Scenarios · Workplace conduct

Accused of Bullying a Colleague: How It Can Become a Fitness to Practise Case

A bullying allegation usually starts as a workplace grievance, not a regulatory case. Whether it ever reaches the GMC, NMC or HCPC depends on what your employer finds, whether there is a pattern and how you respond. This guide explains how common bullying is in the NHS, what the standards require, how the employer and regulator processes fit together, what escalates a case, real outcomes from no action to erasure, what to do if you were bullied yourself, and how to respond in a way that protects your registration.

Reviewed October 2026 against the NHS Staff Survey 2025 national results, GMC Good medical practice 2024, the NMC Code and NMC guidance FtP-2a-iv (updated July 2026), the Equality Act 2010 and published court and tribunal decisions

Employer acts first Patterns, not one-offs Real outcomes

Short answer: Most bullying allegations are dealt with by the employer and never reach a regulator. NMC guidance says employers should act first, and that the NMC will usually only get involved after a local investigation, unless there is an immediate risk to the public. Regulators become involved where there is a pattern of behaviour that has not been resolved locally, where a senior professional has abused their position over junior colleagues, or where the conduct is discriminatory, sexual or retaliatory. In those cases outcomes range from warnings to suspension and erasure. A professional who acknowledges the behaviour, stops it and accepts the employer's outcome often avoids regulatory action altogether.

Key takeaways

  • Bullying is usually treated as a pattern. A single difficult conversation is rarely a regulatory matter.
  • The employer's investigation is your best chance to resolve it, so engage with it fully.
  • Regulators see bullying as harder to put right because it suggests an attitudinal problem.
  • Pressuring or punishing the people who complained is treated far more seriously than the original behaviour.
  • If you were bullied yourself, regulators will take that context into account.

How common bullying is in the NHS

The NHS Staff Survey 2025, with 766,285 respondents, asked staff whether they had experienced harassment, bullying or abuse at work in the previous 12 months. 17.01% said they had from other colleagues and 9.11% from managers. Both figures have fallen gradually since 2021. 54.89% said the last incident was reported, up from 48.89% in 2021, which means more complaints are entering formal processes.

NHS staff reporting harassment, bullying or abuse at workNHS staff reporting harassment, bullying or abuse at workFrom other colleagues, 202118.7%From other colleagues, 202517.0%From managers, 202111.5%From managers, 20259.1%Last incident reported, 202148.9%Last incident reported, 202554.9%
Figure 1. Share of NHS staff experiencing harassment, bullying or abuse in the previous 12 months, and share saying the last incident was reported. Source: NHS Staff Survey 2025 national results briefing (March 2026).

The GMC's National Training Survey 2025 found wide differences between specialties: 20% of emergency medicine trainees and 43% of trainers said rudeness or incivility had affected their experience, against 7% and 10% in general practice.

What the standards require

GMC

Kindness, courtesy and respect

Good medical practice 2024 says you must treat colleagues with kindness, courtesy and respect (paragraph 48), help to create a respectful, fair, supportive and compassionate culture by role modelling (paragraph 52), and must not abuse, discriminate against, bully or harass anyone (paragraph 56). Those in leadership roles must act when they become aware of such behaviour.

NMC

Without bullying or harassment

Code standard 20.2 requires you to treat people fairly and without discrimination, bullying or harassment, and 20.3 to be aware of how your behaviour can affect and influence others. NMC guidance defines bullying as unwanted behaviour that is offensive, intimidating, malicious or insulting.

The GMC has also said that bullying, harassment and discriminatory behaviour can have a negative effect on the public's confidence in the profession. Where bullying is related to a protected characteristic such as race, sex or disability, it may also be harassment under section 26 of the Equality Act 2010, which looks at the effect on the person as well as the intention, taking into account their perception, the circumstances and whether it was reasonable for the conduct to have that effect.

Related courseTeamwork and respectful working relationships→

Two processes: your employer and your regulator

NMC guidance FtP-2a-iv, updated in July 2026, sets out the approach clearly. Employers should act first to deal with bullying, unless there is an immediate risk to public safety, and the NMC will usually only get involved after a local investigation. Repeated conduct that is not resolved locally is more likely to need regulatory action.

