What to do before you leave for retirement or reduce clinical work?

Retirement or stepping back from general practice marks a significant transition in the professional life of any practitioner. After years spent supporting patients, managing clinical demands, and contributing to local communities, stepping back from practice is both a professional milestone and a personal shift. It is a moment that invites reflection as well as preparation.

For GPs, the path to retirement or taking on different clinical roles involves more than meeting contractual obligations or finalising administrative details. It requires careful consideration of practice succession, financial planning, regulatory responsibilities, and the continuity of patient care. Equally important is acknowledging the dimension of leaving long-standing doctor-patient relationships and the familiar rhythm of work, so as such your personal wellbeing should be a consideration throughout all of this. Below are some considerations to make this process clearer and easier to prepare for.

What to consider 

In the transition period from when you decide to retire or step back to the final working date, there are many areas to consider: 

• Ensuring continuity of care for patients – Including handling data and records. 

• What to do with medical data – Retention and destruction.

• Updating details and who to notify – Update your indemnity and whether to remove name from register of medical practitioners. You need to notify HSE, Medical Council, and your indemnity provider. 

• Financial planning – Tax implications and pension entitlements. 

• Personal wellbeing – It is a personal change that brings exciting opportunities, but the impact is something that should not be underappreciated.

Ensure continuity of care 

It is key to plan well in advance how to manage your patients. Doctors have a regulatory obligation to ensure continuity of care. The Medical Council guide is very clear on this, and the need to be proactive if retiring from clinical practice e.g. consultant stepping back from HSE work, stopping private practice, or a GP handing back their GMS list.

The guidance states… 

IMC Chapter 4, para 40 

40. Cessation of practice and transfer of patient care

40.1 Patient care can be impacted where doctors are no longer able to provide care and where continuity of care arrangements are not in place. You should have plans in place to deal with foreseen and unforeseen cessation of practice. 

40.2 If you are planning to reduce your patient list or cease practice, you should make arrangements for continuity of patient care and facilitate the transfer of your patients to another doctor or service. You should let your patients know before these arrangements take effect. With the patient’s consent, all relevant medical records should be sent to the doctor taking over the care of the patient.61 

Practical steps that doctors should take: 

• Inform patients well in advance of planned retirement. This is especially important if the patient has any ongoing care needs, a chronic illness, or active treatment plans. 

• Use multiple methods to inform patients and seek explicit consent for transfer of care and medical records. This could include emails, posters in surgery, letters (mail shot to all patients or attached to repeat prescriptions or invoices, etc), a message on answer phone advising of upcoming retirement, and so on. Different patient cohorts have different communications needs and requirements so it’s important to capture all of these.

Ensure all opportunistic opportunities are taken by staff to notify patients, such as when calling to make appointment or get results. 

If you’ve had no response regarding consent to transfer details within a defined period of time, consider a call to the relevant patients as follow up to notify them of your retirement, explain the handover of care and seek their explicit consent for transfer of their medical records.

• Ensure communication is clear about your retirement date, the deadline for patients to respond about the transfer of their care and the transfer of their medical records, as well as the consequence of not replying to you (no transfer of their care to another doctor and retention of their medical records). You should also share with them who they can contact and how they can establish contact after your retirement to make these arrangements.

• GMS patients – the HSE will communicate with GMS patients and make these transfer arrangements to facilitate the transfer of the GMS list to another GP Transfer of patients' records should be arranged as soon as possible once the new GP is confirmed. 

• For private patients, consider which colleagues are appropriate to hand over the care of patients to. You must discuss this transfer of care with each patient and obtain their consent before the handover of care is arranged. Ensure that you provide a detail summary of their past medical history. If a patient objects to the transfer of their care to the colleague that you have recommended, you should arrange the transfer to the consultant or GP of patient choice. 

• Notify other HSE and private healthcare providers as well as the radiology and laboratory providers, professional bodies, Medical Council, and other healthcare services which you have a contractual arrangement with or provide services for, such as cervical check.

• Link in with your union such as IMO and IHCA to discuss any contractual and employment issues regarding the handing back or transfer of GMS lists.

• Place a notice on the practice website, in the local newspaper, or local social media groups and notice boards to further communicate the change.

Medical records 

Doctors are considered data controllers if they are GPs and private consultants. In compliance with the Data Protection Acts, “Personal data must be kept in a form which permits identification of data subjects for no longer than is necessary for the purposes for which the personal data are processed.” 

The Data Protection Commission has issued helpful guidance on the principles of data protection, available on the Commission’s website here: www.dataprotection.ie 

The Medical Council’s Guide states… 

39. Retention of Medical Records

 39.1 “The length of time for which you keep patient records should take account of medical professional requirements to retain records (to support continuity of care, transfer of care and potentially for medicolegal purposes) and data protection principles.” 

 39.2 “You must keep medical records for as long as required by law or for as long as they remain clinically relevant.” 

 39.3 “If you have ownership and responsibility for records and receive a request to delete or destroy patient records under data protection principles, you should first consider whether there is a professional and/or medico-legal requirement to retain them. If in doubt about the appropriate time periods and whether deletion of records is appropriate, you should obtain advice from your medical indemnifier, employer or legal adviser.” 

In addition, Medical Protection’s factsheet entitled “Medical Records” also includes some relevant record retention periods: Factsheets (medicalprotection.org).

The retention period for records is dependent on the category and type of the relevant medical record. Once you have identified and categorised the data, this will define the appropriate data retention periods. 

The HSE record retention periods are a useful guide to retention periods (Record Retention Policy) and have been in operation since August 2024.

ICGP have also issued guidance for GPs which states that you should generally keep records for lifetime of patient +8 years. Records should be archived and/or securely stored in accordance with data protection principles, until such time as they can be securely destroyed. 

