The quick answer
If you have ever tried to work out who your designated body is, you will know it can be more confusing than it needs to be. In simple terms, your designated body is the organisation responsible for supporting your appraisal and revalidation. It usually has a Responsible Officer (RO), who makes a recommendation to the GMC when your revalidation is due.
| Who? | What do they actually do? |
|---|---|
| Designated body | The organisation responsible for supporting your appraisal and revalidation. |
| Responsible Officer (RO) | The senior doctor who oversees revalidation arrangements and makes a recommendation to the GMC. |
| Appraiser | The doctor who meets you for your appraisal, discusses your practice and completes your appraisal documentation. |
| Suitable Person | A GMC-approved doctor who may make a revalidation recommendation where you do not have a designated body. |
| GMC | Makes the final decision about your revalidation. |
How it all fits together
Think of the normal route as a simple chain:
| Your annual appraisal | Revalidation oversight | Final decision |
|---|---|---|
| You meet an appraiser and review your whole scope of practice | Your designated body’s RO reviews appraisal and information about your work and makes a recommendation | The GMC decides whether you are revalidated |
An important distinction: your appraiser and RO usually are not the same person. Having a privately arranged appraisal does not, by itself, give you a Responsible Officer or a revalidation recommendation.
What is a designated body?
Why does this matter? A designated body is not just somewhere that files your appraisal. It also provides a route for concerns about performance, professionalism or patient safety to be reviewed and, where necessary, escalated. It gives your Responsible Officer a fuller picture of your work when revalidation comes around.
Your designated body is the organisation responsible for your appraisal and revalidation arrangements. If you have a permanent NHS job, this is usually straightforward. If you work through NHS banks, agencies or several employers, it can be much less obvious.
Start with the GMC’s connection tool and the organisations where you work. The organisation where you do most of your work is often a useful first contact, but your prescribed connection is determined by the responsible officer regulations. Neither you nor an organisation can choose to ignore a connection that exists under those rules. Ask medical staffing or the revalidation team to confirm how the rules apply to your employment or contract.
During foundation training, the relevant postgraduate training organisation is normally the designated body rather than the individual trust hosting a placement.
How do I find my designated body?
Use the GMC’s connection tool, then contact the relevant medical staffing, appraisal or revalidation team. You could ask: “Can you confirm whether my employment or contract gives me a prescribed connection to your designated body, and what appraisal arrangements you provide?” If you work through an agency, speak to its revalidation team too.
If you work in several places, keep a record of where you work, how regularly you work there and whether shifts are through a bank or agency. This makes it easier to establish the correct connection. If an organisation disputes your connection, ask which rule it is applying and request its reasons in writing. Seek GMC advice if the organisations disagree, rather than choosing whichever organisation is willing to accept you.
| Your working pattern | Who to contact first | What to ask |
|---|---|---|
| Substantive NHS employee | Your employer’s revalidation team | Does my contract create a prescribed connection, and how is appraisal arranged? |
| NHS bank shifts | The trust bank where you do most shifts | Does my bank contract create a prescribed connection? What appraisal support or funding is provided? |
| Agency locum | Your agency’s revalidation team | Does the agency provide my connection? Can I use my own independent appraiser? |
| Several banks and agencies | The bank, trust or agency where you do most work | Ask which connection rule applies and seek GMC advice if organisations disagree. |
| FY3/FY4 between posts or new IMG | The organisation where you currently work most, if any | If you are between posts, ask your recent employer and check your appraisal and annual-return position with the GMC. |
A practical point: some NHS banks apply minimum-shift or length-of-service policies to the appraisal support or funding they offer. Ask separately whether your contract creates a prescribed connection and what appraisal support is provided; a local funding policy does not itself determine your statutory connection. If you are asked to arrange or fund an external appraisal, clarify the arrangements with the revalidation team. Agencies may use a preferred appraisal provider; ask whether you can use an independent appraiser and whether RO approval is needed.
What does a Responsible Officer do?
Your RO oversees the governance and revalidation process for connected doctors. Typically, they review your appraisal history and other information about your work, including any significant concerns. They do not usually conduct a second face-to-face appraisal just before your revalidation date.
At the end of the cycle, an RO may recommend revalidation, a deferral where more information or time is needed, or non-engagement where the relevant criteria apply. The GMC, not the RO, makes the revalidation decision. A concern reaching an RO does not automatically mean a GMC referral: the appropriate response depends on its seriousness.
What evidence does an RO actually look at? Usually your appraisal history across the revalidation cycle, evidence of learning and quality improvement, patient and colleague feedback where required, and relevant information from the organisations where you work. The overall picture matters more than any one certificate or form.
If you are missing evidence, a deferral can sometimes allow more time to complete it. A deferral is not the same thing as a GMC fitness-to-practise investigation.
What is a Suitable Person?
A Suitable Person is a doctor approved by the GMC to oversee revalidation for someone who does not have a designated body. They can make a revalidation recommendation to the GMC, rather like a Responsible Officer.
This is not simply a senior colleague willing to sign a form. The GMC has detailed approval requirements, including access to your appraisal, governance and fitness-to-practise information. Arrangements can be difficult to secure and may involve a fee, so investigate this well before revalidation is due.
A Suitable Person is not an automatic fallback if an employer declines to be your designated body. The doctor must be GMC-approved for this role and have enough access to your appraisal and governance information to make an informed recommendation. Independent arrangements may involve a substantial fee, so explore this early rather than close to your revalidation deadline.
If your GMC registration has an approved practice setting restriction, check that restriction before exploring a Suitable Person arrangement. In the UK, doctors with this restriction generally need a designated-body connection until it is lifted after revalidation; a Suitable Person is not a general alternative.
