Open consultation

Reforming the General Medical Council legislative framework - consultation document

Published 24 March 2026

Foreword

The regulation of healthcare professionals in the UK is one of the essential components of our health and care system. It is vital in delivering patient and public safety, ensuring that healthcare professionals have the right skills, knowledge and values to deliver high-quality and safe care that the public rightly demand.

However, the regulatory system for healthcare professionals in the UK is out of date, making it difficult for professional regulators such as the General Medical Council (hereafter referred to as ‘GMC’) and the Nursing and Midwifery Council (NMC) to deliver swift public protection when it is needed, and to adapt quickly to changes in the UK healthcare workforce.

Over recent years, the need for a more flexible approach to regulation has become clear. This government, in partnership with the health and care professional regulators, the Professional Standards Authority for Health and Social Care (PSA), and the devolved governments, is committed to delivering a regulatory system that is responsive, flexible, and resilient.

The proposals set out in this consultation, which is a joint consultation on behalf of the Secretary of State for Health and Social Care and the Scottish ministers, build on extensive engagement with stakeholders and the public, including previous consultations, and consider the lessons learned from regulating new professional groups.

We invite all interested parties to engage fully with this consultation. Your insights and experiences are vital as we work to shape regulatory reforms that underpin high standards, uphold public confidence, and most of all protect patients and the public for generations to come.

Introduction

The current UK model of regulation for healthcare professionals is rigid, complex and needs to be reformed to better protect the public, support our health services and help the workforce meet future challenges.

For example, the Medical Act, which governs the regulation of doctors, dates back to 1983 but has roots in even older statutes and has only received piecemeal updates since its inception. Streamlining and updating regulators’ legislation will enable them to operate more efficiently and to consistently uphold high standards and maintain public confidence in the professions the regulators oversee.

In 2021, the former government consulted on policy proposals to reform the regulation of healthcare professionals and to introduce statutory regulation for anaesthesia associates and physician associates in the UK. This was also a joint consultation on behalf of the Secretary of State for Health and Social Care and the Scottish ministers. Responses to this consultation, Regulating healthcare professionals, protecting the public (‘the 2021 regulating healthcare professionals consultation’), showed widespread support for reform of regulators’ legislative frameworks to make them more efficient, modern and consistent.

The reforms that were consulted on span 4 main areas of regulation:

• governance and operating framework
• education and training
• registration
• fitness to practise

Draft legislation to establish a legislative framework for the regulation of anaesthesia associates and physician associates was underpinned by the policy proposals set out in the 2021 regulating healthcare professionals consultation. The subsequent consultation in 2023, Regulating anaesthesia associates and physician associates, consulted on that draft legislation. The Anaesthesia Associates and Physician Associates Order 2024 (AAPAO) came into force on 13 December 2024, apart from one provision not currently in force. The AAPAO was laid before the Westminster and Scottish Parliaments, in accordance with the requirements of the Health Act 1999.

The regulation of physician associates and anaesthesia associates in Scotland is a devolved matter because these professions were first brought into regulation after the Scotland Act 1998 became law. In Northern Ireland, the regulation of healthcare professions is a transferred matter, meaning the Northern Ireland Assembly has legislative competence, although it has historically chosen to continue with the UK‑wide regulatory model. In Wales, regulation of healthcare professions is a reserved matter. GMC operates on a UK‑wide basis to ensure consistent standards, patient safety and workforce mobility across all 4 nations, and as such this is a UK-wide consultation.

The AAPAO paved the way for full scale reform of the regulatory frameworks of all the healthcare professional regulators by providing a legislative template to expand upon.

The government is starting its programme of legislative reform with this consultation on the draft General Medical Council Order 2026 (‘the draft order’) (described below and published alongside this consultation document on the Reforming the General Medical Council legislative framework page). This legislation, once fully in force, will repeal the majority of provisions in the Medical Act 1983 and the entire AAPAO and will provide GMC with the statutory powers and duties required to safely and efficiently regulate medical practitioners, physician assistants in anaesthesia and physician assistants in the UK.

To note: in this document when discussed in the context of the Leng Review or current regulation under the AAPAO, references are made to ‘physician associate’ and ‘anaesthesia associate’. When discussed in the context of the draft order, references are made to the proposed names of ‘physician assistant’ and ‘physician assistant in anaesthesia’ as used in the order.

Following Professor Gillian Leng CBE’s independent review into the anaesthesia associate and physician associate professions, which highlighted concerns around the existing professional titles, we are seeking views on changing the professional titles of anaesthesia associate and physician associate to physician assistant in anaesthesia and physician assistant in legislation. As set out in the ‘Offences relating to registration’ section of this document, this would mean that the titles ‘physician assistant’ and ‘physician assistant in anaesthesia’ would be protected in law.

The government has worked with the healthcare professional regulators, PSA and the devolved governments to refine some of the policy positions set out in the 2021 regulating healthcare professionals consultation. Now, this consultation provides a first step to modernising the legislative frameworks of each of the healthcare professional regulators.

Modernising the system of professional regulation in the UK is a complex programme of work, requiring multiple pieces of legislation. We plan to work with each regulator in turn to identify any profession-specific variation to our proposals. Changes to each regulator’s legislation will then have to be consulted on.

This consultation is being taken forward in accordance with the requirements of section 60 of the Health Act 1999. The regulation-making power in section 60 permits changes to the regulation of healthcare professions by means of an order in council and sets out that before any draft legislation can be laid in Parliament, a 3-month consultation must take place. Following this statutory consultation, the draft order will be laid in both the Westminster and Scottish Parliaments and will be subject to the affirmative Parliamentary process, meaning that it will be subject to debates and a voting process in both parliaments before any changes can become law. This is because legislation regulating any healthcare professions which were first brought into regulation after the Scotland Act 1998 became law must be laid in the Scottish Parliament as well as in both houses of the UK Parliament.

Following the laying of the final General Medical Council Order 2026, the UK government, in partnership with the devolved governments, intends to bring forward legislation to modernise the legislative frameworks of NMC and the Health and Care Professions Council during this UK Parliamentary term. The General Medical Council Order 2026 will act as a blueprint for these frameworks, although there will need to be bespoke changes made to account for the nuances of each regulator’s operations.

The purpose of statutory regulation

The overarching purpose of regulation of healthcare professionals is public protection. Regulation plays an important role in letting the public, employers and other healthcare professionals know that those providing care are safe to practise and can be held to account if serious concerns are raised about their conduct or performance.

General Medical Council

GMC regulates medical practitioners and the anaesthesia associate and physician associate professions in the UK. It is responsible for:

• setting professional standards for these 3 professions
• approving undergraduate and/or postgraduate training and the assessments professionals must pass to register with GMC
• keeping registers of medical practitioners, anaesthesia associates and physician associates, known as ‘registrants’, who meet its standards
• taking action if registrants seriously depart from its professional standards

Benefits of professional regulation reform

Our professional regulation reforms will benefit service users and registrants of GMC, giving regulators the flexibility to respond to patient safety risks and creating a regulatory system that is fit for the future and able to meet future workforce challenges.

Our education and training reforms aim to give GMC greater flexibility to determine how they set standards for, approve and quality assure education and training. This flexibility will allow GMC to:

• adapt to changes in the healthcare environment and to the changing needs of service users and the general public more quickly
• provide ongoing assurance that newly qualified professionals are equipped to offer safe and effective care

Our registration reforms aim to enable GMC to swiftly, and without a lengthy Parliamentary process, adapt their registration requirements where needed.

Our fitness to practise reforms aim to provide greater consistency between regulators’ fitness to practise functions and, overall, deliver a fitness to practise process that is swifter, fairer and less adversarial for GMC and other regulators. Our fitness to practise reforms should benefit all parties involved in fitness to practise proceedings and, most importantly, they will ensure swift public protection where needed.

Implementation of review recommendations

The Leng Review - an independent review into physician associate and anaesthesia associate professions

An independent review of the physician associate and anaesthesia associate professions in England was commissioned by the Secretary of State for Health and Social Care in November 2024 and was led by Professor Gillian Leng CBE.

Professor Leng was asked to consider the safety of the roles and their contributions to multidisciplinary healthcare teams, making recommendations for the future.

The conclusions of the review and its 18 recommendations were published on 16 July 2025. The Secretary of State for Health and Social Care has in principle accepted all of the review’s recommendations - noting that recommendations 1 and 9 are within the scope of this consultation.

Work to implement the recommendations is ongoing. Professor Leng is undertaking a temporary and continuing role to support implementation of the review’s recommendations. This includes wider discussions with a range of system partners including NHS England, GMC, royal colleges, professional bodies and higher education institutions to consider further the changes needed to implement the recommendations in full.

Professor Leng’s report highlighted widespread confusion from patients, in particular around the name and role of the professions. The review found that the majority of stakeholders, particularly patient groups, expressed concern that patients were unclear about who they were being treated by.

Recommendation 1 states that:

The role of physician associate should be renamed as ‘physician assistant’, reflecting the role as a supportive, complementary member of the medical team.

Recommendation 9 states that:

Anaesthesia associates should be renamed as ‘physician assistants in anaesthesia’ or PAA and should continue working within the boundaries set in the interim scope of practice published by the Royal College of Anaesthetists.

As part of this consultation, we are seeking views on the legal implementation of recommendations 1 and 9 which would mean that the titles physician assistant and physician assistant in anaesthesia would be protected in law rather than the current professional titles of physician associate and anaesthesia associate.

This means that, once the titles are protected in law, it will become an offence for anyone to use the titles ‘physician assistant in anaesthesia’ or ‘physician assistant’ while practising in the UK without being registered with GMC. The draft order itself uses the new proposed names.

Professor Sir Norman Williams’ review into gross negligence manslaughter in healthcare (‘the Williams Review’)

In February 2018, Professor Sir Norman Williams undertook an independent review to consider the wider patient safety impact resulting from concerns among healthcare professionals that simple errors could result in prosecution for gross negligence manslaughter, even if they occur in the context of broader organisation and system failings.

On 11 June 2018, Professor Williams published his review into gross negligence manslaughter in healthcare and made several recommendations.

As per recommendation 5.3 and paragraph 7(5) of schedule 3 of the AAPAO, the draft order makes it clear that GMC cannot require the professionals it regulates, for fitness to practise purposes, to provide material produced for the purposes of professional development or while reflecting on their professional practice. The government is of the view that implementing this recommendation should encourage a culture of open learning and safety.

Lord Mann Review of antisemitism and other forms of racism in healthcare

In October 2025, Lord John Mann was commissioned by the Secretary of State for Health and Social Care to undertake a rapid, internal review into tackling antisemitism and other forms of racism in the healthcare regulatory system and across the NHS (‘the Mann Review’).

Within the wider context of several high-profile GMC cases in 2025 related to allegations of antisemitic behaviours by UK doctors, Lord Mann was asked to examine how the regulatory system for healthcare professionals supports recognition and reporting of racism, and tackles it at every stage - from employment through to national oversight and professional regulatory bodies.

Engagement with stakeholders during this review process highlighted the need for regulators to go further in increasing transparency and accountability during the regulatory investigation and decision-making process.

The Mann Review therefore makes recommendations to extend the powers of PSA to ensure sufficient oversight of regulator decision-making to improve transparency, efficiency and consistency in handling allegations of racism. Ahead of further Mann Review recommendations, this consultation sets out and seeks views on the first tranche of recommendations from the review, which relate to legislation and regulatory reform.

The Mann Review will make a number of other recommendations for the UK health regulators, the government and the NHS, to strengthen how racism is tackled with the aim of increasing public protection, which cannot be delivered through the GMC reform order and are therefore out of scope for this consultation. Work is underway to ensure parity across the UK health regulatory landscape and to finalise a range of further recommendations from the Mann Review, which will be shared in due course.

Description of the draft order

The next section of the consultation provides a high-level description of what the draft order proposes and should be read alongside the draft order, published on the Reforming the General Medical Council legislative framework page.

Part 1: general

This part introduces the draft order and sets out the timing of when provisions in the draft order will come into effect. The draft order covers GMC’s regulatory activity across the UK. In so far as the draft order relates to the professions of physician assistant or physician assistant in anaesthesia in Scotland, this consultation is undertaken with the consent of the Scottish ministers. Whenever commenced, the proposal from the UK and Scottish governments is that the changes relating to physician associates and anaesthesia associates should extend to Scotland as well as the rest of the UK.

Article 2 relates to commencement. We need to ensure that the commencement of the draft order is managed in a safe and effective way that mitigates the risks of a regulatory gap while GMC transitions doctors, physician associates and physician associates in anaesthesia to the new regulatory framework.

After secondary legislation becomes law, it will not have legal effect until it has been commenced. This is also known as coming into force. Commencement may happen automatically on a date identified in the secondary legislation or it may be brought into force by ministers (or others to whom this power has been given, for example the Privy Council) at their discretion, using tertiary legislation.

In the draft order, the provisions in part 1 will come into force immediately upon the order being made, which is necessary to enable GMC to start the transition to the new framework. The full implementation of parts 2 to 10 is dependent upon GMC consulting upon its rules and being ready to safely transition from the Medical Act 1983 and Anaesthesia Associates and Physician Associates Order 2024 across all of its regulatory functions.

A ‘coming into force date’ is currently proposed for parts 2 to 10, on the face of the draft order. However, there is no specific date supplied for when parts 2 to 10 come into force as per article 2(2)(b) of the draft order. Article 2(2)(b) relates to the coming into force of the majority of the provisions within the draft order.

Although a coming into force date on the face of the order would provide clarity, there are advantages in specifying the commencement date elsewhere, in particular for areas involving transition of cases from the old framework to the new one. This could be achieved by specifying the coming into force date in tertiary legislation - for example to be made through a Privy Council Order - and would enable more flexibility for the coming into force date to reflect further work on an implementation timeline over the coming months.

Part 2: the regulator

Article 4 of the draft order enables GMC to continue as a body corporate and to have the functions assigned to it by the draft order. Detail relating to GMC’s constitution is set out in schedule 1. The regulator’s objective has been reworded for clarity.

The regulatory principle in article 7 would be carried forward from the Medical Act 1983 and the AAPAO, which would ensure that GMC continues to have regard to the need to exercise its functions in a manner which is transparent, accountable, proportionate and consistent, and that regulatory activity should be targeted only at cases in which action is needed.

Part 3: incidental powers and duties

Delegation of functions

There are certain functions that cannot be delegated or are subject to restriction, that are set out in the draft order. Rule-making powers cannot be delegated. Paragraph 8 of schedule 3 to the Health Act 1999 sets out the restrictions for delegation under section 60.

If any function is delegated, GMC will retain responsibility for its delivery. GMC may still exercise any function it has delegated elsewhere. Through incidental powers, GMC may also discharge a function, or part of a function, which is delegated to it by another regulator. Payment may be sought or made for delegating or carrying out a delegated function.

Disclosure of information

Article 9 of the draft order provides a general power for GMC to disclose and publish information which relates to its functions. GMC may only disclose and publish information which relates to the fitness to practise of a particular regulated professional, regulated professionals in general, or regulated professionals of a particular class if GMC considers it to be in the public interest to do so. It includes a power for GMC to publish:

• a decision of the regulator or reasons for a decision

• an outcome of an assessment or determination or reasons for the outcome

Consequential amendment to the National Health Service Reform and Health Care Professions Act 2002 - paragraph 36(5) of schedule 5 of the draft order

Lord Mann, in his review into tackling antisemitism and other forms of racism in healthcare, found the need for greater accountability in relation to regulator decision-making. As such he has recommended that PSA should be given powers to require that regulators, such as GMC, share information with it for the purposes of enabling PSA to discharge its statutory functions. This will ensure PSA has access to the information necessary to make decisions on exercising its right to appeal fitness to practise decisions, and also to enable a more agile approach to regulator performance monitoring. The government is minded to support this recommendation and consult to support an increase in the efficiency of UK health regulation oversight. We welcome respondent views on how best to address the above recommendation in full to ensure parity across the health regulators.

