Public consultation on guidance: Leadership and management and Raising and acting on concerns about patient safety

Consultation runs: 30 October 2025 – 22 January 2026 (23:59 pm)

About this consultation

We are updating our guidance on Leadership and management and Raising and acting on concerns about patient safety and we want to hear your views. We originally published both pieces of guidance in 2012. While they have undergone technical updates since then, including in December 2024 to reflect the fact that we began regulating physician associates (PAs) and anaesthesia associates (AAs), we are now carrying out an in-depth review to ensure that they reflect developments across the UK’s healthcare systems and wider social changes. We want to make sure they remain clear, relevant and helpful.

We're reviewing both pieces of guidance together because they're connected and share several key issues we want to explore. Leaders and managers play a vital role in shaping workplace cultures where staff feel safe and confident to speak up about patient safety concerns without fear of negative consequences and with the assurance that doing so will lead to meaningful improvements.

This guidance review builds on the key principles in the recently updated version of Good medical practice, our core guidance on professional standards. This focuses on behaviours and values that foster fair, inclusive, and compassionate cultures where everyone feels empowered to speak up, share ideas, and ask questions.

Both pieces of guidance are for doctors, PAs and AAs registered with us. They apply to the extent that they are relevant to the practice of each of these distinct professions. The guidance is for doctors, PAs and AAs of all role types and sectors, whether or not they routinely see patients or work within or outside the NHS.

Why we want to hear from you

It’s vital that our guidance reflects real experiences from patients, doctors, PAs, AAs and the wide range of individuals who provide healthcare. Our aim is for both pieces of guidance to help all our registrants – doctors, PAs and AAs – as they strive to place patient safety and high-quality care at the forefront of health services. 

The issues raised in this consultation may apply differently across the healthcare systems and legislation of England, Northern Ireland, Scotland, and Wales. That’s why we’re encouraging individuals and organisations from all four countries of the UK to take part.

Your feedback will shape the updated guidance and help to make sure it reflects the needs and experiences of everyone it affects.

The consultation is open for 12 weeks, from 30 October 2025 to 23:59 pm on 22 January 2026, so please share your views with us. 

Consultation questions  

We want to hear your views on important themes we’ve identified through our research and engagement with a range of individuals and organisations. These themes are also informed by findings from public inquiries and insights from our own data, such as our annual survey of doctors in training and trainers across the UK.  

You’re welcome to answer as many questions as you like. There’s no need to respond to every section, just share your views and experiences where they feel most relevant to you.

In this consultation, we will ask you:

• introductory questions on how easy it is to use the guidance, the titles of the guidance and equality, diversity, and inclusion
• questions on the key themes we identified through our research and engagement. We have made it clear in each question whether we are just asking about the Leadership and management guidance, just the Raising and acting on concerns about patient safety guidance, or if the question relates to both
• operational questions about how the guidance can be implemented across the UK
• for any other comments you’d like to share that aren’t covered elsewhere.  

Practical information about taking part

• To take part, you can submit a response to the consultation on SmartSurvey.
• For flexibility there’s an option to save your progress and continue later.
• Once competed, you can print your full response if you want to.

Alternative formats and options 

• If you’re unable to complete the consultation online and need a reasonable adjustment, email us at professionalstandards@gmc-uk.org. 
• You can send any printed responses to LMRC consultation, Standards and ethics team, General Medical Council, 3 Hardman Street, Manchester, M3 3AW.  
• You can download a version of this consultation document in Welsh on our website. If you need the consultation documents in other languages, easy read, or another format, call us on 0161 923 6602 or email us at publications@gmc-uk.org.  

Points to consider when completing the consultation

Who we are and what we do

We are the independent regulator of doctors, PAs and AAs in the UK. We work with them and others to: 

• set the standards of patient care and professional behaviours doctors, PAs and AAs need to meet 
• make sure doctors, PAs and AAs get the education they need to deliver good, safe patient care 
• check who is eligible to work as a doctor, PA or AA in the UK and work with them and their employers to confirm they’re keeping up to date and meeting the professional standards we set 
• give guidance and advice to help doctors, PAs and AAs understand what’s expected of them 
• investigate where there are concerns that patient safety, or the public’s confidence in doctors, PAs or AAs may be at risk and take action if needed. 

As a multiprofessional regulator, we recognise and regulate doctors, PAs and AAs as three distinct professions. We carefully consider our policies, processes and guidance to make sure we are clear on which are relevant to all three professions and where there are differences. 

Our guidance

Good medical practice is our core guidance on professional standards. This is an ethical framework, which supports doctors, PAs and AAs to deliver safe care to a good standard, in the interests of patients. It isn’t a set of rules. Doctors, PAs and AAs must use their professional judgement to apply the standards to their day-to-day practice.

Good medical practice is supported by a range of more detailed guidance which expands on key principles. This includes Leadership and management and Raising and acting on concerns about patient safety. 

Like all of our professional standards, both pieces of guidance apply to all doctors, PAs and AAs who are registered with us, to the extent that they are relevant to the individual’s practice. The guidance applies regardless of role type or specialty and whether or not an individual routinely sees patients or works within or outside the NHS.

It’s important that we avoid duplication and don’t create unrealistic or extra burdens for doctors, PAs and AAs. So, we will only introduce new sections of guidance if they are: 

• relevant to the practice of individual doctors, PAs and AAs, not an action for employers, educators or government
• actionable and can be evidenced, e.g. through appraisal and revalidation
• necessary to protect patients, maintain standards or to uphold confidence in the professions we regulate. 

We commit to drafting the best guidance possible. This consultation allows us to hear your views so we can shape the updated guidance and make sure it is relevant not just for today’s healthcare but for the future too.

What this consultation is not about

In December 2023, the Anaesthesia Associates and Physician Associates Order (the AAPAO) was laid in Parliament and is now law. This means that we regulate three distinct professions - doctors, PAs and AAs. As a result, this consultation will not ask you about:

• whether PAs and AAs should be regulated by us, as that decision has already been made by the UK Government.
• the professional titles of ‘physician associate’ and ‘anaesthesia associate’. Many of our stakeholders will be aware that in a recent independent review into PA and AA professions, led by Professor Gillian Leng, there have been recommendations to change these titles. While it is uncertain as to exactly when and how the titles will be amended or what the plans of the governments in Wales, Scotland and Northern Ireland are, we will continue to use the PA and AA titles as they are enshrined in the AAPAO order and new legislation will be needed to change them. We’ll keep our position under review over the coming months as we liaise with other affected organisations to consider the changes proposed by Professor Leng.
• how the practice of PAs and AAs differs from that of doctors, or which leadership and management responsibilities are relevant for different professional groups. It isn’t the role of the regulator to decide what tasks individual professionals can safely carry out once they are registered with us, because that depends on their individual skills and competence, which develop over time. We don’t determine job descriptions or scope of practice for PAs and AAs beyond initial qualification competencies just as we don’t determine them for doctors.  

Your responses and equality, diversity and inclusion 

Your responses to this consultation will help us understand how the guidance might impact any doctors, PAs and AAs, patients and members of the public with protected characteristics. We ask for demographic information from individual respondents to help us understand if any groups have raised specific issues about the guidance. We can then consider what steps to take. 

Your personal information

In accordance with the data protection legislation, we make sure that we handle personal data with the utmost care. We have a privacy policy in place to allow data subjects to be aware of how we handle your personal information. If you would like to read our privacy notice, please visit Privacy and cookies - GMC.  

At the end of the consultation process, we may publish a report explaining our findings and conclusions. We won’t include any personally identifiable information in this report but may include anonymised illustrative quotes from consultation responses.