When doctors have a legal and professional obligation to refer a colleague to the GMC, how to make a referral, what happens after a referral, and how to protect yourself when referring
Referring a colleague to the GMC is one of the most difficult professional decisions a doctor faces. But in some circumstances it is not a choice — it is a legal and professional obligation. This guide explains when and how.
Good Medical Practice is explicit: if you have concerns about a colleague's conduct, performance, or health that may put patients at risk, you must take action. The specific obligation depends on the nature of the concern and your role, but the principle is clear, patient safety takes precedence over professional loyalty.
Doctors who become aware of a serious patient safety risk posed by a colleague and fail to act face their own fitness to practise risk. The relevant GMP provisions on this obligation are found in the section on working with colleagues and the duty to raise and act on concerns.
A referral to the GMC is required where the concern about a colleague's conduct, performance, or health is serious enough that it cannot be adequately addressed through local processes, where local processes have been exhausted without resolution, or where the concern is so serious that immediate GMC notification is
required. Common circumstances that trigger a referral obligation include: sustained or serious clinical performance failures that local management has not resolved; conduct that poses a direct patient safety risk; dishonesty in a clinical or professional context; a health condition that is affecting practice and is
not being appropriately managed; and conduct that would, if known to the regulator, call into question the colleague's fitness to practise.
The guide to what GMC insight means provides context for understanding the professional values at the heart of referral obligations.
In most cases, the appropriate first step is not a direct GMC referral but a report to the responsible officer (RO). The RO has statutory duties to refer to the GMC where fitness to practise concerns arise that cannot be managed locally.
Reporting to the RO, and documenting that report, is both the professionally appropriate route and the route that protects the referring doctor. Where the RO fails to act appropriately on a serious concern, or where the concern involves the RO themselves, direct GMC referral becomes appropriate.
CPD Certified, Online, Immediate Access
GMC referrals are made through the GMC's online referral system. The referral should include a clear factual account of the concern, the specific patient safety risk identified, the steps already taken to address the concern locally, and
any supporting documentation. The referral should be factual and specific, it is not an opportunity to express personal views about the colleague.
The GMC treats referrals confidentially in the first instance, though complete anonymity cannot be guaranteed in all cases. The guide to NHS employer referral to the GMC provides relevant context on how institutional referrals work alongside individual doctor obligations.
Making a GMC referral in good faith, in accordance with your professional obligations, is protected. The GMC and employment law provide protection for doctors who raise concerns in good faith about patient safety.
Document everything: the concern identified, the steps taken locally, the referral made, and the response received. Contact the MDO before making a GMC referral to ensure the referral is appropriately framed and that you are protected.
The referral should be based on factual observations, not assumptions or interpretations. A referral made maliciously or without reasonable grounds is itself a fitness to practise concern.
The guide to demonstrating professional values provides context for the professional framework within which referral obligations sit.
After a GMC referral is received, the GMC triages the concern and decides whether to investigate. The referring doctor may be contacted for further information. The referred colleague will be informed of the concern in due course.
The referring doctor is not automatically a witness in subsequent proceedings, though they may be asked to provide a statement.
The guide to ethics courses as GMC remediation evidence covers the professional values framework that underpins both the referral obligation and the GMC process that follows.
UK-registered doctors can access professional ethics training through Healthcare Ethics Courses.
Doctors with connections to Ireland can consult ethics training in Ireland.
Those with connections to Canada can review professional development in Canada.
10 CPD-certified courses for £500. Professional ethics CPD demonstrates active engagement with the professional obligations — including referral duties — at the heart of Good Medical Practice.
Bulk Buy 10 Courses →Where the concern about a colleague's conduct, performance, or health cannot be adequately addressed through local processes, where local processes have been exhausted, or where the concern is so serious that immediate GMC notification is required.
In most cases the first step is a report to the responsible officer, who has statutory duties to refer to the GMC where fitness to practise concerns cannot be managed locally.
Making a GMC referral in good faith, in accordance with professional obligations, is protected. Document all steps taken before and during the referral.
A clear factual account of the concern, the specific patient safety risk identified, steps already taken locally, and supporting documentation.
The GMC treats referrals confidentially initially, but complete anonymity cannot be guaranteed in all cases.
The GMC triages the concern and decides whether to investigate. The referring doctor may be contacted for further information.
The professional obligation to protect patient safety takes precedence. Document any instruction not to refer. Contact the MDO immediately.
Yes. A referral made maliciously or without reasonable grounds is itself a potential fitness to practise concern.
GMP is explicit that doctors must take action if they have concerns about a colleague's conduct, performance, or health that may put patients at risk.
Yes, where the health concern is affecting the colleague's ability to practise safely and is not being appropriately managed.
Contact the MDO for advice before making a decision. The MDO can advise on whether the concern reaches the threshold for a GMC referral.
Not where the referral is made in good faith and in accordance with professional obligations. Failing to refer where there is a clear obligation does carry a fitness to practise risk.
Contemporaneous notes of specific observations, dates, and any steps taken to address the concern locally — not interpretations or assumptions, just factual records.
This guide is for educational purposes only and does not constitute legal advice. Seek independent legal advice from a solicitor experienced in GMC regulatory proceedings.