Paragraph 27(1) of the National Health Service Reform and Health Care Professions Act 2002 provides that GMC must in the exercise of its functions co-operate with PSA.

Paragraph 36(5) of schedule 5 of the draft order inserts the new section 27A into that act to require that GMC must provide information or documents requested by PSA that are necessary for it to discharge its functions in relation to GMC.

New section 27A(3) sets out that if GMC fails to comply with a notice requiring GMC to provide the information or documents specified in the notice, PSA may apply to the High Court for an order requiring GMC to comply with the notice.

Guidance

Article 10 of the draft order enables GMC to publish, vary or revoke guidance in connection with the exercise of its functions, including how a person may comply with requirements imposed by rules.

Matters incidental or conducive to the exercise of regulator functions

Article 11 provides a power for GMC to do anything which is incidental or conducive to the exercise of its functions outlined in the draft order, including making a payment a person employed by GMC in connection with the exercise of a function.

Regional differences

Article 12 provides that GMC must have regard to any differences relating to practise as a regulated professional in England, Wales, Scotland and Northern Ireland.

Public engagement

Article 13 provides that GMC must have and publish its arrangements for engaging with the public and keeping the public informed regarding the exercise of its functions. These must be published, at the latest, 6 months after article 13 comes into force and must be reviewed and, where necessary, updated. This policy was introduced as an outcome of the responses to the consultation on policies for reform.

Co-operation

Article 14 of the draft order requires GMC to co-operate, as it considers appropriate, with organisations and persons listed in article 14(1). This is intended to secure or improve the regulation of health professionals and social care workers and the services they provide or contribute to. This could be through engagement or by sharing of information.

Equality, diversity and inclusion

Article 15 requires that GMC must put in place arrangements to ensure it applies good practice in relation to equality and diversity (within the meaning of the Equality Act 2006) and must take appropriate steps to make improvements in this area. In putting arrangements in place, GMC must also have regard to any current or future principles set by PSA regarding equality, diversity and inclusion. GMC must publish these arrangements and keep them under review. GMC may amend such arrangements as it considers appropriate.

Annual report and statistical analysis

GMC already has a requirement to publish an annual report on the exercise of its functions and a statistical analysis of the arrangements in place to protect the public from registered professionals whose fitness to practise is impaired. Article 16 of the draft order includes this and provides for additional detail of what the report must include, such as details of the arrangements GMC has put in place to ensure it applies good practice in relation to equality, diversity and inclusion (see article 15). GMC will be required to submit a copy of the annual report and statistical analysis to the Privy Council, who will then lay copies of these before each House of Parliament and the devolved legislatures.

Regulators remain accountable to Parliament and the devolved governments. As outlined above, the Privy Council laying the reports before each House of Parliament and the devolved legislatures enables scrutiny by peers and MPs and their counterparts in the devolved legislatures. Further, the Health and Social Care Select Committee and the Health, Social Care and Sport Committee of the Scottish Parliament can hold hearings with GMC and scrutinise their activity. Additionally, PSA oversees the 10 health and care regulators and carries out regular performance reviews to evaluate their performance. PSA may also escalate serious or intractable concerns to others, including government and/or Parliament.

Reports specific to each part of the United Kingdom

Article 17 has been added to the draft legislative framework following the proposal included in the 2021 regulating healthcare professionals consultation to provide additional accountability to the devolved legislatures. GMC will be required to publish each year a report on the exercise of its functions specific to each part of the UK. This can either be a single, combined report or individual reports each referring to different parts of the UK. GMC must submit a copy to the Privy Council, who will then lay a copy of the report or reports before each House of Parliament and the devolved legislatures.

Strategic plan

This provision carries forward from the Medical Act 1983 and requires GMC to publish a strategic plan that will be submitted to and laid by the Privy Council before Parliament and the devolved legislatures. The plan must be published on a regular basis that GMC will determine. However, the first must be published no later than 6 months following article 18 of the draft order coming into force and up to a maximum period of 5 years thereafter.

Part 4: further provision relating to the regulator

Fees

Along with 3 other regulators, GMC already has the power to set its own fees without requiring approval from Parliament (or for devolved matters, the Scottish Parliament). As part of the reform programme, we intend to make this consistent across all the regulators. Article 19 requires GMC to make rules regarding the setting and charging of fees in connection with the exercise of its functions, including the various fees in relation to:

• registration
• appeals
• work carried out by GMC that powers allow it to charge for, including for activity outside of the UK

In line with the AAPAO, rules may not provide for fees to be set other than with a view to ensuring that, so far as reasonably practicable, the regulator’s fee income does not exceed its expenses, including amounts reasonably required to be set aside as reserves. We would expect GMC to take a pragmatic approach by setting its fees at a level that allows for and smooths out year on year variations in its income and expenditure. Where, over time, there is divergence between income received and expenditure incurred, GMC will need to adjust its fees accordingly to bring these back into alignment.

There is no provision for GMC to charge in connection with specific proceedings to determine a regulated professional’s fitness to practise. In relation to registration fees, GMC may also make rules to determine a longer-term approach, for example, a framework. The existing requirement to consult will also apply to any longer-term approach to fee setting.

Borrowing

Article 20 provides GMC a power to borrow money for the purposes of exercising its functions under this draft order and for management of its financial affairs.

Grants and loans

A power for the Secretary of State, the Scottish ministers, the Welsh ministers and the Department of Health in Northern Ireland to make a grant to GMC was introduced as part of the AAPAO. This has been carried forward in article 21 of the draft order and extended to include loans to provide greater flexibility in how funding can be made to GMC.

Funding can already be provided to regulators, however a grant and loan-making power provides an easier mechanism to do this.

Regulator expenses

Article 22 enables the expenses of GMC to be met out of:

• fees charged
• money borrowed
• grants and loans
• any other sum paid to the regulator in connection with the exercise of its functions, or from other sources of income

Annual accounts

Article 23 provides that GMC must prepare and publish annual accounts, along with any auditor’s report, in respect of each financial year. Accounts are to be audited by an appropriate person appointed by GMC. The Privy Council will lay a copy of the accounts and the auditor’s report (if any) once received from GMC before each House of Parliament and the devolved legislatures.

Default powers of the Privy Council

The Privy Council currently has default powers which can be used if it considers that GMC has failed to carry out its functions in relation to the professions it currently regulates. Article 24 carries forward these powers into the new draft order to enable the Privy Council, where it is of the opinion GMC has failed to exercise a function it should have exercised, to notify GMC of its opinion and require GMC to make representations.

Having considered this, the Privy Council may direct GMC regarding the exercise of the function as it considers appropriate. If GMC fails to comply with the direction, the Privy Council may act itself instead of GMC. However, it may not make, amend or remove an entry from the register.

Part 5: education and training

Regulators are responsible for setting standards for professionals’ education and training and practice. By assuring that these standards are met, regulators ensure that providers educate and train individuals who have the knowledge, skills, experience and behaviours needed to offer safe and effective care.

Standards of education and training

Article 25 of the draft order provides that GMC must determine standards of education and training in connection with practising as a regulated professional. Before determining the standards, it must consult such persons as it considers appropriate. GMC must publish its standards. Furthermore, it must keep its standards under review and vary them where appropriate.

Approval of education and training

Article 26 of the draft order sets out the powers GMC will have to approve and to refuse, vary and withdraw approval of education and training, assessments and qualifications. GMC may also attach conditions to anything they approve.

To train as a medical practitioner, the first stage is to take a degree at medical school. These are usually 5-year courses but there are some alternative options.

Training continues for graduates with the foundation programme. This is a 2-year work-based training programme that intends to bridge the gap between medical school and specialty training. After the foundation programme doctors may proceed into specialty training, working towards becoming a consultant in that specialty or a general practitioner.

To train as a physician associate the common path is to complete a 2-year postgraduate physician associate degree.

Anaesthesia associates also undertake a 2-year postgraduate degree.

GMC is responsible for approving and quality assuring undergraduate and postgraduate training for medical practitioners and qualifying courses for physician associates and anaesthesia associates. Any prospective registrant must pass an assessment before being allowed to join GMC’s register.

Approval of education and training overseas

Some UK medical schools deliver medical degrees outside of the UK. Under the Medical Act 1983, as those schools are included in the list of approved bodies for the purposes of awarding a UK primary medical qualification, GMC is able to quality assure overseas medical courses provided by those schools, but cannot charge a fee for this activity.

In the 2021 regulating healthcare professionals consultation, it was proposed that restrictions should be removed and regulators should be able to set out in rules their charges for services. The majority of respondents to the consultation agreed with this proposal.

Article 26(3) of the draft order provides that GMC may approve education and training delivered outside the UK or determine that it is otherwise of a standard appropriate to practising as a regulated professional in the UK. Article 19(4) of the draft order permits GMC to make rules on the collection and recovery of fees. This means that under the draft order, GMC would be able to charge for services approving and quality assuring overseas education and training.

The Medical Training (Prioritisation) Act 2026

The Medical Training (Prioritisation) Act 2026 introduced prioritisation of UK medical graduates and persons in the priority group for UK foundation programme posts. For UK specialty training posts, the act also introduced the prioritisation of:

• UK medical graduates
• persons in the priority group
• individuals who have completed the UK foundation programme or a relevant earlier stage of UK specialist training
• for posts starting in 2026, individuals with certain immigration statuses

Under the act, graduates from Ireland and from the European Free Trade Association (EFTA) states of Iceland, Liechtenstein, Norway and Switzerland will be prioritised as part of the priority group.

The act will ensure a sustainable medical workforce that can meet the health needs of the population. It will mean we are less reliant on an unpredictable labour market and can make best use of the substantial taxpayer investment in medical training. It will reduce competition for places and give homegrown talent a path to become the next generation of NHS doctors. The act will not exclude international talent and individuals who are not prioritised will still be able to apply for posts.

It should be noted that where GMC approves an overseas undergraduate medical education and training programme (which may lead to a graduate obtaining a UK primary medical qualification) or an overseas foundation programme, this does not guarantee that graduates of these programmes will be eligible for prioritisation for foundation or specialty training in the UK. This is because the Medical Training (Prioritisation) Act 2026 excludes from the definition of ‘UK medical graduate’ anyone who spent the majority of their time training for a UK primary medical qualification outside the British Islands.

Other approval provisions

Article 26(6) provides that the person or body concerned must be given the opportunity to make representations to GMC within a specified time, before GMC can:

• subject the approval or determination to a condition (GMC will use determinations to assess whether international qualifications held by individual applicants are acceptable)
• vary or revoke an approval or determination

Article 26(7) places a duty on GMC to notify a provider responsible for education and training, examinations and assessments, or qualifications of:

• an approval
• a variation of an approval
• a revocation of an approval

Furthermore, GMC must publish an approval, variation or revocation of an approval.

Information and evidence

Article 27 of the draft order provides that GMC may for the purpose of carrying out its education and training function require a person or organisation to supply specified information, or produce a specified document, which GMC considers the person is reasonably able to supply or produce.

GMC may, for the purposes of granting an approval or making a determination or varying or revoking an approval or determination, carry out an assessment against, otherwise monitor compliance with, such of the standards of education and training as GMC considers appropriate in relation to the approval or determination.

Assessment or monitoring may, in particular, be carried out by attending premises used by a provider of approved education and training for the purposes of education and training.

Certification of completion of a course of education or training

A certificate of completion of training (CCT) confirms a person such as a medical practitioner has completed an approved UK postgraduate training programme. Article 28 of the draft order provides that GMC may certify that, in its opinion, a person has successfully completed a course of postgraduate education or postgraduate training approved by GMC.

Offences relating to education and training

In the 2021 regulating healthcare professionals consultation, it was proposed that all regulators should have the same set of offences relating to education and training in their governing legislation. The majority of respondents to the consultation agreed that regulators should have the same set of offences.

Article 29 of the draft order provides that a person commits an offence if the person, with intent to deceive, falsely represents a person (including himself or herself) to have a qualification approved by GMC. A person who commits an offence under this article is liable on summary conviction in England and Wales to a fine, or on summary conviction in Scotland or Northern Ireland to a fine not exceeding level 5 on the standard scale.

Power to make procedural rules on education and training

Article 30 of the draft order provides that GMC may make procedural rules in connection with the exercise of a function to:

• approve education and training
• vary or revoke an approval of education and training
• gather information and evidence, including assessment and monitoring
• issue CCTs

Co-ordination of education and training, etc, of health professionals

Article 31 of the draft order provides that GMC may take such steps as it considers appropriate to:

• promote high standards of education and training
• co-ordinate stages of education and training

Co-ordination may, in particular, include the development of a policy for general application to education and training or facilitating implementation of the policy.

Part 6: registration

This part covers both the register and registration. The register refers to the list of professionals who have satisfied GMC that they:

• are appropriately qualified
• have the necessary knowledge, experience and skills
• are capable of safe and effective practice

The next section on ‘The register’ sets out the information that will be collected and recorded on the register, as well as the publication and disclosure requirements relating to such information. The following sections relating to registration establish how GMC will provide assurance that the individuals on its register have the education, training, knowledge, skills and experience required to practise safely in the UK.

The register

Under the Medical Act 1983, GMC has a duty to hold multiple registers. These are the:

• Medical Practitioners Register
• General Practitioners Register
• Specialist Medical Practitioners Register

The Postgraduate Medical Education and Training Order 2010 (‘the PMET Order’), made under powers in the Medical Act 1983, sets out which categories of medical practitioners are eligible for entry into the general and specialist registers. Under the AAPAO, GMC has a duty to hold the register of anaesthesia associates and physician associates, which is divided into 2 parts, one for each profession.

In the 2021 regulating healthcare professionals consultation, it was proposed that all regulators should hold and publish a single register of professions, which can be divided into parts for each profession that a regulator regulates. The majority of respondents to the consultation agreed that all regulators should hold a single register.

Article 32 of the draft order therefore sets out that GMC must establish a single register of the regulated professionals it regulates. The register is to consist of only 3 parts, one for each regulated profession (medical practitioners, physician assistants in anaesthesia and physician assistants). The draft order provides that the register must be maintained by GMC’s registrar. A regulated professional must be entered in the part of the register that relates to their relevant profession. They must have only one entry in any one part of the register.

GMC’s registrar must take steps to ensure that the information entered in the register remains accurate and GMC may prescribe the form in which the register is to be kept. GMC must publish an entry in the register and any amendment to an entry in the register.

Information to be recorded

Article 33 of the draft order provides that an entry in GMC’s register must record and publish:

• a regulated professional’s name and registration number
• the date on which the regulated professional was registered or, if more than once, the most recent date on which registered

Article 33 of the draft order provides that an entry in GMC’s register must record:

• the regulated professional’s address and such other contact details for the regulated professional as may be prescribed in rules
• such other information in connection with the regulated professional’s identity as GMC considers necessary for the protection of the public

Furthermore, GMC must record and publish on its register the following information:

• a warning issued to the regulated professional as part of fitness to practise proceedings or following a revision of a decision or following an appeal
• a registration measure imposed on a regulated professional’s registration as part of fitness to practise proceedings or following a revision of a decision or following an appeal
• an interim registration measure imposed on a regulated professional’s registration as part of interim registration measure proceedings or following an appeal
• such other information in connection with practice as a regulated professional as GMC considers necessary for the protection of the public

The entry must also record and publish any restrictions or enhancements that the registration of a regulated professional is subject to or benefits from. The ‘Registration restrictions and enhancements’ section below provides further details (article 37).

Standards applicable to registration

Article 34 of the draft order sets out that GMC must determine standards applicable to registration as a regulated professional. GMC’s standards must make provision in respect of:

• knowledge and skill
• experience
• professional performance
• conduct and ethics
• proficiency in the English language
• such other matters as GMC considers appropriate

Before determining its standards, GMC must consult such persons as it considers appropriate and, once determined, it must publish the standards and keep them under review, varying the standards where appropriate.

