GMC Colleague Referral: A Complete Guide for UK Doctors

Deciding whether to make a GMC colleague referral is one of the hardest calls a doctor will face — you're weighing patient safety against loyalty to someone you may work alongside every day. This guide explains when the duty to act applies, the red flags worth watching for, and exactly what happens once a concern is raised, using the GMC's own published guidance.

Whether you're the one raising the concern, supporting a colleague through it, or facing a referral yourself, understanding the process removes some of the fear from what is, by design, meant to protect patients rather than punish doctors.

What Is a GMC Colleague Referral?

A GMC colleague referral is a formal concern raised with the General Medical Council about a doctor, physician associate or anaesthesia associate whose behaviour, health or performance may pose a risk to patients or to public confidence in the profession. Referrals can come from an employer, a responsible officer (RO), a colleague, a patient, or the doctor themselves.

When Should You Make a GMC Colleague Referral?

Good Medical Practice is explicit: if you have concerns that a colleague may not be fit to practise and may be putting patients at risk, you must ask for advice from a colleague, your defence body, or the GMC — and report it if you're still concerned. The full duty is set out in the GMC's Good medical practice guidance.

Certain signs are worth watching for before matters escalate to the point of risk:

• A sudden rise in patient complaints, or complaints of a more serious nature than usual.
• Behaviour that's noticeably out of character — irritability, withdrawal, or uncharacteristic errors.
• Visible signs of exhaustion, ill health, or possible substance use affecting performance.
• Deteriorating timekeeping, reliability, or a backlog of results and referral letters left unactioned.
• A pattern of near misses or safety incidents rather than a single, isolated event.

What are the steps of the referral process?

1. Consider whether the concern can be resolved locally first — most GMC guidance expects you to raise it with a manager, responsible officer, or through your organisation's own procedures before referring externally.
2. Get advice from a colleague, your medical defence organisation, or the GMC's confidential helpline if you're unsure whether the concern meets the threshold.
3. Gather the specifics — dates, incidents, and any supporting documentation — since the GMC can only investigate concerns where the doctor can be identified and the details are clear.
4. Submit the concern using the GMC's online form, or, if you're a responsible officer, through GMC Connect or the RO referral form.
5. Respond to any follow-up requests — the GMC may ask for further information before deciding whether to open a formal investigation.

Full detail on identifying the doctor, what to include, and the different referral routes for responsible officers and employers is set out on the GMC's own raise a concern page.

What Happens After You Make a GMC Colleague Referral?

Once a concern is submitted, the GMC reviews it to decide whether it falls within its remit and meets the threshold for investigation, usually responding within about 10 working days.

• Initial review: the GMC checks the concern is about a registrant it regulates and that enough detail has been provided to act on it.
• Formal investigation: if opened, this can involve gathering medical records, statements, and an independent expert opinion, and notifying the doctor's employer.
• Case examiners: one medical and one lay case examiner review the completed investigation and decide whether there's a case to answer.
• Outcome: the case can close with no action, a warning, agreed undertakings, or referral to a hearing before the Medical Practitioners Tribunal Service (MPTS).

The GMC's own explanation of this process, including the principles it follows and the support available to doctors under investigation, is set out in Fitness to practise of doctors explained.

Protecting Yourself When You Raise a Concern

Doctors sometimes hesitate to make a GMC colleague referral for fear it will damage working relationships or invite retaliation. The GMC's guidance on raising and acting on concerns makes clear that whistleblowers are protected, and gagging clauses that try to prevent staff from raising patient safety concerns are void.

If you're on the other side of a referral — facing a concern yourself — early advice and genuine insight make a real difference to how a case unfolds. See our insight, reflection and remediation courses for structured support building that evidence.

Conclusion

A GMC colleague referral is never a step to take lightly, but it exists for good reason: to catch risks to patients before they cause serious harm. Knowing when the duty applies, what red flags to look for, and exactly what happens at each stage — from local escalation through to a GMC decision — makes the process far less daunting, whichever side of it you're on. For more on reflective practice and regulatory concerns, see our blog, browse our insight, reflection and remediation courses, and ask about our bulk booking discount if you're supporting a whole team through CPD. Start building your evidence today.

This guide is for general information and educational purposes only and does not constitute legal advice. For advice specific to your situation, contact a specialist regulatory solicitor, your medical defence organisation, or the GMC directly.