In 2007 through an amendment to the Medical Act 1983 (part II, section 44D), the new registration framework for doctors was introduced. Newly fully registered doctors are required to undertake the first 12 months of their employment in an approved practice setting (APS) and crucially may only practice medicine in the UK if they do so in such a setting.

APSs are those identified by the General Medical Council (GMC) as appropriate for newly registered practitioners and must provide governance arrangements such as appraisals and supervision. On completion of the 12 months, doctors must apply to have the restriction removed.

The requirement to work in an APS for 12 months also applies to doctors returning to the profession after a long absence from practising in the UK.

This issue came to light recently when a junior doctor, a core medical trainee 1 in anaesthetics, was reported to the GMC by a pharmacist for prescribing painkillers to a colleague who had severe back pain. The junior doctor had written out a private prescription whereas he was only allowed to prescribe painkillers for a patient in an approved practice setting. The pharmacist discovered the restriction on his practice when he looked at the prescribing doctor’s GMC registration details.

The GMC investigated this case and they decided not to take any further action. However, this case has alerted junior doctors to the change in the registration framework for doctors.

A list of approved practice settings is provided by the GMC on their website and the relevant explanatory pages can be found here.