Applications for registration

Article 35 of the draft order provides that an application for registration must comply with such procedural requirements as may be prescribed by GMC in rules and such additional requirements as GMC’s registrar may direct. An application for registration must be accompanied by proof of the applicant’s identity, and evidence that the applicant has in force, or will have in force before practising as a regulated professional an indemnity arrangement, an insurance policy, or a combination of both, which provides appropriate cover in respect of the applicant’s proposed practice as a regulated professional. All regulated healthcare professionals in the UK are legally required to maintain appropriate clinical negligence cover to meet the costs of claims and damages awarded to patients arising from clinical negligence.

Article 35(3)(a) of the draft order provides that GMC’s rules may make provision preventing an application from being made within a prescribed period following the refusal of an application for registration or removal of an entry from the register.

Article 35(3)(b) provides that the rules may limit the number of applications which may be made following the refusal of an application for registration or removal of an entry from the register.

Article 35(4) of the draft order provides that an application for re-entry to the register may not be made by a person whose entry in the register has been mandatorily removed from the register following conviction for a listed offence set out in schedule 4 of the draft order, unless the conviction from which the removal arose has been quashed or is a lower level listed offence set out in part 2 of schedule 4 of the draft order, and the custodial sentence has been quashed and a non-custodial sentence imposed. This is a change from the policy position set out within the AAPAO, which allows former registrants who have been convicted of listed offences to re-apply for registration with GMC, subject to GMC’s rules.

It should be noted that registrants who are convicted of sexual offences contained within schedule 4 of the draft order will also be prevented from reapplying for registration, irrespective of whether a custodial sentence has been imposed.

Under the AAPAO, a registrant who has been convicted of sexual assault can only be mandatorily removed from the register where a custodial sentence has been imposed. We propose that the custodial sentence caveat should be removed from the listed sexual offences within schedule 4, and the list be extended to include additional lower level sexual offences, thereby underlining the seriousness of convictions for sexual offences and the effect these have on patient trust and safety.

Registration of an entry on the register

Article 36(1) of the draft order provides that GMC’s registrar must register a person who applies for registration if the person meets the standards of education and training and the standards applicable to registration.

Article 36(2) provides that the registrar may register a person who meets all the standards set out in article 36(1) except in respect of experience. In these circumstances article 37(5) stipulates that GMC must make provision in rules for the registration of a medical practitioner registered in accordance with article 36(2) to be restricted for the purpose of gaining sufficient experience and for the medical practitioner to undertake training under a foundation programme. This is explained in more detail in the ‘Registration restrictions and enhancements’ section below.

GMC must notify the person applying for registration of its decision and the notification must include information regarding a right of appeal for applicants who are refused registration.

Registration restrictions and enhancements

In the 2021 regulating healthcare professionals consultation, it was proposed that all regulators should be given a power to annotate their register, including the power to amend, remove or restore annotations, to provide further information about the skills, knowledge and experience of registrants. It was proposed that annotation of the register would allow the regulators to indicate where registrants hold specialist qualifications rather than holding separate registers or specialist lists. Furthermore, it was proposed that annotations could be used to reflect a decision to restrict a registrant’s scope of practice or registration. The public would be able to view annotations on a regulator’s online register. The majority of respondents to the consultation agreed with the proposal to give regulators a power to use annotations.

Following the government’s announcement in May 2025 that it would be modernising GMC’s legislative framework, it has worked with the regulators to develop the policy on annotations, which is now called ‘Registration restrictions and enhancements’ in the draft order.

Under the draft order all registrants will hold registration, and restrictions or enhancements will apply to particular classes of registrants. These restrictions or enhancements mean a registrant may have a limitation on certain areas in which they can practice or additional areas beyond the standard in which a practitioner can practice. GMC will have the power to develop restrictions and enhancements that are either profession specific or that can be applied to all 3 of its registrant groups. Regulated professionals may be registered with or without a restriction (such as provisional or temporary restriction) or an enhancement (such as specialist enhancement).

A provisional restriction means a registrant cannot perform certain tasks without supervision. This is comparable to being provisionally registered under the Medical Act 1983. A registrant benefitting from an enhancement is comparable to being on the Specialist Register or GP Register under the Medical Act 1983. For example, under the draft order, we anticipate that a GP and a paediatric surgeon would both be registered with an enhancement that described their individual specialty or multiple specialties which allows them to practise in the area or areas outlined.

Medical practitioners may apply for a complete restriction on their registration. This is comparable to a medical practitioner not holding a licence to practise under the Medical Act 1983. Medical practitioner registrants will be able to practise unless they have a complete restriction applied to their registration.

Under the Medical Act 1983, in order to practise medicine, medical practitioners in the UK need to hold a licence to practise along with registration. It is the licence to practise that entitles medical practitioners to carry out specific clinical activities including prescribing, signing death certificates and treating NHS patients. Currently doctors can remain on the register without a licence to practise. This can happen in a number of different circumstances including where:

• doctors are undertaking activities but a licence is not a requirement
• they don’t intend to practise for period of time but want to remain in good standing with GMC
• GMC has removed their licence, for example for failure to revalidate

The draft order does not replicate the licence to practise. Instead registrants who have demonstrated that they meet all of the standards and information requirements set out under the draft order can have a complete restriction applied to their registration.

Article 37(7)(b) sets out that where the complete restriction is applied to registration, that individual is exempted from having to undergo the periodic assessment.

The complete restriction will not be applied to the registration of physician associates and anaesthesia associates. This means all physician associates and anaesthesia associates will be registered or not registered and will have to undergo periodic assessment. Physician associates and anaesthesia associates can be removed from the register if they fail to comply with procedural rules relating to the periodic assessment or if the outcome is that they fail to meet the standards.

Registrants with a complete restriction on their registration will have demonstrated that they meet all of the standards and requirements required for registration but the restriction means they will not be able to undertake specific clinical activities such as those currently undertaken by medical practitioners with a licence to practise.

Article 37 of the draft order allows for the registration of a regulated professional to be subject to either restrictions or enhancements. The registrar may add, vary or revoke a restriction or enhancement. GMC must notify the regulated professional of any change.

Article 37(4) of the draft order provides that the categories of restrictions to which the registration of a class of regulated professional may be subject must be prescribed in rules.

Article 37(5) provides that these rules must make provision for when a registrant may have a provisional restriction applied to their registration where they do not meet the required standard of experience. The provisional restriction will enable them to participate in year 1 of the foundation programme to gain this necessary experience.

A foundation programme is defined at article 37(8) as a programme of training approved under article 26, which provides a medical practitioner registered subject to the restriction with sufficient experience to be registered without such a restriction, and which complies with such requirements as may be prescribed.

Article 37(6) set outs that the categories of enhancements from which the registration of a class of regulated professional may benefit are:

• in respect of registration as a medical practitioner:
  • the categories of specialty in practice as the Privy Council must by order specify
  • such other categories as may be prescribed in rules
• otherwise, such categories as must be prescribed in rules

As a consequence of modernising GMC’s register and legislative framework, many of the current provisions contained within the PMET Order will become obsolete. We are therefore proposing that the PMET Order is revoked, including the list of recognised specialties contained in the schedule to the PMET Order, and the Privy Council is instead given the power in article 37(6)(a)(i) of the draft order to specify categories of specialty in practice in the UK in an Order of Council. This will be relevant to the registration of medical practitioners only.

The Privy Council will continue to have oversight of the categories of specialty in practice (formerly known as the list of recognised specialties under the PMET Order) and the order will be subject to the negative Parliamentary procedure, which means it will be subject to annulment in pursuance of a resolution of either House of Parliament. Any proposed future changes to the categories will be consulted on by the government and the devolved governments.

Removal of an entry from the register

In the 2021 regulating healthcare professionals consultation, it was proposed that regulators should be able to remove registrants’ entries from their registers for a range of reasons.

Removal of an entry from the register - mandatory 

Article 38 of the draft order sets out that an entry relating to a regulated professional must be removed from the register by GMC where the regulated professional has been convicted of a listed offence set out in schedule 4 of the draft order or where a case examiner or fitness to practise panel has found that the registrant’s fitness to practise is impaired and imposed a removal from the register order. Furthermore, the registrar must remove a registrant if they are satisfied that the regulated professional has died.

Removal of an entry from the register - discretionary 

Article 39 sets out that an entry relating to a regulated professional may be removed from the register by GMC under certain additional circumstances, as outlined in the article. For example, where the regulated professional has requested that the entry be removed or has not paid a prescribed fee.

Removal of an entry from the register - supplementary

Article 40 of the draft order sets out that a removal of an entry in the register has effect from such date as may be determined in GMC’s rules.

GMC must send notification of the removal of an entry to:

• the regulated professional
• where known:
  • the regulated professional’s employer
  • any other person with whom the regulated professional has entered an arrangement to provide services as a regulated professional
  • any other regulator with which the regulated professional is registered

The notification to the regulated professional must include information regarding rights of appeal.

Re-entry on the register

Under the Medical Act 1983 and the AAPAO, GMC may restore former registrants to its registers, including those who have previously been removed due to the imposition of a final registration measure. GMC can also restore former registrants who have previously requested voluntary removal from the register or where former registrants have been removed from the register for other reasons such as non-payment of fees.

Article 41 of the draft order provides powers allowing GMC to register former registrants subject to specific requirements having been met at the time of applying for re-entry to the register.

Where a former registrant’s entry in the register has been removed due to the imposition of a registration measure, GMC’s registrar must register the person if all the following requirements are satisfied:

• their fitness to practise has subsequently been determined by a fitness to practise panel to no longer be impaired

• they meet the standards of education and training
• they meet the standards applicable to registration
• they have applied for registration in accordance with the provisions of or made under article 35

Where a former registrant has been removed other than due to the imposition of a registration measure, for example voluntary removal, GMC’s registrar must register the person if all the following requirements are satisfied:

• in such circumstances as may be prescribed in rules, their fitness to practise has subsequently been determined by a fitness to practise panel not to be impaired
• they meet the standards of education and training
• they meet the standards applicable to registration
• they have applied for registration in accordance with the provisions of or made under article 35

GMC’s rules may provide that, instead of a fitness to practise panel, a determination is to be made by such a person as may be prescribed.

GMC must send notification of the outcome of a re-entry to the register determination to the former registrant. The notification must include a statement of the reasons for the determination and information regarding rights of appeal.

Proceedings of a fitness to practise panel in reaching a re-entry to the register determination must be held in public, however, GMC may prescribe in rules the circumstances in which proceedings before a fitness to practise panel are to be held in private.

Periodic assessment

Periodic assessment may be referred to as revalidation, continuing professional development (CPD) or something else, depending on the regulator.

Article 42 of the draft order provides that GMC must set out in rules its process for the periodic assessment of regulated professionals. This must include periodic assessment against such standards of education and training and such other standards applicable to registration as GMC considers appropriate. Rules may prescribe additional criteria that a regulated professional is to be assessed against, the maximum period between assessments and the circumstances in which an assessment is otherwise to take place.

Article 27(7)(b) provides that, where rules make provision for a restriction in relation to all areas of medical practice, rules may provide for the disapplication of periodic assessments. This is comparable to doctors who are currently registered without a licence to practise (that is, non-practising doctors) not being required to complete period assessments in order to retain their registration.

Registration of an entry on the register in an emergency

Emergency registration allows regulators to register people temporarily during emergency periods such as pandemics or during times of conflict. The aim is to increase the capacity of the health and social care workforce to ensure that services can meet demand and patient care needs during emergency periods.

GMC and the General Pharmaceutical Council are the only regulators to have emergency registration powers on a permanent basis within their governing legislation. In the 2021 regulating healthcare professionals consultation, it was proposed that emergency registration powers should be included in all regulators’ legislative frameworks on a permanent basis. The majority of respondents to the consultation agreed with this proposal.

Articles 43 and 44 of the draft order set out emergency registration provisions. They provide that where the relevant authority (the Secretary of State for Health and Social Care and the Scottish ministers in relation to matters pertaining to physician assistants in anaesthesia and physician assistants in Scotland) informs GMC’s registrar that an emergency has occurred, is occurring or is about to occur, and the registrar should consider taking action (emergency has the meaning provided by section 19(1)(a) of the Civil Contingencies Act 2004), GMC’s registrar may register:

• a person who appears to the registrar to be a fit, proper and suitably experienced person to be registered as a regulated professional with regard to the emergency (for example a former medical practitioner, physician assistant in anaesthesia and/or physician assistant who may be retired and no longer registered with GMC)
• a specified group of persons who appear to the registrar to be fit, proper and suitably experienced persons to be registered as regulated professionals with regard to the emergency (for example medical students, surgical care practitioners or in extreme emergencies veterinarians)

Article 43(3) of the draft order provides that GMC’s registrar may register all the persons in the specified group without identifying each person in the group. Article 43(4) provides that an entry in the register in relation to a person or group registered may be removed by GMC’s registrar at any time and must be removed by GMC’s registrar if the relevant authority informs the registrar that the emergency has come to an end. Article 43(5) provides that an entry in the register in relation to a person who is registered as a member of a group may be removed individually.

If a person registered under the emergency registration power breaches a restriction to which the registration is subject, anything done by the person in breach of the restriction is to be treated for the purposes of the draft order as being done by a person who is not a regulated professional.

Offences relating to registration

Protection of title

Protected title status means it is a criminal offence for someone to practise and use a protected title without being registered with the relevant regulator.

Article 45 of the draft order includes protection of title offences and registration offences. The government has reviewed the protected titles that are currently in Section 49 of the Medical Act 1983. The government is of the view that the protected titles of ‘apothecary’ and ‘licentiate in medicine and surgery’ should be removed from legislation because they do not reflect current practice and are therefore unlikely to cause any public protection concerns or confusion if used by the public. It is also of the view that ‘bachelor of medicine’ should no longer be a protected title as this is linked to a qualification rather than a professional title.

The government is proposing that ‘registered medical practitioner’ should become a protected title. The government appreciates that some people are of the view that the title doctor or consultant should be protected. However, the title doctor can be used legitimately by individuals with doctoral degrees, for example those holding a PhD, and the title consultant is used outside of the healthcare industry, for example a management consultant.

In relation to medical practitioners, schedule 2 of the draft order provides that the following titles should be protected. As the Welsh language is protected by law in Wales, we are proposing that the titles are protected in both English and Welsh:

English:

• Physician
• Doctor of medicine
• Surgeon
• General practitioner
• Registered medical practitioner

Welsh:

• Meddyg
• Doethur mewn meddygaeth
• Llawfeddyg
• Meddyg teulu
• Ymarferydd meddygol cofrestredig

Changes to the anaesthesia associate and physician associate titles following the Leng Review

As set out in the introduction section, an independent review of the anaesthesia associate and physician associate professions was commissioned by the Secretary of State for Health and Social Care in November 2024. The review was led by Professor Gillian Leng CBE and is commonly known as the Leng Review. The review looked at the safety of the roles and their contribution to multidisciplinary healthcare teams.

The Leng Review and its 18 recommendations were published on 16 July 2025.The Secretary of State for Health and Social Care has accepted the recommendations, subject to consultation where required.

Professor Leng’s report highlighted widespread confusion from patients, in particular around the names and roles of the professions. The review found that the majority of stakeholders, particularly patient groups, expressed concern that the name ‘physician associate’ is confusing and that patients were unclear about who they were being treated by. The review stated that this confusion has also frequently been reported by the wider medical profession.

The review set out the need to communicate the function and identity of the roles. In order to provide clarity for patients and distinguish the roles from doctors, recommendation 1 states that:

The role of physician associate should be renamed as ‘physician assistant’, reflecting the role as a supportive, complementary member of the medical team.

Recommendation 9 states that:

Anaesthesia associates should be renamed as ‘physician assistants in anaesthesia’ or PAA […]

The review set out that using the title ‘assistant’ rather than ‘associate’ positions the roles as supportive, rather than as independent practitioners. The review also highlighted that the term ‘assistant’, which was previously used in the UK, is used successfully in the majority of other countries employing similar roles.

As part of this consultation, we are therefore seeking views on whether physician assistant and physician assistant in anaesthesia should replace the titles physician associate and anaesthesia associate in law. To note, the titles of physician associate and anaesthesia associate, while currently the titles used in the AAPAO, are not protected titles in law due to a proposed 2-year transition period between the commencement of the main provisions of the AAPAO on 13 December 2024 and the commencement of the registration offence in section 19(1)(b) on 13 December 2026.