What if I work for several employers?
This comes up all the time. Imagine you do regular bank shifts for one NHS trust, some work through an agency and occasional shifts somewhere else. You still normally have one revalidation connection, not three. But your annual appraisal should reflect your entire scope of practice—not just the work at your designated body.
Use the GMC’s connection tool and ask the relevant employers or agencies how the connection rules apply to your work. If an organisation disputes the connection, ask for its reasons in writing and keep the response. If organisations point to each other or you are getting nowhere, ask the GMC for advice. Do not select a different connection simply because another organisation is willing to accept you.
What if I have no designated body?
First, do not panic. Being between jobs or having an unusual portfolio career does not automatically mean you have done anything wrong. You can, however, still have appraisal and revalidation obligations while holding a licence to practise.
The key is to distinguish two separate problems: how to keep up with annual appraisal now, and who will be able to make your revalidation recommendation later.
| If your position is… | A sensible next step |
|---|---|
| No designated body and no Suitable Person | Check whether you need an annual return and arrange an appropriate appraisal; contact the GMC if unsure. |
| Annual appraisal due | Use a suitable appraiser; for doctors required to provide annual returns, an appraiser-completed REV12 may be needed. |
| Revalidation approaching | Speak to the GMC early about your route: a revalidation connection, approved Suitable Person or the GMC’s direct process. |
| Long period away from clinical practice | Review with the GMC whether keeping a licence to practise is appropriate for your circumstances. |
The GMC’s annual return and REV12 process can help document appraisal when you have no RO or Suitable Person. It does not automatically resolve the separate issue of how revalidation will be decided. Additional evidence or assessment may be required through the GMC’s direct route, depending on your circumstances.
It is worth thinking ahead if you expect to stay outside a designated body for years rather than weeks. Completing an annual return and having an appraiser fill in REV12 can help document your appraisal, but neither gives you a Responsible Officer. At revalidation, the GMC may need to assess your evidence directly and may require additional assessments. That is a much bigger issue than simply arranging an appraisal.
What if my appraisal falls due between jobs?
Here is a familiar example — your appraisal is due in November, but you will not start your new NHS job until January.
Do not assume the January job means you can ignore a November appraisal or annual return. Speak to your current or most recent organisation, check whether any GMC annual return or REV12 is needed, and arrange an appraisal where appropriate. Keep the report to show your new Responsible Officer.
The new RO may be able to take your previous appraisal into account, but joining a designated body later does not retrospectively remove an annual return obligation that was already due.
What if I work overseas?
Working overseas for a few months is different from working abroad for several years. If you keep a UK licence, make sure you understand how your work will be included in appraisal and who, if anyone, will oversee your revalidation.
Do not assume that holding GMC registration alone means you have a designated body. If you are based overseas long term, discuss your licence and revalidation arrangements directly with the GMC.
If you have worked abroad for part of your cycle, ask your RO in advance what evidence they need from that work. If most or all of your clinical practice is overseas, do not assume that an occasional UK shift will automatically solve the problem. The question is whether an RO can properly oversee your complete scope of practice and make a supported recommendation.
If you are not currently practising and do not expect to return for a prolonged period, another option is to consider whether you need to keep your licence to practise. That is different from giving up GMC registration and is something to discuss with the GMC before making a decision.
What if your Responsible Officer raises concerns?
It depends on what the concern is. If you are simply behind with appraisals or missing feedback, the first response is often to explain what is needed and agree a plan for putting things right.
Persistent non-engagement, despite advice and opportunities to address it, is different. An RO may need to make a non-engagement recommendation to the GMC.
Concerns about clinical performance, conduct or patient safety are handled differently. The RO may seek more information, work with an employer on a support plan, or consider whether formal investigation or GMC referral is appropriate. A concern being raised does not automatically mean a GMC referral.
Practical tip — if an RO contacts you about missing evidence or a concern, engage early, ask exactly what needs to be addressed, and keep a written record of the agreed plan.
A simple decision guide
| Question | Yes | No |
|---|---|---|
| Is there an organisation where you do most of your work? | Use the GMC connection tool and ask its revalidation team to confirm how the connection rules apply. | Contact any agency or recent employer and seek GMC advice if no clear option exists. |
| Have you established your prescribed connection with the relevant organisation? | Ask how it wants you to arrange your annual appraisal. | Ask for the reason in writing if disputed and contact the GMC if the correct connection remains unclear. |
| No RO or Suitable Person: is your annual return due? | Follow GMC instructions, including REV12 where required. | Maintain evidence and clarify forthcoming deadlines. |
| Is your revalidation date approaching? | Confirm who can make the recommendation now. | Keep annual appraisal and connection status under review. |
My practical checklist
Use the GMC connection tool and ask the relevant organisation to confirm your prescribed connection.
If you work through an agency or several banks, ask their revalidation teams about your arrangements.
If an organisation disputes your connection, ask for reasons in writing and seek GMC advice if needed.
Confirm who is organising and funding your annual appraisal.
If using an external appraiser, check that the relevant RO has agreed where necessary.
If you have no RO or Suitable Person, check whether you owe an annual return and REV12.
Make sure your appraisal covers your whole scope of practice.
Check who will be able to support your revalidation before the deadline.
The bottom line
For most doctors in a permanent job, designated-body arrangements happen quietly in the background. For FY3/FY4 doctors, locums and IMGs, it may take a few conversations to establish the correct connection. Use the GMC’s connection tool, confirm the position with the relevant organisations and keep GMC Online up to date. Appraisal arrangements and revalidation recommendations are separate matters—you need to plan for both.