GMC Provisional Enquiries: What Happens Before an Investigation
A provisional enquiry is a short, targeted check the GMC makes when it cannot yet tell whether a concern needs a full investigation. Most end there. This guide explains where provisional enquiries come from, which concerns go down this route, what the GMC asks your responsible officer, how health enquiries work, how long they take, who finds out, whether you should send comments, and what happens when an enquiry closes or becomes an investigation.
Reviewed October 2026 against the GMC (Fitness to Practise) Rules 2004, the GMC guide for doctors (updated January 2025), GMC board papers on provisional enquiries, and the GMC annual statistical report 2025
Short answer: A GMC provisional enquiry is "a limited, initial enquiry at the outset of the process", used when a concern might raise a question about your fitness to practise but the GMC needs one or two key pieces of information before deciding whether to investigate. The power comes from rule 4(4) of the GMC (Fitness to Practise) Rules 2004. The GMC typically asks your responsible officer what happened and what has changed since, and may seek records or a clinical opinion. In 2025 it opened 554 provisional enquiries; 467 were closed and 56 became full investigations. It is not a finding against you, but how you engage with it matters.
Key takeaways
- A provisional enquiry sits between triage and a full investigation. It is a check, not a charge.
- The usual questions to your responsible officer are about the incident, what has happened since, and whether there are any other concerns about you.
- Health concerns usually go through a provisional enquiry first, with your consent to contact your treating doctor and employer.
- The GMC says provisional enquiries take about nine weeks on average, against about nine months for a full investigation.
- Insight and local action already taken are among the main reasons an enquiry closes.
This guide covers the provisional enquiry stage only. The full GMC process, from triage to tribunal, is in our GMC fitness to practise guide.
What a provisional enquiry is
Every concern about a doctor is first considered by the GMC's Registrar. Rule 4(4) of the Fitness to Practise Rules allows the Registrar, before deciding whether to refer a concern for investigation, to carry out whatever investigations are appropriate to decide whether the allegation falls within the legal grounds for impairment, or to consider the doctor's fitness to practise. A provisional enquiry is how the GMC uses that power in a limited, focused way.
A short check on one question
Does this concern, once a few facts are confirmed, need a full investigation? The GMC gathers only the information needed to answer that question.
A formal investigation
There are no case examiners, no Rule 7 letter and no outcome against your registration at this stage. The enquiry either closes or is promoted to a full investigation.
The GMC's own guide for doctors describes the choice at triage plainly. If there is no evidence of impairment, the case closes. If the concern does not raise a fitness to practise question but could matter as part of a wider pattern, it may go to your responsible officer. If there is evidence of possible impairment but it is unclear or incomplete, the GMC may carry out a provisional enquiry. Potentially serious concerns go straight to a full investigation.
Where provisional enquiries fit: the 2025 numbers
Provisional enquiries are a small slice of the GMC's work, but for doctors who receive one, the odds are encouraging.
Bars show stages, not scale. Source: GMC, Concerns about fitness to practise, annual statistical report 2025, tables 1a to 1d.
| Year | Provisional enquiries | Closed | Investigation |
|---|---|---|---|
| 2025 | 554 | 467 | 56 |
| 2024 | 547 | 470 | 63 |
| 2023 | 490 | 419 | 53 |
| 2022 | 476 | 396 | 63 |
| 2021 | 490 | 400 | 82 |
| 2020 | 415 | 335 | 76 |
Source: GMC annual statistical report 2025, table 1c. In 2025, 31 enquiries were still open; the 2024 total includes 14 that closed after that year's report.
Across six years, between about one in ten and one in five completed provisional enquiries became a full investigation. The rest closed. That pattern is the reason the stage exists.
Why the GMC created this stage
Provisional enquiries were introduced because full investigations were being opened into cases that almost always ended with no action. The stage has been widened step by step since.
GMC data showed that over 83% of investigations opened resulted in no action against the doctor.
A pilot began under rule 4(4). A May 2015 board paper reported that 48 of the first 68 completed enquiries (71%) closed, with an average length estimated at 52 to 65 days against a 42-day target.
The GMC board considered guidance extending provisional enquiries to single clinical incidents, with a questionnaire to the doctor's responsible officer.
Professor Louis Appleby's review of how the GMC handles doctors' health recommended extending the approach to health cases.
A health provisional enquiry pilot was launched.
Health provisional enquiries became part of the standard process.
Extra decision points were added in some cases on when and how patients or family members are contacted.
554 provisional enquiries were opened, and 467 were closed without a full investigation.
Sources: GMC Strategy and Policy Board papers (May 2015, February 2016); GMC blog by its Head of Provisional Enquiries and Liaison (July 2026); GMC annual statistical report 2025.
