Maintaining Fitness to Practice

During a recruitment process you will undertake various checks. Once the recruitment process has been completed you will need to keep a continuing check on fitness to practice. In this article Peter McKeown touches upon the various tasks that should be maintained.

Some tasks are quick and simple; some not. Some tasks give “sure-fire” results; some not. Clinicians are not always aware of exactly what they have to do to maintain fitness to practice – we can’t rely on others to “watch our backs”.


A search on the GMC website against a doctor’s GMC number will tell you:

  • If they are registered
  • If they have a Licence to Practice
  • If they are on the GP Register
  • If they have Conditions, Undertakings or Warnings

An adverse entry on the first three items will mean you have to stop the doctor from working. The fourth not necessarily so.

Performers List

I don’t rely on this website. In my experience, it’s not kept up to date, neither with additions nor with removals. It seems to lack basic error-checking. I think the safest way is to email the AT and ask if a doctor is on the list. Store the reply safely. Unfortunately I believe the AT will not inform you of any changes to a doctor’s list membership.


GPRs have three months grace during which they can work/train in primary care without being on the performers list provided they submit a valid application to join the list before the commencement date of their training. What you have to watch out for is a situation where one of your GPRs is not on the register by early November, in which case you will have to stop him/her working until he/she is actually on the register.


Nurses need to maintain NMC registration. Equally important is your own practice insurance. Nurses are employees and there is therefore the question of vicarious liability. You need insurance to cover you should a nurse consultation give rise to a serious complaint and/or litigation.


You need to:

  • Ensure that your insurance does actually cover your risks in connection with clinicians working or training at your practice.
  • Ensure that you are complying with the terms of your insurance policy.
  • Ensure that nurses have job descriptions or other practice policies and procedures that carefully specify what they can and cannot do as your employee. You must also be able to show that these job descriptions etc. are more than just pieces of paper but that the day to day work of the practice and the nurses in particular are actually governed by them.

Careful attention to detail is very important.


The various organisations have different rules. What you need to do is ensure that you receive evidence of cover on a continuing basis and as with insurance, check the fine print.

References including Appraisal

References are a one-off task in recruitment. However, doctors need to undergo revalidation, which includes appraisal. Details can be found on the GMC’s website.


You might find my website useful. If you ask for my fact sheet you will see quite a few helpful hints but one thing above all, I think, belongs in this article:

It seems to me that there is no sure-fire way within the DBS system that guarantees that if you get a clear result on a certificate then you can be certain that there are no convictions. The DBS constantly emphasises the need for care and vigilance in the identification process in order that correct information appears on the certificate. Look at it this way: there is an official system at the DBS for dealing with certificates that show convictions when the applicant has no convictions at all. If they can get it wrong this way, why not the other?

Right to Work in the UK

Usually the passport is all you need. You have to take photocopies of the relevant parts and the front cover. You can get help here.