A range of sanctions are available to the GMC when investigating fitness to practise concerns. When first contacted by the GMC, many doctors do not appreciate the far reaching implications of accepting a formal warning, nor the risks associated with challenging it.  Warnings can have a serious impact on career progression and may damage your reputation. 

What is a GMC warning?

A warning may be issued by the GMC in the following circumstances:

  • where there has been a significant departure from Good Medical Practice; or
  • where there is a significant cause for concern following an assessment of the doctor’s performance.

Warnings will not be appropriate where a doctor’s fitness to practice might be impaired. The GMC intend warnings to be viewed as a deterrent to the doctor involved and the wider profession, reminding the doctor that “their conduct or behavior fell significantly below the standard expected and that a repetition is likely to result in a finding of impaired fitness to practise”.

When might a warning be issued?

Complaints investigated by the GMC are first referred to two case examiners; one medical and one lay. They will consider what action the GMC should take in respect of the behaviour in question. A number of options are open to the case examiners:

  • refer the matter to the Medical Practitioners Tribunal Service (MPTS) to determine whether the doctor’s fitness to practise is impaired;
  • conclude the matter with a finding of no case to answer;
  • agree undertakings with the doctor; or
  • issue a warning.

For a fuller overview of the GMC fitness to practice investigation procedure visit our blog post ‘Overview of the General Medical Council’s fitness to practise investigation procedure’.

What is the process for issuing a warning?

Once the case examiners decide that a warning is the appropriate disposal, the GMC will write to the doctor to ask for his or her comments. The Doctor then has 28 days to respond.

If the case examiners disagree or the doctor disputes the facts alleged/disagrees with the formal warning, the matter will be referred to an Investigation Committee who decide at a public hearing whether a warning should be issued. Beware the public hearing and the impact on your reputation – hearings and outcomes are publicised on the GMC website.

What impact does a warning have?

Whilst a warning does not prevent a doctor from holding a licence to practise and does not place any restrictions on their registration, they are publically available and often unfairly misunderstood.

A warning will be published on the List of Registered Medical Practitioners (LRMP) and may be disclosed to any enquirer for a five year period. After five years, the warning will cease to be published on the LRMP; however it will be kept on record indefinitely and disclosed to employers on request. Although warnings are intended to dispose of less serious concerns without a finding of fault, many employers, contracting bodies and patients do not understand the intended effect of warnings and assume that they are an indication of a finding of serious concerns when they are not. The impact of a GMC warning being published against your name on the LRMP could easily hamper career progression and damage your reputation.

What should doctors do if they are offered a warning?

Doctors being investigated should seek legal advice before making submissions to the GMC.  The decision as to whether to agree to the warning or challenge it will depend on a vast number of variables including

  • the nature of the conduct in question
  • your attitude to risk and publicity in respect of the complaint
  • any mitigation that you can advance;
  • and a careful assessment of the likelihood of an adverse finding should the matter proceed further.

As the recent case of Uppal reinforces, where there is evidence of a clear breach of standards, serious consideration may need to be given to accepting a formal warning; where such evidence is absent, doctors may be best advised to challenge its imposition and protect their reputation.