One complaint, two processesOne complaint, two processes1Complaint raised at workGrievance, Freedom to Speak Up or amanager's concern.2Employer investigates firstNMC: employers should act first unlessthere is an immediate risk to thepublic.3Acknowledged, stopped, warningacceptedOften the end of it. The NMC's ownexample needed no regulatory action.4Pattern, dismissal or abuse ofseniorityReferral to the regulator becomes morelikely.5Regulator investigatesTriage, investigation, then caseexaminers or a panel.6Possible outcomesNo action, warning, conditions,suspension or removal.
Figure 2. How a bullying complaint usually moves between the employer and the regulator, based on NMC guidance FtP-2a-iv.
Closed locally

The NMC's own example

The guidance describes a nursing associate whose behaviour was raised, who acknowledged it, stopped and received a formal warning from the employer. The NMC said there was no need for it to become involved unless there were further incidents.

Escalated

When the regulator acts

A pattern across time or across colleagues, a dismissal, behaviour that continues after a warning, abuse of a senior position, or conduct that is discriminatory or sexual. For sexual harassment the NMC says one reported incident can be enough.

For doctors, the GMC's guidance for employers says many issues can be dealt with adequately by the responsible officer or employer, and that referral is appropriate when it is no longer appropriate to manage the matter locally. How the GMC first assesses a referral is explained in our guide to GMC provisional enquiries.

What makes a bullying case serious

Points that help
  • A single incident, or a short period under clear pressure
  • Early acknowledgement and a genuine apology
  • The behaviour stopped once it was raised
  • Accepting and complying with the employer's outcome
  • Evidence of change, such as coaching or feedback from colleagues
  • Testimonials from colleagues who know about the complaint
Points that escalate
  • A pattern over months or years, or several people affected
  • A senior professional targeting junior or non-clinical staff
  • Remarks linked to race, sex or another protected characteristic
  • Pressuring, warning or retaliating against complainants or witnesses
  • Refusing to accept that the behaviour was a problem
  • Continuing after a warning

Drawn from NMC guidance FtP-2a-iv and the decisions below.

NMC guidance says conduct of this type can be more difficult to address because it suggests an attitudinal problem, and that it would expect comprehensive insight, remorse and strengthened practice from an early stage.

Related courseEquality, diversity and dignity at work→

Real outcomes

Real case · High Court · April 2016

Selim v General Medical Council [2016] EWHC 1865 (Admin)

What happened. A GP put pressure on practice staff during a GMC investigation, including getting a dispenser to sign a testimonial he had written, and gave the practice manager a written warning over her part in the investigation. Dishonesty was also found. He was erased.

The outcome. The High Court dismissed his appeal, describing "the placing of grossly improper pressure on non-medical staff", and noting the tribunal had found "no evidence of any change in this underlying attitudinal problem".

The lesson: how you treat the people involved after a complaint matters as much as the original behaviour. Never contact, pressure or penalise complainants or witnesses.

CaseFacts and outcome
Operating department practitioner, HCPC tribunal, May 2026Repeated profane and derogatory remarks about colleagues over 2020 and 2021. The panel noted "fragile control of her emotions in the workplace" and that she refused to accept the basis of her employer's disciplinary sanction. Suspended.
Head of therapies, HCPC tribunal, February 2025A senior occupational therapist who sought "to use his seniority and power to intimidate colleagues", including pressuring junior staff not to complain, alongside sexualised conduct and a racially motivated remark. With "no evidence of remediation", he was struck off.
Consultant surgeon, GMC, Court of Appeal February 2026Misconduct towards junior colleagues over many years, including sexual and racist remarks and abuse of a senior position. A 12-month suspension with review was upheld. The court said it is "a serious matter in any profession or occupation when a senior person abuses his position of power".

Where the behaviour is sexual, the rules and recent law are different again. Those cases are covered in the next guide in this series, on sexual harassment allegations at work.

