Regulating doctors, ensuring good medical practice

Memorandum of Understanding between the General Medical Council and the Pathology Delivery Board

Introduction

  1. 1. The Memorandum of Understanding (MoU) covers the interface between the Pathology Delivery Board (PDB) and the General Medical Council (GMC).
  2. 2. This document sets out our approach to sharing information where there are concerns that a member of the Home Secretary's Register of Forensic Pathologists (the "Home Secretary's Register") may pose a risk to public safety or public confidence in the criminal justice system or medical profession. It is a prerequisite of membership of the Home Secretary's Register that a forensic pathologist must be registered with the GMC and licensed to practise.

Roles and responsibilities of each organisation

The Pathology Delivery Board

  1. 3. The Pathology Delivery Board is responsible for maintaining the Home Secretary's Register. This register includes forensic pathologists personally recommended by the Home Secretary and considered to be of sufficient skill and standing to provide credible expert assistance to police forces, coroners and courts in cases involving violent or suspicious death.
  2. 4. The PDB is an oversight body appointed by the Home Office to maintain national standards for forensic pathology. It supervises the arrangements for training of potential members of the Home Secretary's Register. It makes recommendations on which doctors should be admitted to join the Home Secretary's Register. It operates disciplinary procedures under the Disciplinary Rules set by the Home Secretary. The PDB may take any action within the Disciplinary Rules necessary to maintain the integrity of the Home Secretary's Register and the criminal justice system. The PDB Chair may take action outside the Disciplinary Rules including suspension of members and recommending removal to the Home Secretary.

General Medical Council

  1. 5. The GMC is a statutory body responsible under The Medical Act 1983 for regulating the medical profession in the United Kingdom. Its function is to 'protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine'. Registration with the GMC is a prerequisite for any doctor wishing to work in the UK. Amongst its other functions, the GMC deals with complaints against registered doctors that raise doubts about their fitness to practise. The GMC has statutory powers to impose conditions upon, suspend, or remove a doctor's registration.

Purpose of the MoU

  1. 6. The purpose of this MoU is to enhance public and patient safety, and to maintain confidence in the criminal justice system and medical profession.
  2. 7. In order to achieve these objectives, this document sets out the principles for information sharing between the GMC and the PDB. It also outlines both organisations' legal obligations and powers to disclose information where it is in the public interest to do so.
  3. 8. Operational guidance to support implementation of this agreement is provided at Annex A.

Legal duty to disclose information

The GMC

Duty to disclose

  1. 9. The GMC has a legal duty under Section 35B (1) of the Medical Act 1983 to notify the Secretary of State, Scottish Ministers, the Department of Health, Social Services and Public Safety in Northern Ireland and the Welsh Assembly when it commences an investigation into a doctor's fitness to practise.
  2. 10. It is also required to notify the doctor's employers, and anyone with whom they have an arrangement to provide services in, or in relation to, any area of medicine. Where the GMC is aware that a doctor under investigation is contracted to deliver services to the criminal justice system, the relevant employers are notified in line with this legal duty.

Power to disclose

  1. 11. Under Section 35B (2) of the Medical Act 1983, the GMC has the power to disclose any information relevant to a doctor's fitness to practise to any person, where it considers this to be in the public interest. Our publication and disclosure policy states that we will seek to co-operate with all requests from public authorities, where it is reasonable and in the public interest to do so.
  2. 12. The GMC also has a power to require disclosure of any information or documents relevant to a doctor's fitness to practise under Section 35A(1) of the Medical Act 1983 (as amended by the Medical Act amendment Order 2000).

The Pathology Delivery Board

  1. 13. The Pathology Delivery Board is the oversight body appointed by the Home Office to maintain national standards for forensic pathology.
  2. 14. The Home Office routinely shares information relevant to a doctor's fitness to practise. The Notifiable Occupations Scheme set out in the Home Office Circular 6/2006 recognises that the medical profession carries a special trust and responsibility, in which the public interest in disclosure of conviction and other information generally outweighs the normal duty of confidentiality owed to the individual. The Home Office asks the police to notify the GMC where doctors are convicted of any criminal offence, including a caution or warning. Other relevant information may also be shared on a case by case basis.

