Home > About us > Who we work with > National Care Standards Commission MoU

Memorandum of Understanding made between the National Care Standards Commission and the General Medical Council

October 2002

Preamble

1. The objective of this Memorandum is to set out the framework that the National Care Standards Commission (NCSC) and the General Medical Council (GMC) have agreed for co-operation and collaboration.

2. Collaboration between the NCSC and the GMC will:

  • Help the independent sector – in particular registered medical practitioners – to provide high quality care.
  • Minimise duplication of demands on the independent sector – and, in particular, on registered medical practitioners – by co-ordinating activities and providing consistent advice.
  • Maximise benefit and efficiency by pooling efforts and resources wherever practicable.

3. This Memorandum does not affect existing statutory functions or amend any other policies or agreements relating to the activities of the NCSC and the GMC.

4. This Memorandum should be read in conjunction with other Memoranda of Understanding including that between the Commission for Health Improvement (CHI) and the GMC and in conjunction with the working arrangements agreed between CHI and the NCSC.

Functions of the NCSC and GMC

5. The GMC sets standards and may investigate the professional performance of individual doctors. The NCSC regulates private and voluntary hospitals and clinics and independent medical agencies alongside other care services.

The National Care Standards Commission

The NCSC is an independent body established by the Care Standards Act 2000, responsible for regulating independent sector care services, including healthcare services, in England. The NCSC is established to:

  • Register Providers of Health and Social Care not in the statutory sector
  • Conduct inspections of independent sector health and social care services against a set of Regulations and National Minimum Standards
  • Investigate complaints and concerns raised about social care and independent healthcare services
  • Take action against those who fail to comply with Regulations
  • Consider the degree to which a regulated service complies with the National Minimum Standards when determining whether or not a service should be registered or have its registration cancelled, or whether to take any action for breach of Regulations
  • Make information about services registered and/or inspected by the NCSC available to the public
  • Provide advice, guidance and support to service providers
  • Report regularly to the Secretary of State for Health on the range and quality of social care and independent healthcare services in England
  • Recommend ways in which the quality of the services provided may be improved.

General Medical Council

The GMC licenses doctors to practise medicine in the United Kingdom. The law gives the GMC four main functions:

  • Keeping up to date registers of qualified doctors.
  • Fostering good medical practice.
  • Promoting high standards of medical education.
  • Dealing firmly and fairly with doctors whose fitness to practise is in doubt.

Scope of this Memorandum

6. This Memorandum relates to the areas of interface between the NCSC and the GMC. It does not place additional responsibilities on either organisation; or imply any transfer of responsibility from one to the other or sharing of statutory responsibilities.

7. Interfaces may arise between the GMC and the NCSC in England:

  • Through on-going exchange of information and co-ordination of activity.
  • If the NCSC wishes to bring specific concerns to the GMC’s attention.
  • If the GMC wishes to bring specific concerns to the NCSC’s attention.

Exchange of information and coordination

8. It is understood by the NCSC and the GMC that statutory and other constraints on the exchange of information will be fully respected, including the requirements of the Data Protection Act and the Human Rights Act.

9. Subject to the statutory and other constraints, the working relationship between the NCSC and the GMC will be characterised by regular on-going contact and open exchange of information, through both formal and informal meetings and at all levels, including senior levels.

10. Each organisation will respect and, as appropriate, take steps to protect the confidential nature of documents and information that the other may provide.

11. The NCSC has legal powers to require information from any person for legitimate purposes.

12. The GMC has the power to demand documents from a third party. This includes documents provided to or prepared by the NCSC in confidence for an unrelated purpose. The GMC may ask NCSC representatives to give evidence in person. Any oral evidence given by NCSC representatives would, other than in exceptional circumstances at the discretion of the relevant GMC Committee, be given in public.

13. Should the NCSC provide documents for use by the GMC, such documents will normally be disclosed to the doctor or doctors concerned, if any, by the GMC.

