional standards. Since 30 May 2025 every GMC decision maker has applied the same three questions to that risk. How serious is the concern? What is the impact of any relevant context, such as your working environment? And how have you responded, including any insight and remediation? When it introduced the change, the GMC said that its thresholds had not changed. What changed was that one set of principles now applies at every stage.

Provisional enquiries

Where the information is too thin to decide, the GMC can open a provisional enquiry. This is a limited, targeted request for information, often to your employer or responsible officer. The GMC says it will let you know first if it needs to ask them anything before it decides. In 2025 the GMC opened 554 provisional enquiries. Of these, 467 closed and 56 became investigations. The other 31 were still running when the GMC extracted the data on 5 January 2026.

Treat notice of a provisional enquiry as a real stage of the process. That is because what your employer tells the GMC at this point shapes the decision to investigate.

Reasons the GMC will not investigate

Three reasons for closing a case at triage are worth knowing. The first is the five year rule in rule 4(5). No allegation proceeds where more than five years have passed between the most recent events and the date the concern reached the GMC. An exception arises only where the Registrar considers it in the public interest in the exceptional circumstances of the case. Second comes a vexatious complaint, which the GMC will not investigate unless the public interest requires it. The third is a third party process. Sometimes another body, such as the police or your employer, is already investigating and its outcome would help the GMC decide. In that case the GMC may wait for that outcome before making its decision. That outcome sometimes leads it to close the case without opening an investigation.

A complainant who withdraws does not end the matter. The guidance tells the GMC to assess the risk regardless. Indeed, the more serious the information, the more likely the GMC is to investigate without the complainant's cooperation.

Who raises concerns

Members of the public raised 10,717 of the 13,465 concerns in 2025, about 80 per cent. Persons acting in a public capacity raised 552, a group that includes responsible officers, managers and the police. Only 190 of those came from employers. The report says the reasons for the rise in concerns from the public are not yet fully understood. An employer referral is far rarer than a public complaint, and it deserves a prompt and careful response.

What to do if the GMC contacts you

The GMC now tries to make its first contact by telephone rather than by letter. The 2025 report describes the change as a response to feedback that a call would feel less daunting than a formal letter. Whichever way the news reaches you, do four things. Write down what you heard, from whom and when. Then contact your defence organisation or a legal adviser the same day, which is also what the GMC itself advises. Do not contact the person who raised the concern. Keep any records that relate to the matter safe and unaltered.

Good medical practice requires you to cooperate with formal investigations. The GMC also tells doctors that early information can help it close a case sooner. But that cooperation works best as a considered written response, prepared with advice, rather than an unguarded telephone conversation. A first account given in haste is hard to move away from later. For that reason I advise every doctor I work with to take a day before saying anything of substance.

If you are a nurse, dentist, pharmacist or other healthcare professional, your regulator runs a different process with its own names and time limits. Our pages for each profession set them out.

If the GMC opens an investigation, Eloquia can act for you through each stage of a GMC case, from triage to a tribunal. We work on a fixed fee for each stage, with a specialist barrister involved from the outset and included in the fee. Our fees and funding page states every fee plus VAT. If an investigation ends with the GMC setting out allegations, our guide to writing your response to the allegations letter explains what that letter asks of you.

Sources

  1. General Medical Council, Concerns about fitness to practise: Annual statistical report 2025 (published 30 July 2026)
  2. General Medical Council, GMC publishes fitness to practise data for doctors (30 July 2026)
  3. General Medical Council, Deciding whether to open an investigation (Doctors)
  4. General Medical Council, New GMC guidance to ensure greater clarity and consistency in handling of fitness to practise concerns (29 May 2025)
  5. General Medical Council, How we investigate concerns: deciding to investigate a concern
  6. General Medical Council, How we investigate concerns: opening an investigation
  7. General Medical Council, Our fitness to practise processes: a guide for doctors (published October 2014, updated January 2025)
  8. The General Medical Council (Fitness to Practise) Rules Order of Council 2004, SI 2004/2608, Schedule (legislation.gov.uk, text as made)
  9. General Medical Council, Good medical practice (in effect from 30 January 2024, updated 13 December 2024)