Healthcare records which have reached their official retention period, should be reviewed under the above criteria to check if they should be destroyed.

If records are to be disposed of, ensure you maintain the confidentiality of the records 

According to the HSE guidance, a register of records destroyed should be maintained as proof that the record no longer exists.

The register should show: 

• name of the file 

• former location of file 

• date of destruction 

• who gave the authority to destroy the records 

For healthcare records, the register of records destroyed should also include: 

• healthcare record number 

• surname 

• first name 

• address 

• date of birth 

All confidential records that haven’t met the criteria for destruction, including handwritten notes, computer generated records, test results, copies of correspondence, etc., should be stored securely and protected against accidental loss, including corruption, damage or destruction at all times. Any laptop or remote devices with access to patient records should be fully secure and encrypted and regular back-up should be ensured.

While most practices hold fully electronic records, it is important to be aware that any paper records must also be dealt with appropriately and in accordance with data protection legislation in respect of storage, disposal and access. Paper records should be locked away in a suitable filing cabinet. 

If you are involved in the ongoing storage of records once retired or you have left the practice, ensure that there is a plan in place to appoint executor (will) or attorney (EPOA) who understands professional and legal obligations of handling patient records. Consider preparing professional archive inventory and instructions for access and timetable for destruction of records when relevant retention periods have expired.

General issues to be aware of when leaving the practice: 

• Retain and transfer records securely of patients still under active care and with explicit patient consent to either your replacement or alternative care provider or doctor of patient choice. 

• Retain other patients’ medical records in accordance with national guidelines and data protection legislation – ensure safe storage. A garage or car boot is not appropriate. You must also have a mechanism for patients to request access to their medical records after retirement.

• Decide where the records will be stored and who will have access. Ensure all digital data remains secure, for example encrypted and access restricted. Seek IT advice from an IT provider if needed.

• For records that can be destroyed, as per national guidelines and regulations, ensure that they are shredded or disposed of in a confidential manner. Keep a log of which records were destroyed as well as when and how.

• If transferring records to another practice and/or another GP, you should agree who is responsible for the transfer, storage, and destruction of records – is it the retiring GP or the new GP. If there is no formal agreement, the new GP may be deemed responsible.

Updating details and professional regulation 

Members must remember to contact Medical Protection membership team to let them know of any changes to working circumstances. This could be a full move to retirement or a change in role, as outlined below: 

• Full retirement – consider removal of name from Medical Council register 

• Retirement from public sector (HSE consultant post or GMS list if GP)

• Reduction in sessions 

• GP sessions or consultant locum work

• GP out of hours work

• Medicolegal work only

• Teaching 

• Charity work 

All of the above, apart from complete retirement and removal from the register (listed as 1), require you to be registered with the Medical Council.

In addition, if you are continuing any form of clinical work, you will need to remain enrolled in a Professional Competency scheme, complete the minimum mandatory amount of CPD and annual audit activity, and pay the annual retention fee. 

Professional Competency Schemes have guidance on relevant and appropriate CPD activities from doctors without clinical practice and audit activity that would be considered reasonable in those circumstances 

If you do remain in clinical practice (options 2-8 in the above list), you must also ensure have appropriate indemnity for any work that is being undertaken.

Who do I need to notify? 

As well and notifying your patients of the upcoming changes, there are several other stakeholders that you must communicate the changes to.

HSE 

Ensure timely notification to the HSE. GPs are required to give the HSE three months written notice of retirement if they hold a GMS contract. Consultants need to consult their contract of employment and adhere to any notice period. Different contracts will have different employments terms and conditions.

If retiring due to ill health, GPs may be able to access emergency support from the ICGP and the HSE in such circumstances.

Indemnity 

Retirement ends your clinical responsibilities but professional liability is ongoing as claims can be notified years after treatment has occurred and doctors have retired. In Ireland it is important to note the statute of limitations, meaning claims can be made up until two years from the date of incident or the date of knowledge. However, minors have until their 18th birthday before the clock starts.

If you are on a claims-made policy, you will require run off cover for claims that are notified when you retired which relate to the care that you provided to patients pre-retirement. You will need to contact your indemnity provider to ensure that you understand the notification obligations and have run off cover in place. 

If you are on an occurrence-based offering, you will need to notify the organisation of a change of working circumstances and any work plans during retirement to ensure you have the appropriate indemnity in place for all non-clinical work or other clinical work to be undertaken.

Contact from solicitors and coroners can still occur when retired. It is important to notify your indemnifier as soon as possible if you receive any such communications and that you do not ignore these even if retired.

Medical Council 

You have two options if you are retiring and stopping practice, if you undertake any clinical work, you must stay registered with the Medical Council.

• Voluntary erasure – removal of name from register. This means that you cannot: 

• Write prescriptions – cannot use your prescriber number or GMS stamp

• Sign passport applications,

• Sign medical certificates

• Undertake any work that requires registration with the Medical Council. 

• If not registered, you cannot become the subject of a complaint investigation with the Medical Council.

• If you remain on the Medical Council register, but then you must remain with a Professional Competency Scheme and complete the necessary CPD and annual audit and pay the relevant fees.

Practice staff 

Notify other GPs and consultants in practice groups and any employees in good time to allow them to make necessary arrangements. Seek legal and financial advice about any partnership or employment, contractual issues for you, the partners, or employees.

Ensure everyone kept up to date with handover arrangements, if relevant.

Financial planning and personal wellbeing 

You should plan in good time for the financial implications of your retirement or stepping back from practice. There could have tax implications, and you also need to consider your pension funds.

Personal wellbeing should not be overlooked either. This marks a significant transition so lean on your support network, be mindful of looking after yourself, and seek support if needed. Your membership at Medical Protection offers you free and confidential counselling 24/7. For information on this, please read: Wellbeing