Related courseInsight: understanding the impact of your behaviour on others→

If you were bullied yourself

Allegations of bullying sometimes arise in teams where the person accused has also been on the receiving end. NMC guidance includes a commitment that it will always carefully consider evidence of discrimination, victimisation, bullying or harassment, including where the professional referred to it was subjected to that treatment. It gives the example of a ward where a senior nurse had been bullying junior staff, and says it would communicate the cultural issues it uncovered to the trust. If this applies to you, say so in your response with evidence, such as emails, grievances or witness accounts, while still taking responsibility for your own conduct.

How to respond to a bullying allegation

  1. 1

    Do not contact the complainant

    Not to explain, apologise or ask them to withdraw. Any approach can look like pressure.

  2. 2

    Get advice and engage with the employer

    Contact your union or defence organisation and take part fully in the local investigation.

  3. 3

    Listen to how it felt

    The effect on the other person matters, not only your intention. Write down what you could have done differently.

  4. 4

    Show change

    Practical steps such as coaching, communication or leadership training and colleague feedback give a panel evidence, not only words.

  5. 5

    Accept the outcome

    Complying with a local warning or action plan is what kept the NMC out in its own example.

  6. 6

    Reflect in writing

    Our guide to insight explains how to show understanding rather than defensiveness.

If the case does reach your regulator, our guide to responding to allegations explains how to structure your written response.

Related courseCommunication skills under pressure→

Frequently asked questions

Will a bullying allegation be reported to the NMC or GMC?

Not usually at first. Regulators expect employers to investigate first. Referral is more likely where there is a pattern not resolved locally, a dismissal, discriminatory or sexual conduct, or an immediate risk.

What counts as bullying in healthcare?

NMC guidance describes bullying as unwanted behaviour from a person or group that is offensive, intimidating, malicious or insulting. It is usually a pattern rather than a single incident.

Can one argument with a colleague lead to a regulator case?

Rarely. A single incident is usually handled locally. Sexual harassment is the exception, where the NMC says one incident can be enough.

Can a doctor be erased for bullying?

Yes, in serious cases. In Selim v GMC (2016) erasure was upheld where a GP placed improper pressure on staff and showed no change in his attitude, alongside dishonesty.

Does being senior make it worse?

Yes. Abuse of a senior position over junior colleagues is a strong aggravating factor, as the Court of Appeal confirmed in a 2026 GMC case.

Should I apologise to the person who complained?

Not directly while a process is live. Contacting them can be seen as pressure. Express regret through the investigation and take advice on any later apology.

What if the complaint is untrue?

Respond calmly with evidence through the employer's process. Avoid counter-accusations against the complainant unless you have clear evidence, and never retaliate.

What if I was bullied too?

Tell the investigation and provide evidence. The NMC commits to carefully considering evidence that the referred professional was subjected to bullying or harassment.

Is bullying the same as harassment under the Equality Act?

Not always. Harassment under section 26 is unwanted conduct related to a protected characteristic. Bullying not linked to a protected characteristic can still breach professional standards.

How common is bullying by colleagues in the NHS?

In the 2025 NHS Staff Survey, 17.01% of staff said they had experienced harassment, bullying or abuse from colleagues and 9.11% from managers in the previous year.

What evidence of change helps most?

Evidence linked to the behaviour: coaching or communication training, structured colleague feedback, a manager's testimonial and a reflection on the impact on others.

Can I be referred after I have left the job?

Yes. Employers and colleagues can refer concerns after you leave, and regulators consider whether there is a current risk wherever you now work.

Primary sources

10 official documents and judgments
  1. NHS Staff Survey 2025: National results briefing
  2. GMC: National Training Survey 2025 results
  3. GMC: Good medical practice 2024, domain 3
  4. GMC: Our regulatory role in cases concerning public confidence
  5. GMC: Deciding whether to refer a matter to the GMC
  6. NMC: Discrimination, bullying, harassment and victimisation (FtP-2a-iv)
  7. NMC: Taking account of context, commitment 3
  8. Equality Act 2010, section 26
  9. Selim v GMC [2016] EWHC 1865 (Admin)
  10. GMC v Gilbert [2026] EWCA Civ 53