Appendix E Concerns formal processes and support

Tool E1 identify the process

Record the exact heading and sender of the communication. Do not infer that every concern is a disciplinary allegation or that an employer review is the GMC process.

Date received: ______________________________________________

Sender and organisation: ____________________________________

Process named: informal feedback / complaint / patient-safety incident / claim / coroner or procurator fiscal / employer fact-finding / capability / conduct / health / GMC / other

Document or policy governing it: _____________________________

Response deadline and how calculated: ________________________

Immediate restriction or instruction: ________________________

Decision-maker: _____________________________________________

Separate related process: ___________________________________

Advice required from: defence organisation / trade union / employer / legal adviser / regulator / occupational health / other

Tool E2 first response

• Read the complete notice and attachments.
• Preserve relevant records lawfully; do not alter or retrospectively recreate them.
• Record deadlines and acknowledge receipt where appropriate.
• Protect patient care and comply with any lawful interim instruction.
• Contact the adviser appropriate to the process before a substantive response.
• Keep confidential information within authorised channels.
• Separate a factual chronology from interpretation, reflection and advocacy.
• Avoid discussing the case widely or seeking informal statements that could compromise evidence.
• Record health or accessibility support needed to participate fairly.

Immediate actions and owners: ________________________________

Advice obtained on: _________________________________________

Tool E3 chronology

For each event record the date and time, source, factual event, people or roles involved, document location and any uncertainty. Distinguish what was known then from what became known later.

Event: ______________________________________________________

Contemporaneous source: _____________________________________

What remains uncertain: _____________________________________

Do not use the chronology to compose an unsupported admission or defensive narrative. Provide it to the appropriate adviser and adapt it to the procedure only after understanding the question being asked.

Tool E4 advice and support record

Adviser or support service: __________________________________

Role in this process: ________________________________________

Date and question asked: ____________________________________

Advice or action agreed: ____________________________________

Next contact and deadline: __________________________________

Potential sources of support include a medical defence organisation, trade union or professional association, SAS advocate, trusted senior colleague, occupational health, employee assistance service, practitioner health service and personal general practitioner. Their roles differ. Emotional support should not be asked to replace procedural advice, and procedural representation should not be expected to provide clinical care.

Closing the record

At the end of a process, retain the written outcome, conditions or actions, appeal information and evidence of completed remediation in the appropriate location. Update appraisal and professional records truthfully without reproducing unnecessary confidential detail. If an outcome corrects an earlier allegation, ensure the accurate status is available to those who legitimately need it. Seek advice about any continuing disclosure obligation rather than assuming either permanent disclosure or complete erasure.

Parallel process check

A single event may produce several processes with different questions. Record each separately.

Process one, owner and deadline: ______________________________

Process two, owner and deadline: ______________________________

Information legitimately shared between them: _______________

Information requiring advice before disclosure: _____________

Possible effect of one timetable on another: _________________

Do not assume that an employer finding determines a regulatory outcome, or that closure by one body requires another to close. Equally, do not send inconsistent factual accounts. A common verified chronology can support advice, but each response must address the legal or procedural question actually being asked.

Reflection and remediation record

Concern or learning need, stated accurately: _________________

Immediate safety action: ____________________________________

Learning activity or supervision: ____________________________

Change in practice or system: ________________________________

Evidence that change was applied: ____________________________

Review of sustainability: ___________________________________

Reflection should demonstrate understanding, not perform an emotion demanded by an audience. Obtain advice where wording may affect an active legal, employment or regulatory process. Remediation is stronger when relevant change is evidenced and reviewed; completion of a course alone may show attendance without showing safer practice.

Recovery plan

Formal correspondence can affect sleep, concentration, health and confidence long after the procedural step has ended. Record practical protection.

Clinical duties or adjustments reviewed with: ________________

Confidential health support: _________________________________

Named personal support: _____________________________________

Review date for any restriction or adjustment: ______________

Plan for return to ordinary work: ____________________________

An unresolved reputation concern should be addressed through accurate records and appropriate communication, not repeated informal explanation. Support should continue when the outcome arrives; resolution of the file does not necessarily resolve its effect on the doctor.

Deadline and disclosure control

Deadline: ___________________________________________________

Source and date calculation: _________________________________

Person who confirmed it: ____________________________________

Extension requested or agreed: _______________________________

Submission confirmation: ____________________________________

Possible appeal or review deadline: __________________________

Some time limits have legal or contractual consequences and may run while a conversation continues. Do not assume that a grievance, discussion, sickness absence or request for documents pauses another clock. Obtain process-specific advice promptly, including from a representative or lawyer where appropriate.

When asked to disclose a concern or outcome, record the precise question, the recipient, the governing requirement and the advice obtained. Answer truthfully and proportionately. Do not conceal a required matter, but do not expand the answer into unrelated confidential history. If wording such as “investigation”, “finding”, “warning” or “restriction” is used, ensure it accurately describes the status on the relevant date.

Question asked: _____________________________________________

Accurate status: ____________________________________________

Requirement and advice: _____________________________________

Information supplied and date: _______________________________