We are aware that the proposed title of physician assistant is currently used by a small number of NHS employers for unregulated roles, where postholders perform a mixture of clinical and administrative tasks. Subject to the outcome of the consultation, we will work with employers and professionals to minimise any confusion in the system. These individuals will need to either become GMC registered physician assistants in anaesthesia or physician assistants (as applicable) or stop using that title.

While the Leng Review looked at England only, and devolved governments are responsible for considering the operational deployment of these roles within their own workforces, ongoing engagement across the 4 nations has been undertaken to facilitate consistent approaches to implementation where possible.

More specifically, the regulation of new roles is a devolved matter in Scotland and therefore any legislative proposals to change the protected titles of the above professions require approval from both Westminster and Scottish Parliaments.

Article 45(1)(a) and (b) and schedule 2 of the draft order protect the titles physician assistant in anaesthesia and physician assistant by making it an offence for someone to use those titles without being entered in the relevant part of the register or to fraudulently procure entry to that part of the register.

In order to allow time for the healthcare service to implement the new titles effectively as required following consultation, we also propose that the protection of the assistant titles should commence following a transition period of 6 months after the order comes into force, if approved by Parliament.

We are also seeking views on the protection of the current titles of ‘physician associate’ and ‘anaesthesia associate’ as a potential way to limit their use in the healthcare system should the new titles be adopted, support clarity on titles and avoid misuse.

Registration offences

Article 45 of the draft order provides that a person will commit an offence if the person, with intent to deceive:

• uses a protected title without being entered in the part of GMC’s register for the regulated profession with which the title is associated
• uses a protected title having fraudulently procured entry in GMC’s register for the regulated profession with which the title is associated
• otherwise procures, or attempts to procure, the inclusion of information in, or exclusion of information from, GMC’s register
• falsely represents a person (including himself or herself) to be entered in GMC’s register, or in a part of GMC’s register
• falsely represents the registration of a person (including himself or herself):
  • as not being subject to a restriction to which the registration is subject
  • as benefiting from an enhancement from which the registration does not benefit
• otherwise makes a false representation as to the content of GMC’s register

Under the Medical Act 1983, in order to practise medicine, medical practitioners in the UK need to hold a licence to practise along with registration. It is the licence to practise which entitles medical practitioners to carry out specific clinical activities including prescribing, signing death certificates and treating NHS patients. Under section 49A of the Medical Act 1983 a person commits an offence if they hold themselves out as having a licence to practise or engage in conduct which suggests that they have a licence to practise.

The new offence of falsely representing the registration of a person (including himself or herself) as not being subject to a restriction to which the registration is subject, applies to all registrants of GMC and the public. This offence has the effect of replicating the current section 49A offence in the Medical Act 1983 for doctors. The draft order does not contain provisions relating to a licence to practise on the face of the legislation like the Medical Act 1983 does. GMC will be able to continue to register medical practitioners not in active practise and for a time-limited period if they meet all of GMC’s registration standards and information requirements under the draft order. GMC will apply a complete restriction on their registration or time-limited registration. Any restrictions on registration will be recorded on GMC’s register and published.

Where members of the public or GMC registrants with a complete or conditional restrictions on their registration represent themselves as holding unrestricted registration with GMC they will be committing an offence.

A person who commits a registration offence is liable on summary conviction:

• in England and Wales to a fine
• in Scotland or Northern Ireland to a fine not exceeding level 5 on the standard scale

European qualifications - basic medical training

Prior to 1 January 2021, the end of the UK’s European Union Exit transition period, the European Union Directive 2005/36/EC allowed European Economic Area (EEA) and Swiss professionals to have their qualifications recognised in the UK (and vice versa) with minimal barriers. It ensured that the qualifications of medical practitioners and other healthcare professionals met minimum agreed standards and enabled their automatic recognition by regulatory bodies throughout the EU. Additional treaties ensured the same also applied with the EEA EFTA states.

As this directive would no longer apply after 31 December 2020, the Department of Health and Social Care put in place the European Qualifications (Health and Social Care Professions) (Amendment) (EU Exit) Regulations 2019 (‘the EU Exit Regulations’) to ensure the UK retained a system of recognition for EEA and Swiss healthcare qualifications that was similar to the previous system for a specified period.

The EU Exit Regulations came into force on 31 December 2020. Under these regulations, UK regulatory bodies have continued to recognise EEA-obtained qualifications without additional tests, other than language skills tests and checks on fitness to practise, where necessary.

The standstill provisions (regulation 14 of the EU Exit Regulations) placed a legal duty on the Secretary of State for Health and Social Care to review these arrangements no earlier than January 2023 and to publish a report within 6 months of the review’s start date.

In 2023, the former Secretary of State undertook a review of the standstill provisions, and a report was published on 29 June 2023, confirming the decision to retain them. The government will decide whether to conduct a further review of this decision after a period of 5 years (2028). A future change in policy may require a change to this order.

EEA qualified medical practitioners are therefore able to continue to register with GMC without the need to sit additional professional exams, mitigating delays to registration and employment in the NHS.

Article 46 of the draft order therefore allows GMC to register EEA qualified medical practitioners subject to them holding and being able to evidence specific qualifications.

European qualifications - general practice and specialist training 

Article 47 of the draft order provides that GMC’s registrar may place a registration restriction or enhancement on the registration of an EEA qualified medical practitioner. A restriction may be that the registrant holds time-limited or purpose specific registration and an enhancement may be that a registrant has completed full medical training in a specialised area of medicine.

Part 7: fitness to practise

Regulated health and care professionals are required to meet the standards for practising their profession safely and effectively. This is one of the principal means by which regulators ensure public protection. This part of the draft order sets out GMC’s fitness to practise process for the professionals it regulates. Please note that registrants registered under GMC’s emergency registration powers at article 43 will not be subject to fitness to practise proceedings as their register entry can be removed by the registrar at any time.

Impairment of fitness to practise due to criminal conviction 

In the 2021 regulating healthcare professionals consultation, it was proposed that all regulators should be given a power to enable them to automatically remove a registrant from their register, if the registrant has been convicted of a serious criminal offence (known as a listed offence). Automatic removal means that a registrant can be removed from a regulator’s register without the regulator having to investigate or hold a fitness to practise panel hearing to determine whether the registrant’s fitness to practise is impaired.

The majority of respondents to the consultation agreed that regulators should be given automatic removal powers. The AAPAO therefore includes a duty for GMC to remove an anaesthesia associate or a physician associate from its register following conviction for a listed offence. The AAPAO only permits mandatory removal for lower level listed sexual offences and theft and blackmail offences if a custodial sentence is imposed.

The government and the devolved governments have considered the listed sexual offences and are of the view that the listed offences should be extended to include the following sexual offences:

• Sexual Offences Act 2003:
  • Section 14 - Arranging or facilitating commission of a child sex offence
  • Section 15 - Meeting a child following sexual grooming etc
  • Section 15A - Sexual communication with a child
  • Section 66 - Exposure
  • Section 66A - Sending etc photograph or film of genitals
  • Section 66B - Sharing or threatening to share intimate photograph or film
  • Section 67 - Voyeurism
  • Section 67A - Voyeurism: additional offences
• Sexual Offences (Scotland) Act 2009:
  • Section 7 - Communicating indecently etc
  • Section 8 - Sexual exposure
  • Section 9 - Voyeurism
  • Section 34 - Communicating indecently with an older child etc
  • Section 35 - Sexual exposure to an older child
  • Section 36 - Voyeurism towards an older child
• Sexual Offences (Northern Ireland) Order 2008:
  • Article 22A - Sexual communication with a child
  • Article 70 - Exposure
  • Article 71 - Voyeurism
  • Article 71A - Voyeurism: additional offences (genitals and buttocks)
  • Article 71B - Voyeurism: additional offences (breasts)

Furthermore, under the draft order conviction for all of the sexual offences listed in schedule 4, regardless as to whether they incur a custodial sentence, will lead to mandatory removal from GMC’s register. Sexual assault, violence or misconduct of any kind is unacceptable, and the government and the devolved governments are determined to drive positive cultural change throughout the health and care service.

Article 48 of the draft order therefore provides that the fitness to practise of a regulated professional is impaired if the regulated professional has been convicted of an offence listed in part 1 of schedule 4, or part 2 of that schedule in respect of which a custodial sentence has been imposed. It should be noted that this is not a retrospective power, therefore this article does not apply if the offence to which the conviction relates is committed before the day on which this article comes into force in respect of the relevant regulated profession.

Article 40(2) provides that GMC must send notification of an automatic removal of an entry to:

• the regulated professional
• where known:
  • the regulated professional’s employer
  • any other person with whom the regulated professional has entered into an arrangement to provide services as a regulated professional
• any other regulator with which the regulated professional is registered

Where an entry in the register is mandatorily removed it must be published by GMC as set out in article 40(4).

Registrants who are mandatorily removed from the register will have a direct right of appeal to the High Court in England and Wales, the High Court in Northern Ireland or the Court of Session in Scotland against the registrar’s removal decision as set out in article 73(2).  

Impairment of fitness to practise due to standard of care, misconduct or health

Grounds for action set out the basis on which regulators can investigate and take action where there is a concern about a regulated healthcare professional’s fitness to practise. A regulated professional’s fitness to practise can only be found to be impaired if one or more of the grounds for action are met.

Following the announcement in May 2025 that the government would modernise GMC’s legislative framework, several stakeholders requested that adverse physical or mental health remains a separate ground for action, highlighting that health is a separate ground for action under the Medical Act 1983 and that GMC currently manages health cases compassionately.

The government has considered the concerns raised by stakeholders and has included a separate ground for action of adverse physical or mental health in the draft order, on the basis that this should enable GMC to continue to manage health cases with empathy and compassion. The absence of such a ground could prevent GMC from being able to assess the ongoing risk that a registrant’s health condition may represent to patients.

Article 49(1) of the draft order provides that the fitness to practise of a regulated professional may be impaired if the regulated professional:

• is unable to provide care to a sufficient standard
• has behaved in a way which amounts to misconduct
• is adversely affected by a physical or mental health condition

Article 49(2) provides that chapter 2 on determination of impairment and imposition of registration measures makes provision for determining whether fitness to practise is impaired under this article.

Article 49(3) provides that GMC must issue guidance on what may constitute impairment. Article 49(4) provides that before issuing and amending guidance GMC must consult such persons as it considers appropriate. Articles 49(5) and (6) provide that GMC must publish their impairment guidance and may vary it.

Stage one - initial assessment

The first stage of the fitness to practise process will be the initial assessment stage. Where GMC considers that the fitness to practise of a registrant may be impaired, it will have a duty to carry out an initial assessment of the registrant’s fitness to practise and, where it considers appropriate, refer the matter to a case examiner.

If GMC is minded to refer a matter to a case examiner, it must provide the regulated professional with a statement of reasons as to why it is so minded and notify the regulated professional of the manner in which, and time within which, written representations regarding the referral may be made to GMC.

As set out in article 50(4), GMC may not refer a matter to a case examiner unless written representations have, in the manner notified, been made by the regulated professional and considered by GMC, or the time within which written representations may be made has expired.

Article 50(5) provides that GMC may, where it considers appropriate, notify the regulated professional or an interested party of the outcome of the assessment.

Removal of GMC’s 5-year rule

Section 35CC, paragraph 5 of the Medical Act 1983, permits GMC to make rules preventing allegations that are more than 5 years old from being investigated unless it is deemed it is in the public interest to investigate these allegations. Rule 4(5) of the General Medical Council (Fitness to Practise) Rules Order of Council 2004, commonly known as the 5-year rule, makes rules to this effect.

In the 2021 regulating healthcare professionals consultation, it was proposed that any legislative restrictions on regulators from being able to consider fitness to practise concerns more than 5 years after they came to light should be removed from legislation.

The government is of the view that the 5-year rule should be removed from legislation. The draft order does not include a rule-making power which would allow GMC to replicate its current 5-year rule in its fitness to practise rules. The removal of the 5-year rule will help to ensure robust and continued means to challenge concerns about unfitness to practise so that patients can be kept safe, and this is reflected in the Mann Review.

Stage 2 - determination by a case examiner

The second stage of the fitness to practise process will be the case examiner stage. Case examiners are decision makers appointed by GMC.

The role of the case examiner at GMC was introduced in the General Medical Council (Fitness to Practise) Rules Order of Council 2004, which came into force on 1 November 2004. Under the legislation, at the end of an investigation into a doctor’s fitness to practise a case examiner can:

• refer the case to a medical practitioners tribunal
• agree undertakings (these set out the limits within which a doctor may practise)
• issue a warning (or refer the matter to the investigation committee for a hearing regarding whether to issue a warning)
• conclude the case with no further action
• conclude the case and issue advice to a registrant

As part of the 2021 regulating healthcare professionals consultation it was proposed that the case examiner role should be extended so that a case examiner can:

• refer a case to a fitness to practise panel
• issue a warning to a registrant where a registrant’s fitness to practise is found not to be impaired
• conclude a case with no further action
• conclude a case through an accepted outcomes process (where the registrant accepts that their fitness to practise is impaired and the proposed final registration measure)

A case examiner would be able to impose:

• conditions on registration
• a suspension of registration
• removal of registration

Under the AAPAO, case examiners have the above powers when considering whether an anaesthesia associate or physician associate’s fitness to practise is impaired. We are of the view that the new legislative framework for GMC should mirror the powers case examiners have under the AAPAO. GMC will have a discretion as to how many case examiners it appoints to make a determination on a fitness to practise case. This is on the basis that, in providing that discretion, the regulator is best placed to assess where multiple case examiners may or may not be required.

GMC must inform a registrant of a decision to refer a case to a case examiner and the notification must be accompanied by a statement of the reasons for the decision. As a case examiner will make a determination on a registrant’s fitness to practise on written evidence only, a registrant will be permitted to make a written representation to be considered by a case examiner, rather than an oral representation.

A case examiner to whom a matter is referred must carry out a determination as to whether the fitness to practise of the registrant is impaired. Where the case examiner considers it appropriate it can refer the matter to a fitness to practise panel to determine a registrant’s fitness to practise.

Where a case examiner determines that a registrant’s fitness to practise is not impaired the case examiner may close the case without taking any further action. A case examiner may determine that a registrant’s fitness to practise is not impaired but may choose to issue a warning to the registrant, if they believe this is necessary. This power is provided for at article 51(2). Where a warning is issued to a registrant, GMC will have a duty to publish this as set out in article 54(4)(a).

Where a case examiner determines that a registrant’s fitness to practise is impaired, they will be able to conclude the case through an accepted outcomes process where the registrant accepts both their fitness to practise is impaired, and the proposed final registration measure.

Case examiners will be able to:

• apply conditions to a registrant’s registration
• suspend a registrant’s registration
• remove a registrant from the register

The maximum period for which a condition or suspension could be applied under the draft order is 12 months, although this can be extended by review. In very rare circumstances, a case examiner may find that a registrant’s fitness to practise is impaired but propose that a registration measure is not imposed on a registrant’s registration (for example no action may be taken).

Registrants will be required to respond to a case examiner’s accepted outcomes proposal within a timeframe prescribed in GMC’s rules which may not be less than 28 days beginning with the day on which the information referred to in article 51(4) is sent to the regulated professional or, if on different days, the last day on which the information is sent.

Where a registrant does not accept that their fitness to practise is impaired or the proposed registration measure, the case will proceed to the fitness to practise panel stage.

Article 51(7) of the draft order provides a case examiner with the ability to withdraw a referral to a fitness to practise panel if the panel has not yet reached a determination on whether fitness to practise is impaired.

Where a registrant does not respond to a case examiner’s offer of an accepted outcome within GMC’s timeframe, a case examiner may impose a final registration measure upon the registrant. This is not an accepted outcome, as the registrant has not agreed to the proposal, but a separate power set out in article 51(5)(b) of the draft order and only applies where the case examiner concludes that the registrant’s fitness to practise is impaired.