Sharing of information

Co-operation between the signatory bodies

  1. 15. This agreement sets out the arrangements for information sharing between the GMC and the PDB where there are concerns about a doctor. This exchange will enable both organisations to exercise their powers to investigate complaints and allegations and to take such action as may be appropriate.
  2. 16. The two bodies need to be kept informed throughout the course of an investigation as further information may be of significance in exercising their powers. The officers in charge of the investigation in the two regulatory bodies will be responsible for co-operating in the exchange of information to help the GMC and the PDB to fulfil their statutory functions.
  3. 17. The GMC and the PDB both need sufficiently detailed information to enable them to decide whether it is necessary to make a decision to suspend a forensic pathologist from their registers, or take any other action to protect the public and maintain confidence in the profession.
  4. 18. The operational guidance attached at Annex A sets out the arrangements for information exchange to be rooted in the day-to-day working practice of staff in each of the organisations.

Lawful exchange

  1. 19. The GMC and the PDB are subject to a range of legislative duties in relation to information governance including the Data Protection Act 1998, Human Rights Act 1998, and the Freedom of Information Act 2000. This document sets out the approach to the routine exchange of information between the two organisations within this legal framework.

Resolution of disagreement

  1. 20. Where any issues arise which cannot be resolved at an operational level, the matter will be referred to the policy leads identified at Annex A to ensure a satisfactory resolution.

Review and Governance arrangements

  1. 21. This MoU will have effect for a period of 12 months commencing on the date on which it was signed by the Chief Executive of the GMC and the Chair of the PDB.
  2. 22. Both bodies have identified a MoU manager at Annex B and these will liaise as required to ensure this MoU is kept up to date and to identify any emerging issues in the working relationship between the two bodies.
  3. 23. The MoU managers will also coordinate a formal review of this MoU which will take place no later than 12 months after the date it was signed. The purpose of the review is to consider the operational effectiveness of this agreement in enabling both bodies to fulfil their functions.
  4. 24. The named contacts with responsibility for each area of cooperation identified at Annex B will liaise as required to carry out day-to-day business.  

Niall Dickson
 Chief Executive, General Medical Council

Signed:               Date: 5th November 2012

Alan Pratt
 Chair of Pathology Delivery Board

Signed:                Date: 25th October 2012 

Annex A: Operational Guidance for Implementation of the Memorandum of Understanding between the GMC and the PDB

Introduction

  1. 1. The operational guidance is intended to support the implementation of the Memorandum of Understanding (MoU) on information sharing between the GMC and the PDB. The MoU sets out the legal powers and principles for working together.
  2. 2. This document describes the procedures for ensuring that sharing of information is undertaken efficiently and effectively, and the process for resolving any issues that may arise.

Information sharing during an investigation

Information when a complaint is received

  1. 3. The GMC and the PDB agree to routinely share information in relation to any complaint about a forensic pathologist where the allegations are considered to be serious enough to require further investigation.
  2. 4. The GMC will notify the PDB at the earliest reasonable opportunity, where a decision is taken to begin an investigation into a doctor's fitness to practise, if the doctor is known to be:
    • a current member of the Home Secretary's Register;
    • a former member of the Home Secretary's Register;
    • training to become a forensic pathologist to join the Home Secretary's Register or
    • applying to join the Home Secretary's Register
  3. 5. The PDB will notify the GMC at the earliest reasonable opportunity, when a decision is taken to investigate a complaint or concern that calls into question a doctor's suitability for the Home Secretary's Register (whether or not they are currently a member of the Home Secretary's Register.)
  4. 6. Where notification is given that a complaint about a doctor has been received, this should include the following information:
    • a. The nature of the allegation.
    • b. A description, at least in outline, of any supporting evidence.
    • c. The range of possible sanctions which might in due course be imposed.
    • d. Any issue of sensitivity which may impact on disclosure.
  5. 7. Exchange of information at this stage is in strict confidence and should not be disclosed to any third parties except where necessary to discharge the organisation's role in protecting the public, maintaining the integrity of a register or maintaining confidence in the criminal justice system or medical profession.
  6. 8. Information about a new investigation should be provided, in writing, to the Head of Investigation for the GMC and the Secretariat to the PDB. In more serious cases, for example where there is an immediate risk to the public, it may be appropriate to follow up with a telephone call.

Information as case progresses

  1. 9. Both the GMC and the PDB will keep each other updated in relation to any significant developments such as a change in the nature of seriousness of the allegations, or a decision to refer a forensic pathologist to a committee, hearing or tribunal.
  2. 10. Responsibility for providing regular updates is assigned to the named investigation officers dealing with the case on behalf of each organisation. In general, there is agreement to cooperate with any reasonable request for further information where this is considered to be in the public interest.

Information about interim action

  1. 11. Interim action may be taken by the GMC or the PDB pending the outcome of an investigation into a doctor's fitness to practise or suitability for the Home Secretary's Register.
  2. 12. The GMC has the power to take interim action where it is necessary or desirable in the public interest to protect patients or maintain public confidence in the medical profession. Action may also be taken where it is in the doctor's own interests, for example in health cases.
  3. 13. The PDB has the power to take interim action where it is necessary to protect the criminal justice system or the integrity of the Home Secretary's Register.
  4. 14. Where a doctor is referred to a committee, panel or hearing to consider whether it is necessary to take interim action while the matter is investigated, the two signatory bodies agree to share this information.
  5. 15. If action is taken to restrict a doctor's scope of practice or suspend them from a register pending the outcome of the case this information will be shared at the earliest opportunity, together with the reasons for the decision.
  6. 16. In such circumstances, any interim action taken by either organisation will be placed in the public domain. However, the reasons for the action, and the nature of the allegations, should be treated in strict confidence and not disclosed to enquirers.

Information sharing at the end of an investigation

  1. 17. At the end of an investigation, the GMC and the PDB will notify each other of the outcome and cooperate with any reasonable requests to share information about a doctor's fitness to practise where this is considered to be in the public interest. Relevant information may include witness statements and transcripts of interviews. Information will also be exchanged in cases which are closed with no adverse outcome where this may assist the PDB or the GMC in considering whether it is necessary to continue their own investigation.

Confidentiality

  1. 18. The information exchanged must only be used for the purposes for which it was exchanged and all parties will observe the common law duty of confidentiality. The information must only be viewed by staff/members of the organisation in the exercise of their roles within the organisation related to the purpose for which the information was exchanged.

Freedom of Information

  1. 19. Both signatories to this MoU are subject to the Freedom of Information Act 2000. In many cases information exchanged between signatories will be sensitive in nature and likely to be exempt from disclosure, but there may be more general information shared which would be subject to disclosure under the provisions of the Act. If one of the signatories receives a request to disclose information to a third party and that information has originated from the other signatory, then the request will be discussed first.

Resolution of disagreement

  1. 20. Any disagreements will normally be resolved amicably at working level. If this is not possible, it may be brought to the attention of the managers of the Memorandum of Understanding identified at Annex B who will then be jointly responsible in seeking to settle the issue and ensure a mutually satisfactory resolution.  

Annex B Contacts

The Memorandum of Understanding will be managed on behalf of the two bodies by the following contacts:

Managers for the MoU:

The General Medical Council

Anna Rowland
Assistant Director of Policy, Standards and Fitness to Practise
General Medical Council

Email: arowland@gmc-uk.org

The Pathology Delivery Board

Dean Jones
Senior Forensic Pathology Manager
Pathology Delivery Board

Email: dean.jones2@homeoffice.gsi.gov.uk  

Operational contacts

General Medical Council

Joanna Farrell
Head of Regional Investigation Team
General Medical Council

Email: jfarrell@gmc-uk.org

The Pathology Delivery Board

Dean Jones
Senior Forensic Pathology Manager
Pathology Delivery Board

Email: dean.jones2@homeoffice.gsi.gov.uk