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GMC to reduce the stress on doctors by piloting fitness to practise changes

4 August 2016

The General Medical Council (GMC) has launched two pilot schemes to speed up fitness to practise cases and reduce their impact on doctors.

One of the pilots will involve cases where doctors are alleged to have made a one off mistake involving poor clinical care. Instead of opening a full investigation the GMC will first gather a few pieces of key information about the case, such as medical records and incident reports. Only after reviewing this evidence will the GMC decide whether to open a full investigation, refer the matter to the doctor’s Responsible Officer*, or close it with no further action.

If the evidence shows this was indeed a one-off mistake without an ongoing risk to patient safety, that the doctor accepts his or her error, and takes steps to make sure it will not be repeated, the case is likely be closed.

This builds on a similar approach, introduced last year, for other types of cases which has been highly successful.  The initiative is expected to avoid the need for a full investigation in around 230 cases a year, as well as significantly increasing the speed with which these cases are handled. Cases dealt with in this way on average conclude within around three months – half the time for most investigations.

The second pilot takes forward one of the recommendations of Sir Anthony Hooper’s review for the GMC of whistle-blowers in our procedures. It will require designated bodies, such as NHS organisations and independent healthcare providers, to disclose whether the doctor being complained about to the GMC has previously raised any patient safety issues. The person referring the concerns will also have to make a declaration that the complaint is being made in good faith, and that steps have been taken to make sure it is fair and accurate.

This will help the GMC to assess whether a full investigation is necessary, and will help to reduce the risk of doctors who have acted as whistle-blowers subsequently being disadvantaged.

The GMC discussed the referral form with Responsible Officers* before introducing the pilot, and they will also be approached for their feedback.

Niall Dickson, Chief Executive of The General Medical Council, said: ‘A GMC investigation can place great pressure on the doctor involved and these pilots are the latest in a series of proposals to reduce the stress and make the whole process faster while continuing to make sure they are fair and we protect patients.

‘We have acted on information from Sir Anthony Hooper’s review** and this latest initiative means we will seek assurance that complaints are made accurately and in good faith. Sir Anthony found that some doctors are concerned about retaliation from employers who raise concerns about patient safety.’

The GMC is keen to introduce further reforms to its fitness to practice process, but changes to legislation are required.

Mr Dickson added: ‘We believe there should be fewer full GMC investigations, and employers have a crucial part to play in dealing with concerns at a local level. We know our procedures can be too long and onerous for doctors and patients – we are dealing with complaints faster and we are becoming more responsive we are constrained by outdated legislation.

Both pilots are being implemented in the four parts of the UK’s, and will be reviewed after six months.

In addition to the pilots, further work is underway to reduce the impact of GMC procedures on doctors. Professor Louis Appleby, one of the UK’s leading mental health experts and Professor of Psychiatry at the University of Manchester, worked with the GMC to review every stage of its investigation process to identify what further changes could be made to support vulnerable doctors.

The GMC expects to start introducing further changes, as a result of that work, later this year with others being implemented from 2017.


Notes for Editors

*A Responsible Officer (RO) is likely to be the medical director of the organisation that is supporting a doctor with their appraisal and revalidation. The GMC will revalidate a doctor based on a recommendation it receives from a responsible officer.

** Sir Anthony Hooper’s independent whistle-blowers’ review was published in March 2016 and contained a number of recommendations.

The action plan for implementing the recommendations can be found on the GMC’s website.

More information about Prof Louis Appleby’s work with the GMC is also available on the website.