Article 53(2) of the draft order provides that GMC may make rules setting out the date from which a registration measure takes effect.

Article 54 requires that GMC must notify a registrant of a case examiner’s decision and provide a statement of the reasons for the decision and information in respect of any right of appeal against the decision.

GMC must also send notification of a case examiner’s decision to:

• any person by whom the registrant is employed, or with whom the registrant has entered into an arrangement to provide services as a regulated professional (where known)
• any regulatory body with which the registrant is registered (where known)
• any other party as GMC considers appropriate (for example, a person who raised a concern)

GMC will have a discretion as to whether or not to provide these parties with a statement of the reasons for the decision, but the notification must inform them of any power GMC has to revise specific case examiner decisions as set out in its rules.

Article 54(4) of the draft order provides that GMC will have a duty to publish information about final registration measures imposed by case examiners including decisions to take no action where the registrant’s fitness to practise is found to be impaired.

Stage 3 - determination by a fitness to practise panel 

The third stage of the fitness to practise process is the fitness to practise panel stage. As set out in paragraph 8(1) of schedule 1 of the draft order, GMC will continue to have a statutory committee responsible for running fitness to practise panel hearings. However, it will now be called the Medical Tribunal Service (MTS) rather than the Medical Practitioners Tribunal Service (MPTS). This name change reflects the fact that GMC has become a multi-professional regulator since the advent of MPTS, through the regulation of anaesthesia associates and physician associates as well as medical practitioners.

GMC may choose to provide in rules that a fitness to practise panel can join multiple referrals in respect of one registrant and cases relating to the same circumstances in respect of multiple registrants. Furthermore, GMC may join cases involving different types of registrants for example a doctor and a physician assistant. This is provided for at article 64(2)(g) of the draft order.

Following a referral of a case by a case examiner to MTS, the fitness to practise panel must determine if a registrant’s fitness to practise is impaired or not. Proceedings of a fitness to practise panel must be held in public, however, GMC may prescribe in rules the circumstances in which proceedings before a fitness to practise panel are to be held in private such as when discussing a registrant’s health. 

Where a fitness to practise panel determines that a registrant’s fitness to practise is not impaired a fitness to practise panel may close the case without taking any further action, or issue a warning to the registrant, if they believe this is necessary. Where a warning is issued to a registrant, GMC will have a duty to publish the warning as set out in article 54(4)(a).

Where a fitness to practise panel determines that a registrant’s fitness to practise is impaired, it will be able to impose a final registration measure. Article 53(2) of the draft order provides that GMC may make rules setting out the date from which a registration measure takes effect. 

GMC or MTS must notify a registrant of a fitness to practise panel’s decision and provide a statement of the reasons for the decision and information in respect of any right of appeal against the decision. 

GMC or MTS must also send notification of a fitness to practise panel’s decision to:

• any person by whom the registrant is employed, or with whom the registrant has entered into an arrangement to provide a service as a regulated professional (where known)
• any regulatory body with which the registrant is registered (where known)
• any other interested party as GMC considers appropriate (for example, a person who raised a concern)

GMC or MTS will have a discretion to provide these parties with a statement of the reasons for the decision.

Furthermore, GMC or MTS will have a duty to publish information about final registration measures imposed by fitness to practise panels, including decisions to take no action where the registrant’s fitness to practise is found to be impaired.

Registration measures - review

A review of a registration measure (except a removal order) may be carried out by a case examiner or fitness to practise panel at any time during the period for which the measure has effect.

A registration measure cannot be imposed on a registrant’s registration during a registration measure review unless the registrant affected has been given an opportunity to make a representation to the case examiner or fitness to practise panel beforehand. Where a case examiner is carrying out the review, GMC must notify the regulated professional of the manner in which, and time within which, representations may be made to the case examiner. Where a fitness to practise panel is carrying out the review MTS must notify the regulated professional of the manner in which, and time within which, representations may be made to the fitness to practise panel.

As set out in article 55(3) of the draft order, the case examiner or the fitness to practise panel may, taking into account any changes in impairment of the fitness to practise of the registrant to whom the registration measure relates, modify the measure by:

• amending the period for which the measure has effect
• amending, revoking or imposing a condition on registration
• revoking or imposing a suspension of registration
• imposing a removal of registration

The case examiner or fitness to practise panel may not, on each review, amend the period for which the registration measure is to have effect to provide that the regulated professional is subject to the measure for more than an additional 12 months.

Article 53(2) provides that GMC may make rules setting out the date from which a registration measure review decision takes effect.

GMC or MTS must send notification of the outcome of the review and any decision to modify a measure to the regulated professional. The notification must be accompanied by a statement of the reasons for the decision and information regarding any right of appeal against the decision. 

GMC or MTS must also send notification of a case examiner’s or fitness to practise panel’s decision to modify a registration measure to:

• any person by whom the registrant is employed, or with whom they have entered into an arrangement to provide services as a regulated professional (where known)
• any regulatory body with which the registrant is registered (where known)
• other interested parties as the regulator considers appropriate (for example, a person who raised a concern)

The notification may include a statement of the reasons for the decision and must include information regarding the power to revise a case examiner’s decision.

Article 55(7) provides that GMC or MTS must publish a decision of a case examiner or a fitness to practise panel whether or not to modify a registration measure.

Part 8: further provision relating to registration and fitness to practise

Interim registration measures - referral and imposition 

Under article 57 of the draft order, a fitness to practise panel will be able to impose an interim registration measure at any point in the fitness to practise process, after an initial assessment is opened and until a final outcome is reached.

In addition, the draft order provides that a fitness to practise panel’s powers with regard to imposing interim registration measures are extended so that a fitness to practise panel can impose an interim measure during registration proceedings. For example, GMC will be able to apply to a fitness to practise panel to impose an interim registration measure while it investigates whether a registrant’s register entry is fraudulent or while it investigates whether a registrant has an indemnity arrangement or insurance policy in place which provides appropriate cover in respect of their practice as a regulated professional. 

A referral of a matter to a fitness to practise panel may be withdrawn by GMC or a prescribed person if the fitness to practise panel has not yet reached a determination.

MTS must notify the registrant of the manner in which, and time within which, representations may be made to the fitness to practise panel. However, the fitness to practise panel does not need to wait to receive a representation from the registrant ahead of imposing an interim measure if it considers there is a need for urgent action to be taken.  

A fitness to practise panel to which a matter is referred must determine whether it should impose an interim registration measure. Article 57(1) of the draft order provides that the fitness to practise panel may only impose an interim registration measure if, in the opinion of the fitness to practise panel, to do so is necessary:

• for the protection of the public
• otherwise in the public interest
• in the interests of the regulated professional to whom the proceedings relate

Article 57(3) provides that the registration measures which may be imposed are:

• a condition on registration
• a suspension of registration

As set out in article 57(4), the period for which an interim registration measure has effect begins with a day determined in accordance with rules. 

The period for which an interim registration measure has effect ends with the expiry of such period of no more than 18 months as the panel must specify or, if earlier, the day on which the registration proceedings or fitness to practise proceedings are concluded.

MTS must send notification of a decision to impose an interim registration measure to:

• the regulated professional
• where known:
  • the regulated professional’s employer
  • any other person with whom the regulated professional has entered into an arrangement to provide services as a regulated professional
  • any other regulator with which the regulated professional is registered
• such other interested parties as the regulator considers appropriate

The notification of a decision to the regulated professional, must include a statement of the reasons for the decision and information regarding rights of appeal. The notification of a decision to any other party may include a statement of the reasons for the decision. 

Article 57(8) provides that MTS must publish a decision of a fitness to practise panel to impose an interim registration measure.

Interim registration measures - extension of maximum duration

As set out in article 58 of the draft order, GMC may apply to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland for an extension to an interim registration measure. A court will be able to extend the interim measure for a further 12 months with further extensions possible subject to GMC making further applications to the court.

Interim registration measures - review 

Article 59(1) provides that a review of an interim registration measure may be carried out by a case examiner or fitness to practise panel at any time during the period for which the measure has effect. Article 59(2) provides that a review must be carried out before the end of the period of 6 months beginning with the day on which:

• the measure is first imposed
• a previous review under this article takes place
• a court extends the period for which a measure has effect

The regulator, where a case examiner carries out the review, or MTS, where a fitness to practise panel carries out the review, must notify the regulated professional of the manner and time in which representations may be made to the case examiner or panel.

The case examiner or fitness to practise panel may, taking into account any changes in what may be necessary for the protection of the public, otherwise in the public interest or in the interests of the regulated professional to whom the interim registration measure relates, modify the measure by:

• amending the period for which the measure has effect
• amending, revoking or imposing a condition on registration
• revoking or imposing a suspension of registration

The case examiner or fitness to practise panel may not amend the period for which the measure is to have effect to provide that the regulated professional is subject to an interim registration measure or measures in respect of the same matter for more than 18 months.

The regulator or MTS must send notification of the outcome of the review and any decision to modify a measure to:

• the regulated professional
• where known:
  • the regulated professional’s employer
  • any other person with whom the regulated professional has entered into an arrangement to provide services as a regulated professional
  • any other regulator with which the regulated professional is registered
• such other interested parties as the regulator considers appropriate

The notification of the outcome and any decision to the regulated professional must include a statement of the reasons for the decision, and information regarding rights of appeal. The notification of the outcome and any decision to any other party may include a statement of the reasons for the decision and where the review has been carried out by a case examiner, must include information regarding any power to revise the decision. 

Article 59(8) of the draft order provides that GMC or MTS must publish a decision of a case examiner or fitness to practise panel whether or not to modify an interim registration measure.

Registration assessments and fitness to practise determinations

Under the Medical Act 1983 and the AAPAO, GMC can direct that registrants undertake different types of assessments to assess their fitness to practise and to help a decision maker at GMC determine whether a registrant should be granted re-entry to GMC’s register. These include:

• performance assessments
• health assessments
• English language assessments

Article 60(1) provides that GMC may, in connection with registration or fitness to practise proceedings, take such steps as it considers necessary for the purpose of:

• assessing whether a regulated professional, or an applicant for registration as a regulated professional, meets:
  • the standards of education and training
  • the standards applicable to registration
• determining whether the fitness to practise of a regulated professional is impaired

Articles 60(2) and (3) provide that the steps may include:

• requiring prescribed persons to supply prescribed information
• setting examinations
• testing language proficiency
• directing that a regulated professional, or an applicant for registration as a regulated professional, undergo a physical or mental health assessment

To future-proof the legislation we have not specified each individual assessment that GMC may direct that a regulated professional undertake

Powers relating to the gathering of evidence 

In the 2021 regulating healthcare professionals consultation, it was proposed that regulators should have a power to require information from:

• a registrant (excluding reflective material for the purposes of professional development or in the course of reflecting on their professional practice, for fitness to practise purposes)
• a third party

Where a third-party refuses to supply the information, a regulator would be able to seek an order of the appropriate court requiring the information to be supplied. This policy broadly aligns with current GMC evidence-gathering powers under section 35A of the Medical Act 1983.

Article 61 of the draft order provides that GMC may, for the purpose of gathering evidence relevant to the exercise of its functions in connection with registration, fitness to practise and interim registration measure proceedings, require a person to supply such information, or produce such a document, as the regulator may specify. 

Article 61(2) provides if the person required to supply information or produce a document is a regulated professional who is the subject of the proceedings and fails to supply the information or supply the document, GMC may take such action as may be prescribed including taking any step a fitness to practise panel may take under article 53 following a determination of impairment of fitness to practise. This is a change from the policy position within the AAPAO which provided that if the regulated professional fails to supply information or produce a document within 14 days of being required to do so and which GMC considers the regulated professional is able to supply or produce, GMC may seek an order of the appropriate court requiring the information to be supplied or the document to be produced.

As article 39(12) of the draft order provides that GMC may remove a regulated professional from its register for failure to supply information or produce a document, we are of the view that the court enforcement power, which applies to third parties, should not extend to the registrant who is subject to proceedings.

Having 2 consequences of non-compliance with supplying information or producing documents within the legislation could potentially cause confusion for registrants subject to proceedings. We are of the view that the removal power is proportionate.

Powers relating to the administration of oaths, etc 

Article 62(1)(a) of the draft order provides that a fitness to practise panel or an appeal panel of GMC may administer oaths ahead of panel proceedings. Witnesses may be asked to attend either a fitness to practise panel hearing or an appeal panel hearing by GMC.

GMC may also request that a person provides it with a specific document which relates to the fitness to practise or appeal proceedings.

Where a witness refuses to attend proceedings or a person refuses to provide a specific document which GMC has requested, article 62 sets out that GMC may apply to the High Court of Justice in England and Wales or the High Court of Justice in Northern Ireland for a writ of subpoena ad testificandum (a writ compelling an individual to attend as a witness) or a writ of subpoena duces tecum (a writ requiring the production of specific documents related to the proceedings). In Scotland, the Court of Session may grant a warrant for the recovery of documents or grant commissions to persons to take the evidence of witnesses or to examine havers and receive their exhibits and productions.

Other parties to the proceedings may also apply to the courts for the above writs or warrants. This article mirrors the power in paragraph 2 of schedule 4 of the Medical Act 1983.

Supply of information and production of documents - supplemental 

Article 63(1)(a) would implement recommendation 5.3 of the Williams Review and it would replicate paragraph 7(5) of schedule 3 of the AAPAO (in relation to fitness to practise proceedings). The government is of the view that implementing this recommendation should encourage a culture of open learning and safety. The article makes clear that GMC cannot require the professionals it regulates from having to provide material produced for the purposes of professional development or while reflecting on their professional practice in order to improve it, for fitness to practise and registration proceedings. However, if a registrant or a former registrant would like to provide reflective material to GMC as part of fitness to practise proceedings, as part of appeal proceedings or as part of a re-entry to the register application they should be permitted to do so.

GMC will be permitted to ask for reflective material when investigating whether an entry relating to a regulated professional should be removed from the register because it has been procured fraudulently or made incorrectly and when investigating whether an entry relating to a regulated professional should be removed from the register because the registrant has failed to comply with procedural rules relating to a periodic assessment.

Articles 63(1)(b) and (c) prevent GMC from requesting the supply of information or production of a document which could not be compelled in court on the trial of an action, or which contravenes the data protection legislation (within the meaning of section 3(9) of the Data Protection Act 2018).

Power to make procedural rules on registration, fitness to practise and interim registration measures proceedings

Article 64 of the draft order provides that GMC’s rules may make procedural provision in connection with registration, fitness to practise and interim registration measures proceedings. GMC’s rules may prescribe:

• the manner in which, and time within which, a step must be taken
• the way in which cases are to be managed
• a procedure for the administration of oaths, and other matters in connection with evidence
• a procedure for making representations
• a procedure for an assessment or determination
• requirements for attendance
• the circumstances in which proceedings concerning the same regulated professional, or relating to the same circumstances, may be joined
• the circumstances in which proceedings may be disposed of without a hearing

Power to make rules in relation to non-compliance

The Medical Act 1983 includes non-compliance powers, which allow GMC to deal with instances where a registrant has failed to comply with a reasonable request to provide information made by the regulator, or with a reasonable direction by the regulator to undergo an assessment in relation to a fitness to practise investigation such a health, performance or English language assessment. The powers allow GMC to refer these matters to a medical practitioners tribunal (MPT). MPT is then required to determine whether conditions on practice or a suspension of registration should be imposed on a doctor’s registration (see section 35A(6C) and schedule 4 paragraphs 5A(3) to (3D) and 5C(3) to (4) of the Medical Act 1983).  

Under the draft order article 65(1) provides that GMC’s rules may make provision for the consequences arising from a failure by a regulated professional, who is the subject of registration, fitness to practise or interim measure registration proceedings to comply with a requirement imposed in connection with those proceedings. This may include taking any step a fitness to practise panel may take following a determination of impairment of fitness to practise, in which case the relevant registration and revisions and appeals provisions apply in like manner, subject to such modifications as may be prescribed.

