What is Fitness to Practise?

GMC Fitness to Practise Cases and Doctors

Fitness to Practise in simple terms is the ability of a doctor or other healthcare practitioner to practise safely and independently without the need for intervention by the regulator. It encompasses competence, probity, diligence, the ability to work within their own limitations, safe clinical and/or managerial practice, according to the role the practitioner is undertaking or the stage of training they have reached. It includes being able to get on with patients and colleagues, to work collaboratively in the best interests of patients and the organisation, being in good enough health to be able to perform the role (even if the doctor lives with a disability). A doctor must be able to make good decisions, keep good records, and remain up to date in their sphere of practice. A doctor must also work within the code of conduct for doctors: Good Medical Practice

Where a doctor compromises their position, or patient safety, or otherwise undermines the profession or their employer by acting or omitting to act in a particular way, the GMC may determine to take action against the doctor. This might be by way of providing guidance, issuing a warning, imposing undertakings, or referring a case to a fitness to practise hearing. If a doctor’s fitness to practise is found to be impaired, they can be restricted by way of conditions of registration, be suspended, or be struck off (also known as erasure from the register). The GMC/MPTS Indicative Sanctions Guidance also provides an analysis of the types of cases where fitness to practise is likely to be impaired.

The Medical Act 1983 is the primary Act of Parliament which governs GMC processes and proceedings. Section 35C of the Medical Act 1983 (as amended) reads:

“(2) A person’s fitness to practise shall be regarded as “impaired” for the purposes of this Act by reason only of—

(a) misconduct;

(b) deficient professional performance;

(c) a conviction or caution in the British Islands for a criminal offence, or a conviction elsewhere for an offence which, if committed in England and Wales, would constitute a criminal offence;

(d) adverse physical or mental health; or

(e) a determination by a body in the United Kingdom responsible under any enactment for the regulation of a health or social care profession to the effect that his fitness to practise as a member of that profession is impaired, or a determination by a regulatory body elsewhere to the same effect.”

For more information on the GMC’s processes, see our page on GMC Investigations. For further reading on the definition of ‘fitness to practise’, see the GMC’s policy guidance on ‘Fitness to Practice’ (2014). See also our GMC/MPTS case law  page and in particular the references to the Shipman Reports. The Fifth Shipman Report has a particular focus on definitions of fitness to practise, which has informed most healthcare regulators about best practice. For case law on how the GMC deals with overseas regulators of doctors, see the case of Alhy v GMC.

Doctors Defence Service is an independent organisation providing legal and policy advice to UK registered doctors. For advice and guidance on Fitness to Practise matters, call Doctors Defence Service on: 0800 10 88 739  Or use our online enquiry form.