Which concerns go to a provisional enquiry
A provisional enquiry is used where a concern looks capable of raising a fitness to practise question, but limited extra information could settle quickly whether it does. It is not used where the concern is plainly serious or where there is a major factual dispute that only a full investigation can resolve.
| Type of concern | How a provisional enquiry is typically used |
|---|---|
| A single clinical incident | To confirm what happened, what local review took place and whether there are any wider concerns about the doctor. |
| A single clinical concern | The same approach, extended beyond one incident to a discrete concern about care. |
| Health | To check whether the doctor is working, is following treatment, and whether local safeguards are in place. |
| An unclear or confused allegation | To find out what is actually being alleged, and whether it raises a fitness to practise question at all. |
| A concern already reviewed locally | To obtain the outcome of the employer's own investigation rather than repeat it. |
The GMC's guidance for decision makers says a provisional enquiry will not be suitable where clinical matters are not easily remediable and a question of impairment may remain. The 2016 board guidance also said a provisional enquiry is unlikely to suit cases with clear fitness to practise concerns or significant factual disputes.
What the GMC asks your responsible officer
For clinical concerns, the main source of information is usually your responsible officer, the senior doctor responsible for your revalidation. The 2016 guidance on single clinical incidents describes a questionnaire sent to the responsible officer. It asks for:
- The nature of the incident: what happened, as the organisation understands it.
- What has happened since: any local investigation, learning, supervision, audit or changes to practice.
- Any other concerns: whether the responsible officer is aware of anything else about your practice.
If the responsible officer cannot answer, the GMC may obtain medical records and an opinion. A medical case examiner can give a view on whether the conduct raises a fitness to practise question, and an external expert may be used where specialist knowledge is needed. The 2016 guidance is clear that such an expert is "not being asked to assess the standard of care" in the way a full investigation would.
This is why your relationship with your responsible officer matters before any concern is raised. A responsible officer who has seen you reflect on an incident at appraisal, and can point to what changed, is giving the GMC exactly the information that closes enquiries.
Related coursePatient safety: learning from incidents and showing what changed→Health provisional enquiries
Where a referral is only about a doctor's health, the GMC's question is whether the condition creates a risk to patients. If it needs more information to decide, it carries out a provisional enquiry. According to the GMC, this can include:
Your work status
Checking whether you are working, or intend to work.
Your treating doctors
With your consent, checking you are seeking and following treatment and advice to manage any patient safety risks.
Your employer
With your consent, including occupational health, checking that local safeguards are in place to protect patients.
The GMC says it tries to complete health provisional enquiries within three months, and will tell you if it cannot. If there is no risk to patients, no full investigation is needed. A doctor who already has treatment, occupational health input and sensible local arrangements in place is in the strongest position. How health concerns are handled at later stages is covered in our guide to health and fitness to practise.
How the GMC decides: close or investigate
The 2016 board guidance on single clinical incidents set out the factors that point each way. They are a useful map of what the GMC is looking for, and they match the three questions in its current decision-making guidance: how serious the concern is, its context, and how the doctor has responded.
- The matter is not so serious that action is needed to uphold public confidence
- It is not part of a wider pattern, including past fitness to practise history
- Repetition is unlikely, because the doctor shows insight and is cooperating
- Any ongoing risk can be managed locally
- The matter is serious, for example reckless disregard for patient safety
- It appears to be part of a wider pattern of concern
- Repetition appears likely, because insight or cooperation is lacking
- There is a clear, ongoing risk that local action cannot address
The guidance for decision makers adds that some clinical concerns which would otherwise meet the threshold may not raise a fitness to practise question where the doctor has shown insight and remediation and there is no ongoing risk. In other words, what you have already done can close the case.
Should you send comments?
Defence organisations advise that doctors usually have an opportunity to comment during a provisional enquiry. Whether and how to use it is a decision to make with your medical defence organisation, because a provisional enquiry is a very different moment from a Rule 7 response.
| Provisional enquiry | Rule 7 response | |
|---|---|---|
| Stage | Before any investigation | After the GMC has investigated |
| Purpose | Help decide whether to investigate at all | Answer the allegation before case examiners decide |
| Who decides next | The GMC, on whether to open an investigation | Two case examiners, one medical and one lay |
| Fixed deadline | Set in the GMC's letter, if any | 28 days from the date of the letter |
| Best content | Short, factual, focused on what has changed | A full, structured response to each allegation |
If you do send comments, keep them proportionate. What helps most at this stage is evidence that answers the GMC's three questions quickly:
- A brief factual account of the incident or concern, without blaming others.
- Reflection showing you understand what went wrong and why it mattered. Our guide to the reflective account explains how to write one.
- What has changed: local learning, audit results, supervision or changes to your practice, with evidence. See our guide to evidence of remediation.
- Recent appraisal outputs showing the concern has been discussed with your appraiser.
Do not send large volumes of unsorted material, and never alter or add to clinical records after a concern has been raised. A careless or defensive reply can suggest a lack of insight, which is one of the factors that points towards a full investigation.
Related courseInsight: understanding what went wrong and showing it in writing→Who finds out
Your responsible officer
Usually, because the GMC's questions in clinical enquiries go to them.
Your employer
The 2016 guidance says the GMC does not have to notify the employer of a provisional enquiry; disclosure is required if an investigation follows.
The person who raised it
They are told the outcome. If the GMC decides not to investigate, it explains why.
The public register
The GMC's guide for doctors lists warnings as published on the register. A provisional enquiry is not an outcome against your registration.