The Medical Act 1983 and the AAPAO include provisions on award of costs. An award of costs is an order for one party to pay the legal costs of the other party, typically when a party has acted unreasonably. The government is of the view that award of costs provisions should be included within the draft order as they will incentivise both regulated professionals and GMC to comply with procedural directions in registration, fitness to practise and interim registration measure proceedings and should bring cost and efficiency savings for both GMC and regulated professionals.

Article 65(2)(b) of the draft order sets out that GMC’s rules may prescribe that an award of costs or, in Scotland, expenses, may be imposed. The rules may provide for the assessment or taxation of costs and the enforcement in like manner as had the award been made by an order of the county court or, in Scotland, by decree of a sheriff.

Part 9: revisions and appeals

Revision of prescribed registration and fitness to practise decisions

Rule 12 of the General Medical Council (Fitness to Practise) Rules Order of Council 2004 enables GMC to review certain decisions it has made in respect of doctors and where necessary, change specific fitness to practise decisions. It allows anyone who has an interest in the decision (including a person who has raised a concern) to request a review of:

• a decision not to investigate a concern raised about a doctor
• a decision not to refer a doctor to a medical practitioners tribunal at the end of an investigation

Under the AAPAO, GMC may prescribe in rules the fitness to practise, registration and education and training decisions it may revise in relation to anaesthesia associates and physician associates. The grounds for a revision of a decision are set out in the AAPAO.

The government is of the view that GMC should be able to revise specific registration decisions (except emergency registration decisions as the powers to revise conditions on emergency registration or revoke a registrant’s emergency registration sit separately within article 43) and fitness to practise decisions (except fitness to practise panel decisions as panels are independent in their decision-making from GMC).

Article 66(1)(a) of the draft order provides that GMC may revise a specific fitness to practise decision made by a case examiner. These decisions include:

• where a case examiner determines that a registrant’s fitness to practise is:
  • not impaired and closes a case
  • not impaired but issues a warning
  • impaired and takes no action
  • impaired, and the registrant accepts both their fitness to practise is impaired and the proposed measure imposed through an accepted outcome
  • impaired and imposes a final registration measure on a non-responding registrant
• where a case examiner confirms, extends, varies or substitutes:
  • a final registration measure for another final registration measure following a review
  • an interim registration measure for another interim registration measure following a review

Articles 66(1)(b) and 66(2) of the draft order provide that GMC may make rules setting out that specific registration and fitness to practise decisions can be revised. GMC will be able to revise decisions of its own volition or it may prescribe that employers or people who raise concerns will be able to ask it to revise a decision subject to specific grounds for a revision being met. Article 66(6) provides that rules must make provision regarding the grounds on which, and the circumstances in which, a decision may be revised and may make provision regarding the cases or circumstances in which the person to whom the decision relates may make written representations to the regulator. 

A decision may be revised by:

• quashing the decision
• substituting for the decision being revised a decision that could have been made or reached
• quashing the decision and remitting it to be disposed of in accordance with the regulator’s directions

GMC must, where practicable, send notification of the revision of a decision to each person to whom notification of the decision was sent. GMC must publish a revised decision, unless it considers that to do so is not necessary for the protection of the public.

Consequential amendment to the National Health Service Reform and Health Care Professions Act 2002 - paragraph 36(3) of schedule 5 to the draft order

Under the AAPAO, PSA is able to ask GMC to revise specific case examiner decisions made in respect of anaesthesia associates and physician associates.

The government is of the view that PSA’s remit should be extended so that it can ask GMC to revise fitness to practise decisions made by case examiners in respect of medical practitioners, physician assistants in anaesthesia or physician assistants. This would include interim registration measure review decisions. This is consistent with the recommendation from the Mann Review that interim measure decisions raising public interest concerns should be capable of challenge. This change could help to provide an additional route to challenging decisions made by case examiners.

To allow PSA to request a revision of a case examiner decision we propose to amend section 26 of the National Health Service Reform and Health Care Professions Act 2002 to permit PSA to ask GMC to revise one of the following decisions:

• where a case examiner determines that a registrant’s fitness to practise is:
  • not impaired and closes a case
  • not impaired but issues a warning
  • impaired and takes no action
  • impaired, and the registrant accepts both their fitness to practise is impaired and the proposed measure imposed through an accepted outcome
  • impaired and imposes a final registration measure on a non-responding registrant
• where a case examiner confirms, extends, varies or substitutes:
  • a final registration measure for another final registration measure following a review
  • an interim registration measure for another interim registration measure following a review

Article 66(1)(a) of the draft order should be read in conjunction with the consequential amendment to section 26 of the National Health Service Reform and Health Care Professions act 2002, at paragraph 36(3) of schedule 5 of the draft order. Read together, the 2 provisions will allow PSA to ask GMC to revise a specific fitness to practise decision or interim registration measure review decision made by a case examiner.

Appeal to an appeal panel

In line with the principles of natural justice, applicants for registration with GMC, registrants and former registrants of GMC should have rights of appeal against specific registration, fitness to practise decisions and interim registration measure decisions made by GMC. The Medical Act 1983 and the AAPAO both include appeal rights against specific registration decisions, and against fitness to practise decisions which are made by a fitness to practise panel or medical practitioners tribunal.

Article 67(1) of the draft order provides that a relevant person (for example an applicant for registration, registrant or former registrant) may, with the permission of GMC, appeal to a GMC appeal panel a registration decision made by a registrar or a fitness to practise or interim registration measure decision made by a case examiner.

A request for permission to appeal must be received by the regulator before the end of a period of 28 days beginning with the day on which notification of the decision or outcome is, in accordance with rules, deemed to have been received, or in such circumstances as may be prescribed, such longer period as the regulator may direct.

GMC’s rules must make provision regarding the grounds on which, and the circumstances in which, a decision or outcome may be appealed. 

GMC must send notification of the outcome of an application for permission to appeal to the person to whom the relevant decision or relevant outcome relates. 

Article 67(5) provides that proceedings of an appeal panel under article 67 must be held in public, except in so far as may be prescribed. 

The appeal panel may dispose of an appeal by:

• dismissing the appeal
• quashing the decision or outcome under appeal
• substituting for the decision or outcome under appeal a decision or outcome that could have been made or reached
• remitting the matter to be disposed of in accordance with the panel’s directions

GMC must publish the decision on disposal of the appeal, unless it considers that to do so is not necessary for the protection of the public.

Article 67(8) provides that where an appeal is commenced but, before the appeal is determined, GMC revises the decision to which the appeal relates, the appeal is to lapse.

Registration decisions which may be appealed to an appeal panel

Article 68 sets out that the following decisions made by GMC’s registrar are appealable to an appeal panel of GMC:

• where the registrar is not satisfied that an applicant meets the standards of education and training and standards applicable to registration
• where the registrar has added a restriction or enhancement to a regulated professional’s registration or has varied or revoked a restriction or enhancement to which the registration of a regulated professional is subject
• removal where the registrar is satisfied that the regulated professional has died
• removal where the registrar is satisfied that the register entry has been procured fraudulently or made incorrectly
• non-removal, where the registrant has requested the removal and GMC’s registrar has refused the removal (excludes where the registrant is subject to parallel registration proceedings or fitness to practise proceedings)
• removal where the register entry is subject to a restriction on registration by reference to a period of time and that period has expired
• removal where the regulated professional has failed to comply with a restriction to which the regulated professional’s registration is subject
• removal where the regulated professional has practised within an enhancement to which the regulated professional’s registration is not subject
• removal where the regulated professional has failed to comply with procedural rules relating to a periodic assessment
• removal where the outcome of a periodic assessment is that the regulated professional does not meet the appropriate standards of education and training or the appropriate standards applicable to registration or the additional assessment criteria applicable to a periodic assessment (if any)
• removal where the regulated professional has failed to supply information or produce a document
• where the registrar refuses to re-enter a person on the register whose previous entry on the register was removed for a reason other than the imposition of a registration measure, except where a fitness to practise panel has determined under article 41(2)(b) of the draft order that the person’s fitness to practise is impaired

Fitness to practise decisions or outcomes which may be appealed to an appeal panel

Article 69 provides that a registrant will have a right of appeal to an appeal panel of GMC against the following case examiner decisions:

• where a case examiner determines that a registrant’s fitness to practise is:
  • not impaired but issues a warning
  • impaired and takes no further action
  • impaired and a registrant accepts that their fitness to practise is impaired and the proposed registration measure imposed through an accepted outcome
  • impaired and imposes a final registration measure on a non-responding registrant
• where a case examiner confirms or modifies a registration measure on review

Interim registration decisions which may be appealed to an appeal panel

Article 70 of the draft order provides that a registrant will have a right of appeal to an appeal panel of GMC against a case examiner’s review decision to confirm or modify an interim registration measure which is imposed on the registrant’s registration.

Appeal to an appropriate court

Article 71 provides that registrants or former registrants will have direct rights of appeal to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland against specific fitness to practise decisions and interim measure registration decisions made by a fitness to practise panel or GMC decision maker. The government is of the view that fitness to practise panel decisions should not have an internal right of appeal to an appeal panel of GMC in the first instance due to fitness to practise panels being independent in their decision-making from GMC.

There will also be subsequent rights of appeal from an appeal panel to either the county court or a sheriff or the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland for applicants, registrants and former registrants against specific registration, fitness to practise and interim registration measure decisions.

An appeal to a court must be brought before the end of 28 days beginning with the day on which notification of the decision is, in accordance with rules, deemed to have been received by the relevant person. 

The court may dispose of an appeal by:

• dismissing the appeal
• quashing the decision or outcome under appeal
• substituting for the decision or outcome under appeal a decision or outcome that could have been made or reached
• remitting the matter to be disposed of in accordance with the court’s directions

Where an appeal is commenced but GMC revises the decision to which the appeal relates before the appeal is determined, the appeal will lapse. The court may make any order as to costs or, in Scotland, expenses as it thinks fit.

In line with current practice directions county court or sheriff appeals should be held by way of review and High Court or Court of Session appeals should be held by way of re-hearing. This is set out in the explanatory note to the draft order.

Registration decisions - appeal to a county court or sheriff

Article 72 provides that where permission to appeal to an appeal panel has been refused by GMC or an appeal panel has disposed of the appeal, an applicant for registration, registrant or former registrant will have a subsequent right of appeal against the following registration decisions to the county court or a sheriff: 

• where the registrar is not satisfied that an applicant meets the standards of education and training and standards applicable to registration
• where the registrar has added a restriction or enhancement to a regulated professional’s registration, or has varied or revoked a restriction or enhancement to which the registration of a regulated professional is subject
• removal where the registrar is satisfied that the regulated professional has died
• removal where the registrar is satisfied that the register entry has been procured fraudulently or made incorrectly
• non-removal, where the registrant has requested the removal and GMC’s registrar has refused the removal (excludes where the registrant is subject to parallel registration proceedings or fitness to practise proceedings)
• removal where the register entry is subject to a restriction on registration by reference to a period of time and that period has expired
• removal where the regulated professional has failed to comply with a restriction to which the regulated professional’s registration is subject
• removal where the regulated professional has practised within an enhancement to which the regulated professional’s registration is not subject
• removal where the regulated professional has failed to comply with procedural rules relating to a periodic assessment
• removal where the outcome of a periodic assessment is that the regulated professional does not meet the appropriate standards of education and training or the appropriate standards applicable to registration or the additional assessment criteria applicable to a periodic assessment (if any)
• removal where the regulated professional has failed to supply information or produce a document

Registration decisions - appeal to the High Court or Court of Session

Article 73 provides that a registrant will have a direct right of appeal to the High Court or Court of Session where a registrant’s register entry is removed from the register following a conviction for a listed offence set out within schedule 4 of the draft order.

A former registrant will have a direct right of appeal to the High Court or Court of Session where the registrar refuses to register a person whose entry in the register has previously been removed from the register due to the imposition of a registration measure, and the person’s fitness to practise has been determined by a fitness to practise panel.

Where permission to appeal to an appeal panel has been refused by GMC or an appeal panel has disposed of the appeal, an applicant for registration will have a subsequent right of appeal to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland against the following decision:

• where the registrar refuses to re-enter a person on the register whose previous entry on the register was removed for a reason other than the imposition of a registration measure, except where a fitness to practise panel has determined under article 41(2)(b) of the draft order that the person’s fitness to practise is impaired

Fitness to practise decisions or outcomes - appeal to the High Court or Court of Session

Article 74 provides that where permission to appeal to an appeal panel has been refused by GMC or an appeal panel has disposed of the appeal, a registrant will have a subsequent right of appeal to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland where a case examiner:

• determines that a registrant’s fitness to practise is:
  • not impaired but issues a warning
  • impaired and takes no further action
  • impaired and a registrant accepts that their fitness to practise is impaired and the proposed registration measure imposed through an accepted outcome
  • impaired and imposes a final registration measure on a non-responding registrant
• confirms or modifies a registration measure on review

A registrant will have a direct right of appeal to the High Court of Justice in England and Wales, the Court of Session in Scotland or the High Court of Justice in Northern Ireland against a fitness to practise panel decision. The appealable decision will be where a fitness to practise panel:

• determines that a registrant’s fitness to practise is:
  • not impaired but issues a warning
  • impaired but takes no further action
  • impaired and imposes a registration measure
• confirms or modifies a registration measure on review

Interim registration measure decisions - appeal to the High Court or Court of Session

Article 75 provides that where permission to appeal to an appeal panel has been refused by GMC or an appeal panel has disposed of the appeal, a registrant will have a subsequent right of appeal to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland against a case examiner’s review decision to confirm or modify an interim registration measure which is imposed on the registrant’s registration.

A registrant will have a direct right of appeal to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland, against a fitness to practise panel’s decision to impose an interim registration measure on a registrant’s registration and against a fitness to practise panel’s review decision to confirm or modify an interim registration measure which is imposed on a registrant’s registration.

Regulator appeal to an appropriate court

Section 40A of the Medical Act 1983 provides GMC with a right of appeal against specific fitness to practise decisions made by MPTS. The Williams Review in 2018 recommended that this right of appeal be removed from legislation to contribute towards increasing levels of registrant trust in the regulator, a recommendation that was accepted by the previous government. The government is of the view that the value of oversight, taken alongside historic evidence of proportionate use of this power by GMC and work done to address the concerns raised by the Williams Review, justifies revisiting this. GMC has also set a target to eliminate disproportionality in employer referrals and implemented the Fair Employer Referrals Programme to deliver on this aim.

Lord Mann’s 2026 Review into tackling antisemitism and other forms of racism in healthcare reflects this in its recommendation that GMC’s right of appeal against specific decisions made by a fitness to practise panel should remain in legislation, to ensure sufficient oversight of panel decision-making. Lord Mann’s view is concerns raised regarding the decision-making process and outcomes in a number of high-profile cases that were brought to MPTS have underlined the importance of having appropriate, timely and proportionate appeals routes at every stage of the process.

GMC has a strong record of success on the decisions it chooses to appeal and does not use this power frequently (since GMC right of appeal came into force in January 2016, GMC has issued section 40A appeals in respect of a total of 60 doctors). Maintaining GMC’s appeal right would ensure a route to challenge MPTS decisions which GMC deems insufficient to protect the public, thereby ensuring decisions that improve patient safety. We are therefore consulting on retaining this appeal right, as an important part of maintaining public confidence in the regulatory process.

The government is supportive of a further power for GMC and PSA to appeal interim decisions as a proportionate additional route to ensure protection of the public at every stage. Lord Mann’s review also recommends that GMC and PSA should have a right of appeal against interim registration measure decisions made by a fitness to practise panel to further support protection of the public. GMC has already taken forward work to set out more clearly the processes undertaken when they use their appeals powers, addressing some of the concerns raised by the 2018 Williams Review. This also includes work to develop fairer and more consistent fitness to practise processes and further diversify its investigations teams. GMC has made significant progress against its target to eliminate disproportionate fitness to practise referrals by 2026 and become a more inclusive organisation with higher representation of people from ethnic minority backgrounds, and progression within its own workforce.

