Anna Rowland, the GMC’s Assistant Director of Policy, Business Transformation and Safeguarding, talks about new proposals aimed at easing the pressure on vulnerable doctors subject to a GMC investigation.

Reducing the stress our investigations cause doctors, particularly those with health concerns, is something we are committed to addressing. When we open an investigation, the circumstances that have led to it can often involve very significant distress and difficulties, for any patients who may have received poor care or been harmed but also for the doctor who has chosen a caring profession and may have, for a range of reasons, fallen seriously below the standards expected. Working with such cases for a number of years I have personally witnessed that distress.

Since I joined the GMC I have been involved in taking forward a substantial reform programme and, as well as improving protection for patients, this has involved a number of significant changes in relation to how doctors experience the investigation process, to provide more support and to reduce the impact, including commissioning the BMA Doctors for Doctors unit to provide independent confidential support to any doctor undergoing an investigation.

Over the past year, we have reviewed and revised many of the letters we send to doctors under investigation to make them clearer and more sensitive. We have also changed our approach to make greater use of provisional enquiries when we receive a complaint. This has helped to reduce the number of full investigations we carry out.

We’re also developing a training package for staff to increase their awareness of mental health issues, so that they can deal with cases in the best way.


Patients are the forefront of the GMC’s work but being a fair regulator involves providing doctors with the support they need, particularly if the doctor is unwell.  It is important our investigations are carried out effectively and as sensitively as possible

Last summer we commenced a review of our fitness to practise procedures and towards the end of the year, we appointed Professor Louis Appleby to provide independent advice on what changes could be made to reduce the stress and impact they can have on doctors – particularly those with health concerns.

Headshot of Professor Louis Appleby
“We appointed Professor Louis Appleby to provide independent advice on what changes could be made to reduce the stress and impact they can have on doctors”

Professor Appleby is a Professor of Psychiatry at the University of Manchester where he leads a group of more than 30 researchers at the Centre for Mental Health and Safety and a former mental health tsar who has a wealth of experience in his field.

He has been working closely with me, the policy team and our senior case examiner with responsibility for our approach to cases involving doctors with poor health to review every stage of our fitness to practise process.

In addition to working closely with staff at the GMC, Professor Appleby has been engaging with doctors who have been through the fitness to practise process, along with people with a key interest in the area. He has been listening to people’s experiences and views on the process as it stands and their suggestions for how it might be improved. His encouragement for people to share their experiences with him has been valuable when developing the proposals. Together we have drawn up a series of draft proposals with the aim of reducing stress for doctors, particularly those who may be vulnerable.

Representatives from patient groups and medical defence organisations from across the UK were among stakeholders who attended a workshop earlier this month to discuss these proposals. During the event we had helpful feedback about the benefits and challenges the proposals could bring.

The comments have given us plenty of food for thought which I will reflect upon prior to more concrete proposals being presented to the GMC’s Strategy and Policy Board later this year.


We have posted our proposals on our website and Professor Appleby has discussed them in his blog which details what his work with staff at the GMC has involved.

I would like to thank Professor Appleby for his considerable commitment, sharing his valuable expertise and experience to help us to ensure that the changes we make are as effective as possible at reducing the impact on doctors, while we carry out our work to protect the public.

Anna Rowland - headshot 1


Anna Rowland is the GMC’s Assistant Director of Policy, Business Transformation and Safeguarding

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