Even when a concern closes, the GMC may let your employer know so it can be considered locally, for example as part of appraisal and revalidation, or because it could form part of a wider pattern.
How long it takes
Sources: GMC blog by its Head of Provisional Enquiries and Liaison (July 2026); GMC, What we'll do when a referral or self-referral is made.
Delays can come from waiting for information: a local investigation report, records, or a responsible officer's answers. The 2016 guidance said the GMC would wait for a local investigation only if its conclusion was expected within two weeks; otherwise the enquiry would carry on. Replying promptly to anything the GMC asks you for is the one part of the timetable you control.
When the enquiry ends
No investigation
You will be told the outcome. Reflect on the concern at your next appraisal, so the learning is recorded. The GMC does not normally investigate matters more than five years old unless it is in the public interest, but a closed concern can be relevant if a similar one is raised later.
A full investigation
The GMC tells you and your employer, gathers evidence, and later sends a Rule 7 letter inviting your response. Our guide to the GMC Rule 7 letter explains how to respond within 28 days.
The person who raised the concern can ask the GMC to review a decision not to investigate. A promoted enquiry is still a long way from a sanction: in 2025, 309 of 679 case examiner decisions after a full investigation were no further action.
Related courseRemediation: building evidence of change before a GMC decision→If you have just heard about a provisional enquiry
- 1
Call your defence organisation
Send them the GMC's letter before you reply to anyone. Ask whether comments are advisable in your case.
- 2
Talk to your responsible officer
Make sure they know the facts and what you have done since, so their answers to the GMC are complete and accurate.
- 3
Gather what already exists
Incident review outcomes, reflection, appraisal records, audit results and any learning matched to the concern.
- 4
Fill genuine gaps
If you have not yet reflected or learned from the concern, start now. Choose learning that matches it, as explained in our guide to choosing a fitness to practise course.
- 5
Look after yourself
The GMC-commissioned Doctor Support Service, run by the BMA, gives confidential emotional support from fellow doctors. NHS Practitioner Health supports doctors in England with their own health. Samaritans is free on 116 123.
How insight is judged at every stage is explained in our guide to insight in fitness to practise.
Frequently asked questions
What is a GMC provisional enquiry?
A limited, initial enquiry the GMC makes at the start of the process to decide whether a concern needs a full investigation. It is carried out under rule 4(4) of the GMC (Fitness to Practise) Rules 2004.
Will I be told about a provisional enquiry?
At triage the GMC does not yet inform the doctor or employer. Once a provisional enquiry is under way, doctors usually hear about it and have a chance to comment, and your responsible officer is often asked questions. If it closes, you are told the outcome.
Is a provisional enquiry the same as an investigation?
No. It is a short check before any investigation. There are no case examiners, no Rule 7 letter and no outcome against your registration. It either closes or is promoted to a full investigation.
How many provisional enquiries are closed?
In 2025 the GMC opened 554 provisional enquiries. 467 were closed without a full investigation, 56 became investigations and 31 were still in progress when the annual report was compiled.
How long does a GMC provisional enquiry take?
The GMC says about nine weeks on average. It aims to complete health provisional enquiries within three months.
Will my employer be told about a provisional enquiry?
Not necessarily. Board guidance says the GMC does not have to notify the employer at this stage, although your responsible officer is usually asked questions. Employers are told if a full investigation opens.
What does the GMC ask my responsible officer?
Typically what happened, what has happened since, such as local investigation or learning, and whether there are any other concerns about you.
Do I have to respond to a provisional enquiry?
You will usually have the chance to comment. Take advice from your medical defence organisation first on whether to comment and what to send.
What should I send if I comment?
A short factual account, reflection, evidence of what has changed, and recent appraisal outputs. Keep it proportionate and never alter clinical records.
Are health concerns handled through provisional enquiries?
Usually, where more information is needed. With your consent, the GMC may contact your treating doctors and your employer, including occupational health, to check that treatment and safeguards are in place.
Does a provisional enquiry appear on the medical register?
It is not an outcome against your registration. The GMC's guide for doctors refers to warnings, not enquiries, as published on the register.
What happens if the provisional enquiry is promoted?
A full investigation opens, the GMC tells you and your employer, and you will later receive a Rule 7 letter giving you 28 days to respond.
Can the person who complained challenge a closure?
They can ask the GMC to review a decision not to investigate, particularly if they have new information.
Primary sources
8 official documents and laws
- GMC (Fitness to Practise) Rules 2004, rule 4 (initial consideration and referral of allegations)
- GMC: Our fitness to practise processes, a guide for doctors (updated January 2025)
- GMC: Concerns about fitness to practise, annual statistical report 2025
- GMC Strategy and Policy Board: Provisional enquiries (rule 4(4)) pilot (May 2015)
- GMC Strategy and Policy Board: Enhanced triage guidance, single clinical incidents (February 2016)
- GMC: What we'll do when a referral or self-referral is made (health)
- GMC blog: The evolution of provisional enquiries (July 2026)
- GMC: New guidance for handling fitness to practise concerns (May 2025)