Articles 76 and 77 provide that GMC may directly appeal to the High Court in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland, against the following fitness to practise panel decisions. The panel:

• determines that a registrant’s fitness to practise is:
  • not impaired and takes no action
  • not impaired and issues a warning
  • impaired, and the fitness to practise panel decides to take no action
  • impaired and imposes a registration measure (for example, GMC may be of the view that the registrant should have been removed from the register rather than suspended)
• confirms or modifies a registration measure on review
• determines that a registrant who has previously been removed from GMC’s register due to the imposition of a registration measure can be re-entered on to GMC’s register as the registrant’s fitness to practise has been determined to be no longer impaired
• does not impose an interim registration measure on a registrant
• imposes an interim registration measure (for example, GMC may be of the view that the registrant should have been suspended rather than have conditions placed on their registration)
• confirms or modifies an interim registration measure on review

An appeal must be brought before the end of 28 days beginning with the day on which notification of the decision is, in accordance with rules, deemed to have been received by GMC.

The court may dispose of an appeal by:

• dismissing the appeal
• quashing the decision under appeal
• substituting for the decision under appeal a decision that could have been made
• remitting the matter to be disposed of in accordance with the court’s directions

The court may make an order as to costs or, in Scotland, expenses as it thinks fit.

Consequential amendment to the National Health Service Reform and Health Care Professions Act 2002 - paragraph 36(6) of schedule 5 of the draft order

Recommendation 6.1 of the Williams Review recommends that PSA should retain its right to appeal a decision of a fitness to practise panel to the High Court on the grounds that it is insufficient to protect the public. The draft order includes a consequential amendment to the National Health Service Reform and Health Care Professions Act 2002 to provide PSA with rights of appeal against specific fitness to practise decisions made by a fitness to practise panel.

An amendment will be made to section 29 of the act to provide PSA with a right of appeal to the High Court of Justice in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland, against a fitness to practise panel decision, where a fitness to practise panel:

• determines that a registrant’s fitness to practise is:
  • not impaired and takes no action
  • not impaired and issues a warning
  • impaired, and the fitness to practise panel decides to take no action
  • impaired and imposes a registration measure (for example, PSA may be of the view that the registrant should have been removed from the register rather than suspended)
• confirms or modifies a registration measure on review

The government proposes that allowing interim decisions to be appealed by PSA could ensure that PSA is able to exercise their responsibility to provide oversight of GMC more quickly and effectively and would support in ensuring oversight at all the main points in the regulatory decision-making process. However, it may have a modest cost implication for PSA. Lord Mann, in his review of antisemitism and other forms of racism in healthcare, highlights that PSA should be given a right of appeal to the courts against interim registration measure decisions made by fitness to practise panels, where PSA deems interim registration decisions made are not sufficient to protect the public. This recommendation is intended to address the main themes in the findings of the review around the need to improve oversight of regulator decision-making and ensure accountability at every stage. Further work is required to consider how this recommendation is best operationalised, alongside wider changes to GMC operations in practice to ensure proportionate and effective delivery of its policy aims.

An amendment is therefore proposed to section 29 of the act to provide PSA with a right of appeal to the High Court of Justice in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland, against a fitness to practise panel’s decision, where a fitness to practise panel:

• does not impose an interim registration measure on a registrant
• imposes an interim registration measure (for example, PSA may be of the view that the registrant should have been suspended rather than have conditions placed on their registration)
• confirms or modifies an interim registration measure on review

An amendment will also be made to section 29 of the act to allow PSA to refer to the High Court of Justice in England and Wales, the Court of Session in Scotland or the High Court in Northern Ireland, a decision of GMC or one of its committees, panels or officers, to restore a registrant to a part of GMC’s register following their removal due to the imposition of a registration measure.

Specified state qualifications - additional grounds of appeal

In July 2021, the UK signed a free trade agreement with Iceland, Liechtenstein and Norway and in June 2023 it signed a treaty with Switzerland regarding the recognition of professional qualifications between the 2 countries. To be compliant with the treaties, GMC must notify a person who has applied for registration from one of these countries of a registration decision within 4 months of receipt of their complete application for registration.

Articles 78(1) and (2) of the draft order provides that for the purposes of articles 68(2) (registration decisions which may be appealed to an appeal panel) and 72(2) (registration decisions - appeal to the county court or sheriff), GMC’s registrar is deemed to have decided not to register a person in the following circumstances:

• where the person has applied for registration in reliance on a specified state qualification and where GMC has not, within the notification period, notified the person:
  • in accordance with paragraph (3) of article 36 (registration of an entry in the register), of the registrar’s decision under paragraph (1) of that article
  • in accordance with paragraph (3) of article 37 (registrations restrictions and enhancements), that the person’s registration is to be subject to a restriction or benefit from an enhancement which is commensurate with the person’s professional qualifications

Where permission to appeal by an applicant to an appeal panel is refused by GMC or an appeal panel disposes of the appeal, the applicant will have a subsequent right of appeal against the decision to the county court or a sheriff.

Part 10: supplemental

Orders 

Article 79 of the draft order sets out further provision in relation to the exercise of powers given to the Privy Council under the draft order.

Rules 

The 2021 regulating healthcare professionals consultation proposed that regulators should have similar governance and operating frameworks which balance greater flexibility with effective oversight. Part of this increased flexibility is for regulators to be provided with powers to set more of their own operating procedures through rules or guidance that do not require the approval of Parliament, or where the matter relates to devolved matters, the Scottish Parliament or the Privy Council. This enables regulators to adapt to changing circumstances much more swiftly, to make necessary changes without the need to rely on Parliamentary process.  

Article 80 of the draft order sets out that rules must be made by GMC in writing. An instrument by which rules are made must state the power that such are made and it must also be published by GMC. Article 80(3) provides that before making rules GMC must consult, to the extent it considers appropriate, representatives of the regulated professions, the employers of regulated professionals, the users of the services of regulated professionals, persons providing, assessing or funding education or training for regulated professionals and any other group of persons which appear to the regulator likely to be affected by the rules. Article 80(4) provides that where GMC considers that it is not appropriate to consult before making rules by reason of urgency, it must consult the representatives mentioned in article 80(3) as soon as reasonably practicable after making them.

Consultation must include, to the extent GMC considers it appropriate, representatives of:

• regulated professions
• employers of and those using the services of regulated professionals
• those providing, assessing or funding education or training for regulated professionals
• others who appear to the regulator likely to be affected by the rules

GMC must notify the Secretary of State for Health and Social Care, the Welsh ministers, the Scottish ministers and the Department of Health in Northern Ireland and the devolved legislatures of any rule changes made, or that a consultation has been published in relation to rules.

Interpretation 

Article 81 of the draft order provides interpretations of terms used in the draft order.

Consequential provision

Article 82(1) of the draft order omits parts 1 to 5 and part 6 of the Medical Act 1983 and article 82(3) revokes the Anaesthesia Associates and Physician Associates Order 2024.

Consequential amendments are changes that are made to existing legislation. The amendments ensure consistency by modifying other related regulations to align with the new legislation.

Article 82(2) provides that schedule 5 of the draft order makes amendments to primary legislation consequential on this draft order. 

Articles 82(5) and (6) provide that the Privy Council may by order make further provision that is consequential on this draft order. An order may amend or revoke an enactment contained in:

• subordinate legislation (within the meaning of the Interpretation Act 1978)
• an instrument made under a measure or act of Senedd Cymru
• an instrument made under an act of the Scottish Parliament
• an instrument made under Northern Ireland legislation

Schedule 1: constitution of the regulator 

Part 1: the regulator

The 2021 regulating healthcare professionals consultation proposed a new unitary board replace the current 2-tier governance structure that regulators currently operate. The board will consist of a chair, non-executive members and executive members. Appointments are made on merit and there will no longer be a legal requirement to appoint registered professionals, however it would be extremely likely that the non-executive members would also include regulated professionals. 

Paragraph 1 of the draft order provides for the constitution of the new unitary board which can be up to 14 members. Paragraph 2 provides detail relating to the appointment of members. 

Paragraph 3 enables GMC to pay its board and trustee members. Paragraph 4 ensures GMC operates and publishes a system for board members to declare and register their private interests.

Paragraph 5 provides that the Privy Council must make a further order is made that sets out additional detail regarding the constitution of the unitary board, for example, in relation to terms of appointment and deputising arrangements for the chair.

Paragraph 6 allows GMC to include in standing orders detail around how it conducts its unitary board meetings. However, it stipulates the meeting quorum (the minimum number of members required to be present at a meeting to officially conduct business, vote, or make legally binding decisions) must be a minimum of half its members and that meetings must be held in public unless circumstances set out in standing orders are met. GMC must also set out a process whereby a member of the public can access a record of meetings held in public. Standing orders must be published and may be reviewed and amended. 

Paragraph 7 requires GMC to make and publish arrangements it has in place to take account of the views of regulated professionals and lay people (those who do not hold a qualification approved under article 26 (approval of education and training). GMC must keep these arrangements under review.

Part 2: regulator committees

Paragraph 8 establishes the Medical Tribunal Service (MTS), currently known as the Medical Practitioners Tribunal Service (MPTS). MTS will remain as a statutory committee. The 2021 regulating healthcare professionals consultation proposed that all statutory committees be removed from legislation giving regulators the freedom to establish their own committee structures. However, MPTS was set up for medical practitioners following the Shipman Inquiry.

The General Medical Council (Fitness to Practise and Over-arching Objective) and the Professional Standards Authority for Health and Social Care (References to Court) Order 2015 inserted detailed provisions into the Medical Act 1983 to implement a policy of separation to separate GMC’s investigation role from its adjudicatory role, which would be carried out by the operationally separate MPTS. The 2015 Order established MPTS as a statutory committee to strengthen the separation between GMC’s investigation and adjudication arms, and place medical practitioners tribunals and interim orders tribunals under the administrative control of MPTS. Although there are sufficient safeguards built into the policies on investigation and adjudication relating to fitness to practise cases, we now propose that MTS remains as a statutory committee in GMC’s overarching legislation to continue to meet the intent of the 2015 Order (mentioned above). The policy for the remaining regulators is expected to continue as previously consulted on.

The draft order provides for MTS to carry out the functions assigned to it by the draft order. GMC must make provision in rules in respect of, for example:

• the MTS constitution
• appointments to MTS including terms and duration of appointment
• the quorum applicable to MTS
• the procedure by which MTS is to carry out its functions

GMC also has a power to make rules in respect of the skills and expertise which a person must have to be eligible for appointment to MTS. GMC may appoint regulated professionals to MTS, however, they must not form more than half of its members. Rules regarding MTS must ensure that it can carry out its functions justly and, where there is conflict, may override GMC’s objective. 

Paragraph 9 ensures a member of GMC cannot be appointed to MTS to preserve the separation between the 2. Paragraph 10 enables GMC to pay those appointed to MTS. Paragraph 11 ensures MTS operates and publishes a system for its members to declare and register their private interests. Paragraph 12 allows GMC to direct MTS to delegate specific functions to its chair. Paragraph 13 places a duty on MTS to publish an annual report on its functions and include details relating to equality and diversity (within the meaning of the Equality Act 2006),  the nature and volume of case work and any points of learning that has been identified and how they are being addressed. MTS must submit a copy of the report to the Privy Council who will lay reports before each House of Parliament and the devolved legislatures.

Paragraph 14 provides the power for GMC to establish, through standing orders, additional committees to exercise its functions. For each committee, GMC must specify in standing orders details relating to it and take certain factors into consideration when making appointments to the committees. An additional committee may not exercise a function of MTS, an appeal panel or fitness to practise panel, or exercise the function to make rules. Standing orders must be published and may be amended or revoked.

Paragraph 15 provides the power for GMC to establish sub-committees to exercise its functions and also dissolve sub-committees.

Paragraph 16 ensures a member of the unitary board cannot be appointed to a committee or sub-committee if the terms of reference include a function arising in fitness to practise proceedings. 

Paragraph 17 enables GMC to pay those appointed to a committee or sub-committee.

Paragraph 18 ensures a committee or sub-committee maintains and publishes a register of private interests for its members.

Part 3: adjudicatory bodies

Paragraph 19 provides the power for GMC to convene appeal panels and for MTS to convene fitness to practise panels to exercise, on behalf of GMC, the adjudicatory functions conferred on appeal panels and fitness to practise panels respectively. For appeal panels and fitness to practise panels, GMC must make rules setting out further detail regarding, for example, the constitution of a panel and the process for making appointments. 

Paragraph 20 ensures a member of the unitary board cannot be appointed to an appeal panel or a fitness to practise panel to preserve the separation between the 2. Paragraph 21 enables GMC to pay those appointed to an appeal panel or fitness to practise panel. Paragraph 22 ensures GMC, in respect of an appeal panel, and MTS, in respect of a fitness to practise panel, maintains and publishes a system for persons appointed to such panels to declare and register their private interests.

Part 4: additional appointments 

Paragraph 23 provides a duty for GMC to appoint a registrar to exercise on behalf of GMC the functions conferred on the registrar. Paragraph 24 provides a duty for GMC to appoint a case examiner or examiners to exercise on behalf of GMC the functions conferred on a case examiner. Paragraph 25 provides a power for when GMC appoints a registrar and case examiner for GMC to specify the terms and duration of appointment, the circumstances in which an appointment may cease and any other matter it deems appropriate. In appointing a registrar or case examiners, GMC must consider the skills and expertise required for the appointee to carry out the relevant functions. GMC may make payment to the registrar and case examiners.

Schedule 2: protected titles

Schedule 2 of the draft order sets out the protected titles in both English and Welsh.

Schedule 3: change of title - amendment of the Anaesthesia Associates and Physician Associates Order 2024

Schedule 3 of the draft order sets out the amendments that will be made to the AAPAO with regard to changing the protected titles. Schedule 3 is intended to be a temporary provision. The intention is for this schedule and article 45(4), which introduced this schedule, to be revoked once the General Medical Council Order 2026 is fully commenced and the AAPAO is revoked in full.

Schedule 4: fitness to practise - relevant criminal convictions

Schedule 4 of the draft order sets out the listed offences. Where a registrant has been convicted of an offence listed in part 1 of schedule 4, irrespective of what sentence has been imposed, or part 2 of schedule 4, where a custodial sentence has been imposed, article 38(2)(a) of the draft order requires that the registrar must remove them from the register.

Schedule 5: minor and consequential amendments to primary legislation

Schedule 5 of the draft order sets out the consequential amendments to primary legislation and other minor amendments to primary legislation.

How to respond

Please respond using the online survey.

Do not provide personal data when responding to free-text survey questions. Any personal data included will be removed prior to analysis of these responses and will therefore not be considered in the consultation outcome.

The consultation is open for 13 weeks and will close at 11:59pm on 23 June 2026. If you respond after this date, your response will not be considered.

If you have any queries on this consultation, contact regulationreform@dhsc.gov.uk. Do not send your consultation answers or any personal information to this email address.

Consultation questions

About you

In what capacity are you responding to this survey?

• An individual sharing my personal views and experiences
• An individual sharing my professional views
• On behalf of an organisation

What is your name? (Optional)

Questions for individuals sharing their personal or professional views

What is your profession or job role? (Optional)

• Registered healthcare professional
• Other healthcare professional
• Other, please specify

Where do you live in the UK?

• England
• Scotland
• Wales
• Northern Ireland
• I live outside the UK
• Prefer not to say

What is your age? (Optional)

• Under 16
• 16 to 24
• 25 to 34
• 35 to 44
• 45 to 54
• 55 to 64
• 65 to 74
• 75 to 84
• 85 or above
• Prefer not to say

What is your sex? (Optional)

• Female
• Male
• Prefer not to say

What is your ethnic group? (Optional)

• White - includes British, Northern Irish, Irish, Gypsy, Irish Traveller, Roma or any other White background
• Mixed or Multiple ethnic groups - includes White and Black Caribbean, White and Black African
• White and Asian or any other Mixed or Multiple background
• Asian or Asian British - includes Indian, Pakistani, Bangladeshi, Chinese or any other Asian background
• Black, Black British, Caribbean or African - includes Black British, Caribbean, African or any other Black background
• Other ethnic group - includes Arab or any other ethnic group
• Prefer not to say

Questions for organisations

What type of organisation are you responding on behalf of?

