GMC launches consultation to strengthen fitness to practise guidance for doctors, PAs and AAs

The General Medical Council (GMC) has launched a major consultation to update two key pieces of guidance that underpin professional standards and fitness to practise across the UK’s healthcare workforce. The review focuses on how doctors, physician associates (PAs), and anaesthesia associates (AAs) should raise concerns about patient safety—and how healthcare leaders must respond.

The guidance under review, Raising and acting on concerns about patient safety and Leadership and management for all doctors, sets out expectations for speaking up and taking action when safety issues arise. These documents are central to the GMC’s regulatory framework and play a critical role in shaping workplace cultures that support safe, honest, and accountable care.

The consultation comes amid growing concern about barriers to reporting. The GMC’s 2025 national training survey found that over 20% of trainee doctors were reluctant to escalate concerns about patient care. In a recent speech, GMC Chief Executive Charlie Massey warned that some maternity services were being undermined by cultures that prioritise concealment over transparency.

Professor Pushpinder Mangat, Medical Director and Director of Education and Standards at the GMC, emphasised the link between professional confidence and regulatory clarity. “Our guidance is there to provide support and confidence, as well as practical help, for people to speak up when necessary,” he said. “But speaking up is no good in isolation. Leaders and managers have a duty to act when concerns are raised with them.”

The review marks the first substantial update to these documents since 2012. It aims to reflect changes across the UK’s healthcare systems, evolving social expectations, and the GMC’s expanded remit to regulate PAs and AAs under the Medical Act. These roles will be subject to the same fitness to practise standards as doctors, reinforcing the importance of shared accountability across multidisciplinary teams.

The consultation opens on 30 October 2025 and will run until 22 January 2026. The GMC is inviting responses from doctors, PAs, AAs, patients, healthcare organisations, and other stakeholders. Updated guidance is expected to be published later in 2026.

Printed and email responses are also accepted for those unable to complete the consultation online. Full details are available via the GMC’s website.

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