Patients are ‘approaching the end of life’ when they are likely to die within the next 12 months. This includes:

- those patients whose death is expected within hours or days;
- those who have advanced, progressive incurable conditions;
- those with general frailty and co-existing conditions that mean they are expected to die within 12 months;
- those at risk of dying from a sudden acute crisis in an existing condition;
- and those with life-threatening acute conditions caused by sudden catastrophic events.

The term ‘approaching the end of life’ can also apply to extremely premature neonates [defined as 'newborn infants (less than one month old)'] whose prospects for survival are known to be very poor, and patients who are diagnosed as being in a persistent vegetative state (PVS) for whom a decision to withdraw treatment and care may lead to their death.

A suitable person is a licensed doctor we have approved as suitable to make a revalidation recommendation about your fitness to practise. They should:

- make sure you are taking part in annual appraisal (through their organisation or through an agreement with another medical appraisal provider)
- make revalidation recommendations for you.

To do this, they will have processes in place to:

- monitor any concerns which might arise about your practice
- keep records of evaluations of your fitness to practise, including annual appraisals and any other investigations or assessments
- make sure you're complying with any conditions imposed by, or undertakings agreed with, the GMC.

Typically they will be:

- responsible for the clinical governance or appraisal processes in your organisation
- the responsible officer of a designated body you work for but do not have a connection to
- the medical director of an organisation or membership body that supports doctors who do your particular type of work.

Suitable persons must follow all revalidation guidance and instructions for responsible officers, except where we specify otherwise.