• Academic institution
• Business
• Not for profit
• Public sector body
• Other, please specify

Where does your organisation operate or provide services? Select all that apply.

• England
• Wales
• Scotland
• Northern Ireland
• The whole of the UK
• Outside the UK

What is the name of your organisation?

Commencement

We need to ensure that the commencement of the General Medical Council Order 2026 is managed in a safe and effective way that mitigates the risks of a regulatory gap during this transition.

A ‘coming into force date’ mechanism has been included for parts 2 to 10 of the draft order. However, we have not specified a date for when parts 2 to 10 come into force as per article 2(2)(b) of the draft order. Article 2(2)(b) relates to the coming into force of the majority of the provisions within the draft order.

Although a coming into force date for the General Medical Council Order 2026 would provide clarity, there would be advantages in allowing flexibility regarding when provisions are activated, in particular for areas involving transition of cases from the old framework to the new. This could be achieved by specifying dates in tertiary legislation - for example, to be made through a Privy Council Order.

Do you agree or disagree that a specific ‘coming into force’ date should be included in article 2(2)(b) of the final General Medical Council Order 2026? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

If you have any further comments regarding the commencement of the General Medical Council Order 2026 and the transition to GMC’s new legislation, please set them out here. Do not include any personal information in your response. (Optional, maximum 500 words)

Governance

Separate to annual report requirements relating to equality and diversity, the draft order contains the following for GMC relating to equality, diversity and inclusion:

• a duty to ensure that, in the exercise of its functions, it applies good practice in relation to equality and diversity
• where it considers that an improvement may be required, a duty to take such steps as it considers appropriate to make that improvement
• a duty to have regard to any current or future principles set by PSA regarding equality, diversity and inclusion

Do you agree or disagree with the inclusion of these requirements in the order? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Parts 2 to 4 of the draft order relate to GMC’s governance and operating functions. This includes provisions relating to:

• delegation of exercise of functions
• disclosure of information
• guidance
• annual reports
• fee setting and other financial requirements
• default powers of the Privy Council

The provisions in these sections aim to improve the efficiency of GMC’s administrative functions, reducing bureaucracy.

Do you agree or disagree that the provisions set out in parts 2 to 4 of the draft order enable GMC to carry out its governance and operating framework functions appropriately? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Schedule 1 of the draft order includes provisions to enable GMC and MTS to effectively operate. It outlines how the GMC board may operate under the order, how committees may function and how adjudicatory bodies such as appeal panels may operate. It also puts a duty on GMC to appoint a registrar and case examiner or case examiners to exercise certain functions on behalf of GMC. In addition, the Privy Council must, by order, make further provision as to the constitution of the regulator.

Do you agree or disagree that the powers and duties in schedule 1 on constitution of the regulator are sufficient to enable GMC and MTS to carry out their functions appropriately and proportionately? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

The draft order proposes that the Privy Council’s default powers continue to apply (they are currently contained in section 50 of the Medical Act 1983). These are powers which the Privy Council may use if it feels that GMC has failed to carry out its regulatory functions. In relation to GMC’s rule-making powers in the draft order, the Privy Council will no longer be required to approve new rules or rule changes made by GMC under the draft order. However, should any future rules be deemed to require Privy Council approval, such approval will be put in place.

Do you agree or disagree that the powers and duties in the draft order in relation to the Privy Council are sufficient to support GMC to carry out its functions appropriately? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

PSA evidence gathering

The draft order, as per a recommendation of the Mann Review, provides for a consequential amendment to be made to the National Health Service Reform and Health Care Professions Act 2002 to allow PSA to have a power to compel information from GMC.

Do you agree or disagree that the draft order provides PSA with sufficient and proportionate evidence-gathering powers? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Education and training

The draft order sets out that GMC can approve overseas undergraduate, foundation and postgraduate education and training programmes.

Do you agree or disagree that GMC should be able to approve overseas undergraduate, foundation and postgraduate education and training programmes? This does not mean that people who take part in such overseas programmes would be given priority for places on the UK foundation programme or for speciality training in the UK, subject to a few limited exceptions in the Medical Training (Prioritisation) Act 2026. (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Part 5 of the draft order relates to GMC’s education and training functions. This includes provisions relating to:

• standards in connection with practising as a regulated professional
• approval of education and training, an examination or assessment or a qualification
• supply and production of information and evidence
• criminal offences
• certification of completion of a course
• other related powers

Our proposed changes aim to enable GMC to undertake more flexible and swifter education and training functions.

Do you agree or disagree that the powers and duties set out in the draft order enable GMC to carry out its education and training functions sufficiently and proportionately? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Postgraduate Medical Education and Training Order of Council 2010

As a consequence of modernising GMC’s register and legislative framework, many of the current provisions contained within the Postgraduate Medical Education and Training Order of Council 2010 (‘the PMET Order’) will become obsolete.

The draft order therefore proposes that the PMET Order is revoked, including the list of recognised specialties currently contained in the schedule to the PMET Order, and the Privy Council is given a power to specify categories of speciality in practice in the UK in an order of council.

Do you agree or disagree that the PMET Order should be revoked and the categories of speciality in practice should be set out in a new order of council? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Registration

The draft order provides that medical practitioners may be able to be registered despite having a complete restriction on registration. This means they will be registered as a medical practitioner but not allowed to practise. A medical practitioner may choose to have a complete restriction on their registration, or a complete restriction could be, for example, the result of failing to complete periodic assessment.

Do you agree or disagree that doctors should be able to be registered with a complete restriction on registration? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Part 6 of the draft order relates to registration and includes provisions regarding the process of entering the register. It also includes provisions which enable GMC to provide assurance that individuals on its register have the necessary education, training, knowledge, skills and experience required to practise safely in the UK.

Do you agree or disagree that the draft order enables GMC to carry out its functions relating to registration sufficiently? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Protection of title

Protected title status means it is a criminal offence for someone to practise and use a protected title without being registered with the relevant regulator and on the relevant register, or part of the register, relating to that regulated profession.

The draft order proposes that the titles of ‘apothecary’ and ‘licentiate in medicine and surgery’ should no longer be protected in legislation as they are not reflective of current practice. It also proposes that the title of ‘bachelor of medicine’ should no longer be protected as this is linked to a qualification rather than a professional title.

Do you agree or disagree that the titles of ‘apothecary’, ‘licentiate in medicine and surgery’ and ‘bachelor of medicine’ should no longer be protected in legislation? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Under the draft order, ‘registered medical practitioner’ is due to become a protected title.

Do you agree or disagree that ‘registered medical practitioner’ should become a protected title? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

In line with the recommendation of the Leng Review, the draft order proposes that ‘physician assistant’ replaces the title of ‘physician associate’, and ‘physician assistant’ becomes a protected title.

Do you agree or disagree that the title of ‘physician associate’ should be changed to ‘physician assistant’ and protected in law? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

In line with the recommendation of the Leng Review, the draft order proposes that ‘physician assistant in anaesthesia’ replaces the title of ‘anaesthesia associate’, and ‘physician assistant in anaesthesia’ becomes a protected title.

Do you agree or disagree that the title of ‘anaesthesia associate’ should be changed to ‘physician assistant in anaesthesia’ and protected in law? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

To allow time for the healthcare service to implement the new titles effectively, we are proposing that the protection of the ‘physician assistant’ and ‘physician assistant in anaesthesia’ titles will commence following a transition period of 6 months after the order comes into force, if approved by Parliament.

Do you agree or disagree that there should be a transition period in relation to moving from the associate titles to the assistant titles? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Should there be any protection of the ‘physician associate’ and ‘anaesthesia associate’ titles alongside the proposed new titles? (Optional)

• Yes
• No
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Fitness to practise - mandatory removal from the register

The draft order requires GMC to mandatorily remove a registrant from its register, if the registrant has been convicted of a serious criminal offence, as set out in schedule 4 (known as a listed offence), without GMC having to investigate or MTS having to hold a fitness to practise panel hearing to determine whether the registrant’s fitness to practise is impaired.

Do you agree or disagree with the listed offences set out in schedule 4 of the draft order? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Under the draft order, former registrants of GMC who have been mandatorily removed from the register following conviction for a listed offence in schedule 4 of the draft order will not be able to apply for re-entry to the register.

Exceptions would apply where the conviction has been quashed or was for a lower-level listed offence (blackmail or extortion), and the custodial sentence has been quashed and replaced with a non-custodial sentence.

Do you agree or disagree that former registrants who have been mandatorily removed from the register following conviction for a listed offence should not be able to apply for re-entry to the register, save for in the limited exceptional circumstances prescribed in the draft order? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Fitness to practise - grounds for action

Grounds for action set out the basis on which regulators can investigate and take action where there is a concern about a regulated healthcare professional’s fitness to practise. A regulated professional’s fitness to practise can only be found to be impaired if one or more of the grounds for action are met.

The draft order proposes that the fitness to practise of a regulated professional may be impaired if the regulated professional:

• is unable to provide care to a sufficient standard
• has behaved in a way which amounts to misconduct
• is adversely affected by a physical or mental health condition

Do you agree or disagree with the grounds for action set out in the draft order? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Fitness to practise - proceedings

Fitness to practise proceedings are one of the primary ways by which GMC ensures public protection. The fitness to practise model outlined in the draft order aims to make fitness to practise proceedings swifter, fairer and less adversarial for GMC’s registrants and people who raise concerns.

Do you agree or disagree that the fitness to practise powers and duties set out in the draft order for GMC and MTS are sufficient and proportionate for the safe and effective regulation of the professions GMC regulates? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Interim registration measures

Under the draft order, a fitness to practise panel’s powers will be extended so that the panel can impose interim registration measures during registration proceedings, as well as during fitness to practise proceedings.

This would allow the panel to impose an interim registration measure while investigating whether a register entry is fraudulent, for example.

Do you agree or disagree that a fitness to practise panel’s power should be extended so that it can impose an interim registration measure during registration proceedings as well as fitness to practise proceedings? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Evidence gathering

Under the draft order, GMC may, for the purpose of gathering evidence in connection with registration, fitness to practise and interim registration measure proceedings, require a person to supply such information or produce such a document as GMC may specify. GMC will also be able to require a witness to attend a fitness to practise panel hearing or an appeal panel hearing.

Do you agree or disagree that the draft order provides GMC with sufficient and proportionate evidence-gathering powers? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Rule-making powers

Under the draft order, GMC is able to make rules on specific procedures in relation to:

• governance and operating framework
• education and training
• registration
• fitness to practise
• interim registration measures
• revision of decisions and internal appeals

Do you agree or disagree that the rule-making powers in the draft order are sufficient and proportionate for the regulation of the professions GMC regulates? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Revision of decisions

Under the draft order, GMC will be able to revise specific:

• registration decisions (except emergency registration decisions)
• fitness to practise decisions (except fitness to practise panel decisions)
• case examiner interim registration measure review decisions

Do you agree or disagree that the draft order provides GMC with sufficient and proportionate powers and duties in relation to revision of decisions? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Appeals

Under the draft order, applicants for registration, registrants and former registrants of GMC will have rights of appeal against specific registration and fitness to practise decisions.

Do you agree or disagree that the powers in the draft order provide individuals with sufficient and proportionate appeal rights? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Under the draft order, as per a recommendation of the Mann Review, GMC will have a right of appeal against specific interim registration measure decisions and fitness to practise decisions made by a fitness to practise panel to the:

• High Court of Justice in England and Wales
• Court of Session in Scotland
• High Court in Northern Ireland

Do you agree or disagree that GMC should have a right of appeal to these courts against specific interim registration measure and fitness to practise decisions made by a fitness to practise panel? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Under the draft order, a consequential amendment will be made to the National Health Service Reform and Health Care Professions Act 2002 to allow PSA to appeal specific fitness to practise and interim registration measure decisions made by a fitness to practise panel to the:

• High Court of Justice in England and Wales
• Court of Session in Scotland
• High Court in Northern Ireland

Do you agree or disagree that PSA should be able to appeal specific fitness to practise decisions and interim registration measure decisions made by a fitness to practise panel to these courts? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Under the draft order, GMC will be permitted to administer its own internal appeals function. Applicants for registration, registrants and former registrants will be able to appeal specific registration and fitness to practise decisions to an appeal panel of GMC.

Do you agree or disagree that the draft order provides GMC with sufficient and proportionate powers and duties to administer its appeals function? (Optional)

• Agree
• Neither agree nor disagree
• Disagree
• Don’t know

Please explain your answer. Do not include any personal information in your response. (Optional)

Privacy notice

Data controller

The Department of Health and Social Care (DHSC) is the data controller.

What personal data we collect

People responding to this consultation are asked to provide their name and email address (optional) in case they wish to be contacted following their response.

Individuals (that is those who are not responding on behalf of an organisation) are also asked to confirm the geographical area in which they live. They are also asked about their profession or job role, ethnicity, age and sex but with the option not to answer.

Those responding on behalf of an organisation are asked for the name of their organisation, which sector their organisation operates in and where their organisation operates or provides services. 

We ask responders not to put any personal details into their free text responses.

How we use your data (purposes)

The information described above will be collected as part of the online survey response to this consultation.

Data about respondents’ job role, work location, age and sex, and data on organisations that respondents may be responding on behalf of, will be used in the analysis of the consultation to help DHSC understand how people from different groups respond to the consultation’s proposals.

Legal basis for processing personal data

Under the United Kingdom General Data Protection Regulation (UK GDPR), the lawful bases we rely on for processing personal data are:

• article 6(1)(e): necessary for the performance of a task carried out in the public interest or in the exercise of the department’s official authority
• article 9 (g): substantial public interest conditions

Data processors and other recipients of personal data

The consultation is hosted through an online platform owned by SocialOptic, which is a contracted supplier of DHSC. SocialOptic will delete any personal data in line with the retention and disposal periods outlined below, or earlier if instructed to do so by DHSC.

International data transfers and storage locations

Personal data received will be stored in the UK by DHSC.

Storage of data by SocialOptic is provided via secure servers located in the UK.

Retention and disposal policy

Personal data shall be retained for no longer than 12 months following the closure of the consultation in June 2026 to allow time for analysis and publication of the government’s response to this and future consultations, and in case we need to seek clarification on any comments from respondents.

SocialOptic will securely erase the data held on its system one year after the online survey closes, or when instructed to do so by DHSC if the data has served its intended purpose (whichever happens earlier).

How we keep your data secure

Personal data held by DHSC is stored securely on our records management system and shared only between DHSC employees linked to this project.

Your rights as a data subject

By law, data subjects have a number of rights, and this processing does not take away or reduce these rights under the UK GDPR and the UK Data Protection Act 2018 applies.

These rights are:

• the right to get copies of information - individuals have the right to ask for a copy of any information about them that is used
• the right to get information corrected - individuals have the right to ask for any information held about them that they think is inaccurate to be corrected
• the right to limit how the information is used - individuals have the right to ask for any of the information held about them to be restricted, for example, if they think inaccurate information is being used
• the right to object to the information being used - individuals can ask for any information held about them to not be used. However, this is not an absolute right, and continued use of the information may be necessary, with individuals being advised if this is the case
• the right to get information deleted - this is not an absolute right, and continued use of the information may be necessary, with individuals being advised if this is the case

Comments or complaints

Anyone unhappy or wishing to complain about how personal data is used as part of this programme should contact data_protection@dhsc.gov.uk in the first instance or write to:

Data Protection Officer 
1st Floor North 
39 Victoria Street 
London 
SW1H 0EU

Anyone who is still not satisfied can complain to the Information Commissioner’s Office. Their website address is www.ico.org.uk and their postal address is:

Information Commissioner’s Office 
Wycliffe House 
Water Lane 
Wilmslow 
Cheshire 
SK9 5AF

Automated decision-making or profiling

No decision will be made about individuals solely based on automated decision-making (where a decision is taken about them using an electronic system without human involvement) which has a significant impact on them.

Changes to this policy

This privacy notice is kept under regular review. This privacy notice was last updated on 24 March 2026.