GMC Undertakings and Doctors, and Assurance Assessments
An undertaking is a written agreement (a bit like a contract) between a doctor and the GMC that the doctor will work within prescribed parameters, often in a particular specialism or training setting. A doctor must consent to abide by undertakings; they cannot be imposed upon a doctor where a doctor formally opposes undertakings. In such circumstances a doctor is likely to be referred to a fitness to practise hearing. In some instances, doctors may fare better at such a hearing, obtaining workable conditions that are less onerous that the terms of the proposed undertakings. Each case turns on its own facts.
Undertakings may relate to:
a) restrictions on the doctor’s practice;
b) restrictions as to the doctor’s behaviour;
c) commitments placed on a doctor to practise under clinical supervision;
d) commitments placed on a doctor to undergo re-training;
e) a doctor being monitored as to their health.
There is a variety of undertakings that can be imposed. For more information, see the GMC’s Undertakings Bank, which sets out a number of undertakings that may be imposed in a number of different situations.
Undertakings are often imposed (albeit by agreement with the doctor) where there are concerns about competence or adverse mental or physical health. Evidence of progress, remediation and safe working is usually required over time. There are many doctors who live and work quite well with significant mental health problems, that may go into remission but which leave a vulnerability that needs to be monitored. Visit our GMC Health Cases page for more details about how a doctor’s fitness to practise is assessed in regard to health concerns.
It is not always wise for a doctor to accept undertakings as in some instances the undertakings will be more rigid than conditions agreed through the interim orders tribunal process. A doctor should therefore take legal advice before accepting undertakings.
The GMC has to power to vary and revoke undertakings. Significant evidence will be needed to be able to revoke undertakings altogether. The GMC might on occasions invite a doctor to undergo an Assurance Assessment. in order to obtain objective evidence of fitness to practise without undertakings. They will have a binary decision to make on competence, namely, Acceptable or Unacceptable. For those found to be unacceptable in some areas the assessors may make recommendations. The doctor can also take independent advice.
Assurance Assessments will be undertaken by assessors (both clinicians and lay people). They will assess a doctor’s competence in:
- Maintaining Professional Performance
- Clinical Management
- Operative/technical skills
- Record Keeping
- Safety and Quality
- Relationships with Patients
- Working with colleagues
They will have regard to the GMC Code of Conduct Good Medical Practice.
For further general reading on the subject of GMC undertakings, see the GMC’s Guidance on Varying and Revoking Undertakings, and the GMC’s Guide to Undertakings for Doctors.
For assistance with dealing with the GMC about any issue concerning Undertakings or other legal or regulator matters, contact Doctors Defence Service in strict confidence and without obligation on: 0800 10 88 739