Under investigation: support is available

by Rachel McMahon

Be up to date with learning and development and engage with your appraisal to progress through any review you may be the subject of

Location: UK
Published: Wednesday 8 February 2023
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The case of Manjula Arora, a sessional GP who was suspended by the GMC owing to the 'promises' of a laptop, has highlighted we are all at risk of performance investigations.

We are unlucky enough as GPs to face double jeopardy, in that we can be investigated by the GMC, by our performers list host, or by both simultaneously.

Alongside clinical work as a locum GP, and membership of the sessional GPs committee, I hold a role where I sit on performance panels for NHS England and would like to share my advice to mitigate the potential damage caused by performance investigations.

Firstly, prevention is better than cure. There are several ways you can reduce your risk. These include being clinically up to date and keeping a log of your learning. If you faced an allegation of incompetence in a certain area, then having evidence of previous CPD covering this topic is incredibly helpful. Fully engaging with your appraisal is also imperative, as evidence of previous learning from significant events demonstrates you are a reflective practitioner.

Spend time with colleagues. This helps you to know whether you are working in the same way as other GPs and allows you to ask for help or advice. There is a real concern within some investigation panels around professional isolation and the additional risk this brings, which is particularly relevant for locums and those in non-standard roles.

Be clear about what your job role is. Define this using your contract of employment or locum terms and conditions of engagement. Also, ensure you work safely. Excessive workload and inadequate rest will increase your risk of errors.

There are several processes within each regulatory body for concerns to escalate through before they reach the stage of a formal investigation. If you are notified of an investigation, there will be significant concerns and you need to take this seriously.

In this instance, I would advise that you tell someone. This will be an incredibly stressful time and you will need support. Do not be embarrassed or ashamed – this can happen to anyone. Sources of support include friends and family, your defence organisation, your local medical committee and the BMA counselling and peer support services.

In addition, ensure you read and understand the documents sent to you. Answer all questions you are asked before the deadline provided. Add more information only if you are certain it will help your case – check with someone else first as sometimes extra information can raise even more concerns. Also, demonstrate learning and reflection. If you think you made an error, it is better to say this and explain how you will stop this from happening again.

The regulators need to be reassured that patients are safe. The more quickly you can convince them of this, the more quickly the investigation will be concluded. Much like patient complaints, a high-quality initial response will save time in the long run. I very much hope you never need to use this advice.

Locums are particularly vulnerable financially when under investigation as all your recent employers will be contacted, and this can affect your ability to book work even when no conclusion has been reached (and most investigations do not lead to a punitive outcome).

Locums are also more handicapped by conditions which may arise from any investigations as these will often restrict where you can work.


Rachel McMahon is a locum GP based in Teesside. She is a member of the sessional GPs committee alongside her work as the CEO of Cleveland LMC, a GP appraiser, and a performance panel member for NHS England