The GMC’s new guidance on raising patient safety concerns: implications for doctors’ fitness to practise

The General Medical Council (GMC) has launched a consultation on updated guidance for doctors, physician associates (PAs), and anaesthesia associates (AAs) regarding their professional duty to raise and act on concerns about patient safety. This marks the first major revision of the guidance since 2012.

Summary of the GMC’s proposed guidance

The consultation, open until 22 January 2026, covers two interlinked documents: Raising and acting on concerns about patient safety and Leadership and management for all doctors.

Key proposals include:

• Explicit duty to speak up: All registrants must raise concerns where patient safety may be at risk, regardless of their role or setting.
• Leadership accountability: Managers and clinical leaders are expected to act promptly and effectively when concerns are raised.
• Anti-victimisation clause: A proposed new paragraph would prohibit retaliation against individuals who raise concerns, reinforcing psychological safety in the workplace.
• Cultural change: The guidance emphasises the need for discrimination-free, inclusive environments where all team members feel respected and empowered to speak up.
• Broader scope of concerns: Even issues not directly linked to immediate patient harm are recognised as potentially impacting safety and must be addressed accordingly.

These updates align with the GMC’s revised Good medical practice framework, which prioritises compassionate leadership, fairness, and a culture of continuous improvement.

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Fitness to practise: risks of failing to raise concerns

Failure to raise or act on patient safety concerns can have serious consequences for a doctor’s registration. The GMC has consistently treated such failures as potential breaches of professional standards, particularly where:

• A doctor knowingly ignores or suppresses safety concerns.
• A registrant in a leadership role fails to act on concerns raised by colleagues.
• There is evidence of victimisation or intimidation of whistleblowers.

In fitness to practise proceedings, such failures may be interpreted as misconduct, lack of insight, or deficient professional performance. Sanctions can range from warnings to suspension or erasure from the medical register, depending on the severity and context.

Moreover, the GMC’s annual training survey has highlighted that many trainees still feel hesitant to raise concerns, often due to fear of reprisal or lack of confidence in the system. The updated guidance aims to address these barriers—but it also raises the stakes for registrants who fail to meet the expected standards.

The case for early legal advice

Given the potential regulatory consequences, doctors facing dilemmas about raising concerns—or those subject to investigation for failing to do so—should seek early, specialist legal advice. This is particularly important where:

• There is uncertainty about whether a concern meets the threshold for reporting.
• The concern involves complex team dynamics or senior colleagues.
• A doctor has been accused of failing to act or of retaliating against a whistleblower.

Kings View Chambers offers expert legal representation in GMC fitness to practise matters. Their barristers specialise in regulatory law and understand the nuances of professional obligations, workplace culture, and evidentiary standards. Early engagement can help doctors navigate investigations, prepare robust responses, and protect their careers.

Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.