The General Medical Council (GMC) is updating its core ethical guidance to tackle toxic health service cultures threatening patient safety and staff retention.


New duties for doctors to tackle toxic cultures that threaten patient safety and staff retention are among proposals as the General Medical Council (GMC) updates its core ethical guidance.

The regulator launched its 12-week consultation on the content of Good medical practice on Wednesday 27th April. Last updated in 2013, the guidance outlines the professional values, knowledge and behaviours expected of doctors working in the UK.

The updated draft follows months of working with doctors, employers and patient representatives, as well as other stakeholders, and reflects the issues faced in modern-day healthcare workplaces. The consultation also comes amid concerns over NHS staff retention, burnt-out staff and toxic workplace cultures leading to medical failings. It is currently estimated that there are 110,000 unfilled vacancies in England alone.

Included for the first time is a duty for doctors to act, or support others to act, if they become aware of workplace bullying, harassment or discrimination, as well as zero tolerance of sexual harassment.

The draft guidance also responds to calls from doctors for greater clarity on their use of social media to help combat medical misinformation. A new duty makes clear that they must not use digital communications channels to mislead, and they should “make reasonable checks” to avoid doing so.


“There is a lot of evidence of the damage bad workplace cultures can do to patient safety and, ultimately, to the UK’s ability to retain the healthcare professionals it needs.”


For the first time, the guidance, which will also apply to Physician Associates and Anaesthesia Associates when they come under GMC regulation, proposes 12 commitments, including:

  • Make the care of patients my first concern
  • Demonstrate leadership within my role, and work with others to make healthcare environments more supportive, inclusive and fair
  • Provide a good standard of practice and care, and be honest and open when things go wrong
  • Ensure my conduct justifies my patients’ trust in me and the public’s trust in my profession

GMC Chief Executive Charlie Massey said of the proposals that: “Good medical practice is not a set of rules, but it is the bedrock that helps guide ethical practice in a world of increasingly complex medicine. This update is designed to reflect the type of fair, inclusive and compassionate workplaces we all want to see, and that are good for doctors as well as for patients.

“There is a lot of evidence of the damage bad workplace cultures can do to patient safety and, ultimately, to the UK’s ability to retain the healthcare professionals it needs. Toxic cultures can also spread online, undermining public trust in the medical profession.

“It is important our guidance reflects the reality of what doctors face and the cultures many are working in, and that it supports them to be able to do the best for their patients and for their colleagues.

“We want this guidance to be relevant and helpful now and for years ahead, and to achieve that we need to hear from those who will use it. That is what this consultation is all about.”

The GMC’s consultation on the draft updated Good medical practice runs until Wednesday 20 July. People can find out more, including how to get involved, via this link.