14. The arrangements will be kept under review by focal points at the NCSC and the GMC, whose details are at Annex A.

15. Examples of how the two organisations will exchange information and co-ordinate their activity include:

  • The NCSC and the GMC will share information about trends, concerns, data, approaches and initiatives, which are relevant to the shared aim of helping the NHS and registered medical practitioners to provide high quality patient care.
  • The GMC will inform the NCSC of any investigations it conducts which raise significant issues about clinical governance, including failures in information, appraisal and review systems and, in appropriate cases, will disclose to the NCSC information about individual medical practitioners.
  • The NCSC will inform the GMC of any issues emerging from its activities, or specific concerns within an independent healthcare providers, which raise significant issues about the fitness to practise of individual registered medical practitioners.
  • Each organisation will notify the other of information they receive about concerns relevant to their responsibilities. This might include anonymous and unsubstantiated reports where the organisation with the information considers that it should notify the other organisation.
  • If asked, each organisation will endeavour to assist the other in securing expert advice and provide information for investigations and initiatives to promote the objectives of the two organisations, as needed and to the extent that it is reasonably able to. Where the NCSC asks the GMC to identify a source of expertise from GMC performance assessors, the GMC will approach the assessor(s) before replying, and will not pass names to the NCSC without the assessor's agreement.
  • The organisations will share details of their procedures for dealing with complaints and guiding principles for initiating an investigation or assessment.
  • The organisations will share details of their registration procedures, including the NCSC’s registration processes and the GMC’s revalidation of medical practitioners.
  • Each organisation will consult the other on internal guidelines or staff handbooks, where they relate to the other organisation’s responsibilities or interests.

Communication Issues

16. The NCSC and the GMC will also collaborate on external communications.

This will include, for example:

  • Sharing and working together on relevant drafts, including sections of reports and guidance, as appropriate, in order to ensure factual accuracy, to benefit from each other’s knowledge and expertise, and to promote consistency of advice.
  • Involving each other, as appropriate, in conferences and other public discussion about clinical governance and good medical practice.
  • Assisting each other’s activities to disseminate information about good practice in clinical governance and in medicine.
  • Involving each other, as appropriate, in working groups, meetings and discussions between organisations on clinical governance, good medical practice and inquiries.
  • Ensuring that potential and actual complainants receive accurate and helpful information on the appropriate avenue for pursuing any concerns.

Referring issues from the NCSC to the GMC

Issues relating to an individual registered medical practitioner

17. An inspection or investigation conducted by the NCSC, or information received by the NCSC, may identify an issue that might raise a question about an individual doctor’s fitness to practise. The information could relate to, but is not restricted to, complaints; deaths, injuries and alleged misconduct resulting in harm; clinical and performance indicators; and patient satisfaction surveys.

18. In such a case, the first course of action for the NCSC staff will be to discuss their concerns with the NCSC’s Director of Private and Voluntary Healthcare and with the management of the healthcare provider(s) concerned with a view to resolving the issue. Where appropriate, the NCSC will refer the doctor to the GMC. The management of the healthcare provider may also refer the doctor to the GMC.

19. NCSC staff will be guided by the following principles when referring a doctor to the GMC:

  • NCSC staff will work within the existing framework of responsibilities.

Employment by the NCSC does not confer any specific responsibilities for

monitoring standards of professional conduct. Members of NCSC staff who are health care professionals should base their actions on their standing responsibilities. For example, Good Medical Practice states that registered medical practitioners must protect patients when they believe that a doctor’s or other colleague’s health, conduct or performance is a threat to patients. In any cases of uncertainty about the professional conduct of a registered medical practitioner, the GMC may be consulted via the focal points listed at Annex A. NCSC staff should also keep the management of the healthcare provider(s) concerned fully informed.

  • NCSC staff will assess whether the public interest is at stake and act accordingly.

NCSC staff will use their judgement, based especially on the standing responsibilities of all health professionals and registered medical practitioners in particular, and discuss with the healthcare provider’s management, to decide:

    1. Whether to inform a GMC focal point of the situation informally and without naming (unless requested) any individual registered medical practitioner.
    2. Whether to refer an individual practitioner or practitioners to the GMC.
    3. Whether other courses of action are also possible or necessary, on a case-by-case basis.

20. In all cases, NCSC staff may seek informal or formal advice from the GMC focal points (listed at Annex A).

Issues relating to information systems and arrangements for appraisal and review that could compromise revalidation assessments.

21. The NCSC’s Standards cover information systems which provide data relevant to individual doctors’ fitness to practise. The NCSC’s work also covers annual appraisal for registered medical practitioners, the granting and review of practising privileges and the regular review by a provider’s Medical Advisory Committee of the work of all doctors with practising privileges. These information, appraisal and review systems will underpin the five-yearly revalidation of registered medical practitioners by the GMC. Where NCSC staff consider that failures in any of these clinical governance systems at any independent sector healthcare provider are so acute as to compromise assessments made by revalidation groups, they will raise this concern specifically and explicitly with the Director of Private and Voluntary Healthcare at the NCSC. He or she will decide whether it is appropriate to contact a focal point at the GMC.

