Recommendation R9: GP certification of fitness for NHS employment
From The Allitt Inquiry Report, published 11 February 1994.
Recommendation
We recommend that consideration be given to how General Practitioners might, with the candidate's consent, be asked to certify that there is nothing in the medical history of a candidate for employment in the National Health Service which would make them unsuitable for their chosen occupation (para 5.5.19).
Government response
Guidance on occupational health is to be issued shortly which will cover all these recommendations. Together with the English National Board's new guidelines, this guidance will establish better procedures for selection of student nurses for training, the selection of staff to work on children's wards and the follow up of staff who have a history of excessive absence through sickness.
Delivery
DHSC and NHS England state no delivery position (27 February 2026)
Please see response to recommendations 1 and 7. Health and character are also considered as part of NMC revalidation process. ACAS provides guidance for all employers on seeking medical information on employees.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Superseded”. Table row: section 3.2 No. 9, PDF page 17-18.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
The Nursing and Midwifery Order 2001 (as enacted) provided for the Nursing and Midwifery Council to prescribe the requirements to be met as to the evidence of good health and good character in order satisfy the Registrar that an applicant was capable of safe and effective practice as a nurse.
The Nursing and Midwifery Council (Education, Registration ad Registration Appeals) Rules Order of Council 2004 (as enacted) required applicants to make declarations as to their good health and character accompanied (for applicants applying for admission to the register on or within 6 months of completion of a pre-registration programme) by a supporting declaration from their education institution.
Current Nursing and Midwifery Council Guidance requires student nurses and midwifes to tell their education institution about any health conditions when applying to study to be a nurse, midwife or nursing associate, and which affect their ability to practise safely and effectively.
There is no mention of any request for GP certification.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 3.2 No. 9, PDF page 18.
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding