Ethnic minority GPs suffer ‘disproportionate’ GMC referrals more than other specialties

Primary care tends to have disproportionate referrals of ethnic minority doctors ‘more often’ than other types of NHS employers, a GMC report has shown.

The regulator committed to eliminating disproportionate employer fitness to practise referrals of doctors from an ethnic minority, or who qualified outside the UK, and who are more likely to be referred to the regulator, by the end of 2026.

The report showed the proportion of employers with excess referrals in relation to a doctor’s ethnicity or place of qualification has now reduced by 48% – from 5.6% down to 2.9% – since the initial benchmark of 2016-2020.

However, the regulator said that while it expects to be ‘close to achieving the targets’ it is ‘likely that they will not know with certainty’ this year.

The report said: ‘We expect to be close to achieving our targets by the end of 2026. We calculate the KPIs quarterly, using a five-year rolling period for robust analysis due to small volumes.

‘Given the time lag, it’s likely that we will not know with certainty in 2026 if we’ve achieved the target. But we will have a good indication of where we are heading.

‘The proportion of designated bodies (DBs) with disproportionate referrals continued to decrease in 2024. And the gap in referral rates between ethnicity and primary medical qualification (PMQ) groups also reduced.’

It pointed out that primary care tended to have disproportionate referrals more often than other types of employers, including acute and non-acute trusts.

It mentioned research which identified that research identified that Black and Minority Ethnic (BME) and international medical graduate (IMG) doctors can ‘find it difficult’ to join larger well-funded GP practices ‘in more affluent areas’ and ‘often end up opening sole or two-partner small practices in deprived areas’.

It added: ‘GPs in these practices work longer hours and find it difficult to get cover to attend continuing professional training.

‘When something goes wrong, the standards against which such GPs are judged do not take into account the nature of the environments in which they are working, and they are assessed against standards that are more appropriate for better-funded practices with less complex patient needs.’

The GMC said it has developed ‘a strategic approach’ to consider where they can have ‘the best impact’ in addressing the challenges faced in primary care.

The report said: ‘We continue to work with NHS Resolution, supporting their newly released Fair and Proportionate framework for local investigations. We continue to review our data to assess the influence of primary care trends on our updated disproportionality trends.’

The regulator has also set an ambition to eradicate discrimination, disadvantage and unfairness in medical education and training by 2031, but progress against this longer-term aim is ‘slower’, it said.

Medico-legal experts said they were ‘concerned’ to see that the target to end disproportionate referrals of ethnic minority doctors may not be achieved this year.

Chief executive of MDDUS Chris Kenny said: ‘Every doctor has the right to start their career on an equal footing with their peers, regardless of their background.

‘Therefore, while it is encouraging to learn the GMC has made strong progress in meeting its commitment to end the disproportionate referrals of ethnic minority doctors to disciplinary processes, we are concerned to see they may yet not reach their target.

‘It is frustrating to see the regulator report that “it’s likely that we will not know with certainty in 2026 if we’ve achieved the target” although they express hope they will “be close” to achieving it.’

Medical director at Medical Protection Pallavi Bradshaw said that the report shows progress is being made, but ‘key concerns’ remain.

She said: ‘Chief among them is the levels of disproportionate referrals against ethnic minority doctors as well as international medical graduates in primary care, where structural factors continue to be left unaddressed.

‘More needs to be done across the field to further protect ethnic minority doctors and those who qualify outside of the UK from facing unequal outcomes due to discrimination.’

GMC chief executive Charlie Massey said: ‘Our report shows we have a system moving at two speeds. Unmistakable momentum towards eradicating disproportionality in employer referrals, but limited, and in some measures absent, progress against our ambitions in education, which must be addressed.

‘Across education and training, indicators in the report show significant disparities, with only limited signs of improvement in measures for UK-qualified doctors, or medical students, from ethnic minority backgrounds.

‘This is despite signs the gap is narrowing between UK and non-UK graduates, with differentials in specialty exam pass rates decreasing by seven percentage points.’

In 2024, as disparities in fitness to practise referrals based on ethnicity continued to reduce from previous years, the GMC admitted that more needed to be done.