22. The NCSC and the GMC will continue jointly to consider how the NCSC’s activities relate to the quality assurance of processes that are relevant to revalidation.

Referring issues from the GMC to the NCSC

23. In keeping with the character of their working relations, the GMC and the NCSC will discuss matters as openly and as regularly as possible by both formal and informal contact. The GMC may raise issues with the NCSC through these meetings.

24. Under Section 35B(2) of the Medical Act 1983, as amended, the GMC may disclose to any person any information relating to a practitioner’s conduct, professional performance or fitness to practise which the GMC consider to be in the public interest to disclose. The GMC’s policy intent is to disclose such information to the NCSC when the GMC considers that to be in the public interest. The GMC may write formally to the Director of Private and Voluntary Healthcare to disclose information about a fitness to practise investigation and/or to invite the NCSC to consider appropriate action. Any formal approaches to the NCSC will be taken by, or on behalf of, the Director of Fitness to Practise. The person referring the issue to the NCSC will decide, on a case by case basis, whether it is appropriate to identify to the NCSC the doctor being considered by the Fitness to Practise Directorate. The NCSC will assess any information or invitation received against its guiding principles

25. Information passed to the NCSC may result from fitness to practise investigations. These investigations may relate to individual medical practitioners with whom the NCSC has a formal relationship. Also, performance assessments under the GMC fitness to practise procedures may identify dysfunctional units or services.

26. In the event that revalidation groups, or individual members of those groups, consider that the NCSC should be informed of a concern, they will raise this issue specifically and explicitly with a focal point at the GMC. The GMC will decide whether to raise the matter either formally or informally with the NCSC. When informing the NCSC, in all cases this will be to the Director of Private and Voluntary Healthcare or his or her deputy or named representative.

Investigations and inquiries relevant to both bodies’ functions

27. It is possible that an investigation by the GMC into a doctor’s practice could coincide with a NCSC investigation or inspection at the doctor’s place of work. Should such a situation arise, both organisations will be guided by the following principles:

  • The NCSC and the GMC will co-operate closely with each other.
    This will necessitate planning activities so that they are complementary, keeping each other informed of developments, sharing information (within statutory limitations) in order to minimise burdens and enable greater efficiency and effectiveness, and pooling effort wherever possible. Care must be taken at all times not to contaminate a trail of evidence which is the subject of either party’s enquiries.
  • The NCSC and the GMC will clarify boundaries of responsibilities and remits for the two investigations.
    Whilst those conducting investigations will work closely together, the investigations would remain separate and the limitations of each investigation will be clearly defined.

Reconciliation of Disagreement

28. Any disagreements will normally be resolved amicably at the working level. If this is not possible senior managers at both organisations should seek to settle any issue. The Director of Private and Voluntary Healthcare at the NCSC and the Director of Fitness to Practise at the GMC will jointly be responsible for ensuring a mutually satisfactory resolution and will become personally involved only where necessary.

Review of this Memorandum of Understanding

29. This Memorandum will be reviewed annually in April by the focal points listed at Annex A. They will report their review to the Director of Private and Voluntary Healthcare at the NCSC and the Director of Policy at the GMC, who will jointly decide whether and how to report both to the NCSC Commissioners and to the members of the General Medical Council.

Annex A

Contacts

GMC

178 Great Portland Street London W1N 6JE

Finlay Scott - Chief Executive/Registrar
020 7915 3564

GMC Focal Points

Policy

Isabel Nisbet - Director of Policy (for policy developments, roles and relationships with other organisations, responses to reports and consultation documents)
020 7915 3575

Jane O'Brien - Policy Directorate - Head of Consultations Team
020 7915 3567

Fitness to Practise

Paul Philip - Director of Fitness to Practise
020 7915 7421

Neil Marshall - Head of Screening
020 7915 3540

Gerry Leighton - Casework Manager Conduct and Screening
020 7915 3915

Jackie Smith - Performance Assessment Manager
020 7915 3753

NCSC

Caledonia House, 223 Pentonville Road, London N1 9NG
Ron Kerr – Chief Executive
020 7239 0330

NCSC Focal Point

Ros Gray – Director of Private and Voluntary Health Care 020 7239 0330

back to top