A new communication from the General Medical Council
September 2004, Issue 5

Welcome

Welcome to our fifth edition of our reforms e-bulletin. In this issue we give you the latest on our reforms which are gathering pace with the new fitness to practise procedures due to start in November, and licensing and revalidation.

In addition, we give you news on a new learning facility in our case study section, which will be of interest to both doctors and clinical governance managers. This is on the website and so can be accessed without having to subscribe to the e-bulletin.

We are also delighted to announce that the e-bulletin is going from strength to strength, having reached over 1,000 subscribers who now receive it on a monthly basis. This has grown from an initial circulation of just 50 for our first edition in May.

Thank you for making it a success and please continue to send us your feedback, questions and ideas for topics you would like to see covered in future editions.

Revalidation – Regulations Consultation

The GMC is in the process of introducing the most radical change to the way the medical profession has been regulated since its inception in 1858. Licensing and revalidation will be an important part of our accountability to patients and the wider public. It will mean that doctors working in the UK will need not only to be registered but will also need a licence to practise medicine.

To retain this licence, they will have to “revalidate” by demonstrating at regular intervals that they remain up-to-date and fit to practise.

During the last year the GMC has been finalising the detailed design of our licensing and revalidation processes as we prepare for its introduction in April 2005.

In the coming weeks we will begin a formal process of consultation on the draft licence to practise and revalidation regulations, seeking the views of a wide range of people and organisations, including doctors, doctors’ representatives and employers, the medical royal colleges, and patients’ representatives.

The draft regulations deal with the rules around granting or refusing a licence, withdrawing and restoring a licence and all aspects of revalidation.

We will also publish draft guidance to accompany the regulations. The purpose of the guidance is to explain the process involved in licensing and revalidation and to demonstrate how the GMC will seek to interpret the regulations. Once the guidance is finalised, following the round of consultations, it will serve as a tool for day-to-day reference by doctors so they will know what is required of them in the circumstances of their own practice.

We propose to produce regular updates, through the e-bulletin, on licensing and revalidation issues that will be of interest to you.

Licensing Fee Structure

With the introduction of licensing due in 2005, the Council plans to create a more equitable fee structure, and has proposed a number of changes to the way fees are charged and collected, including a low-income discount. These changes are currently being consulted on.

Case study learning

We have listened to the requests of both doctors and the clinical governance community for more guidance on what to do in difficult situations. To meet this need for greater knowledge we have published a first tranche of case studies on the website within our ethical guidance section.

These cover a range of topics including video taping consultations, criminal convictions and using patients in clinical trials. We are currently drafting more and these will be posted on the website in due course so remember to check back at regular intervals.

The New Doctor – revisions

Following the September Council meeting the GMC will publishing an updated version of the New Doctor.

The revised version of the document reflects the GMC’s wish to move towards outcomes-based training for PRHOs. Previously, PRHO training was experience-based with PRHOs needing to complete a year in PRHO posts of which three months must be in medicine and three months in surgery.

The change comes after the GMC completed extensive and thorough consultation, both informal and formal, on its proposals for modernising The New Doctor. The consultation document was published on line and the link to the document was sent to over 1300 individuals and organisations. It has benefited from approval by the Plain English Campaign following a review, as well as equality-proofing and quality assurance.

The move towards outcomes-based PRHO training is a fundamental change and cannot be achieved overnight.

The Medical Act will need to be amended through a Section 60 Order and Regulations made under the Act will also need review. The Department of Health supports the need for change. There will be full consultation on the Section 60 Order which will cover registration matters as well enabling reform of the PRHO year. We expect the Section 60 Order to be approved by Parliament in 2005.

Locally, the arrangements for PRHO training will need revision and investment, which the GMC envisages will take three years.

Revised Guidance on Prescribing Medicines

The GMC’s Standards and Ethics Committee regularly reviews our published guidance to ensure that it remains relevant and up to date. Following the last Council meeting the Committee will be publishing the revised Guidance on Prescribing Medicines on the website in October and in GMC News.

Look for further information in the next edition of the e-bulletin.

FTP Seminars

With implementation of the new fitness to practise reforms starting in a month’s time, the GMC is embarking on a series of seminars to tell a range of organisations what they need to know.

In London there are two separate sessions, both on 25 October. One is aimed at a range of healthcare organisations and the other is aimed at patient support organisations. A single session aimed at both groups is being held in Manchester on 15 November. Similar events are being arranged for Scotland, Northern Ireland and Wales.

The sessions will provide attendees with an overview of the reforms and focus on some of the key changes. They will also provide attendees with an opportunity to raise any questions they may have, particularly about the practical implementation of the new rules.

The London and Manchester sessions will be chaired by Dr Joan Trowell, chairman of the GMC’s Fitness to Practise Committee. A number of senior GMC operational staff will also be attending.

Space at the sessions is limited – anyone with a particular interest in attending should e-mail Kirsty Sear.

Fitness to Practise reforms

The law governing the way the GMC handles complaints about doctors will change later this year. The changes are the result of a lengthy review and subsequent consultation. They are designed to improve the way in which the GMC deals with concerns by making our processes simpler and more streamlined than those currently in operation. The rules and guidance that underpin the new procedures have now received approval from the Department of Health and the Council of the GMC and our aim is to introduce these on 1 November 2004.

In summary, the changes will affect the way in which we investigate complaints prior to deciding whether to refer a case for adjudication and the way in which cases will be dealt with at the adjudication stage. Under the new procedures, complaints about doctors will no longer follow separate streams for health, performance and conduct. Instead, we will be looking at the doctor’s fitness to practise in the round.

Greater levels of investigation into complaints at the initial stages of our procedures will take place and the current screening and Preliminary Proceedings Committee stages will be abolished. There will instead be a single investigation stage, at the end of which the decision to refer a case to adjudication will be taken by members of staff, who will be known as Case Examiners. Case Examiners have been appointed by the GMC following a rigorous recruitment process to undertake this role. All decisions will be taken by two Case Examiners, one medical and one lay. Where the Case Examiners do not agree, then the matter will be decided upon by the Investigation Committee (a statutory committee of the GMC).

At the adjudication stage, the Professional Conduct Committee, Committee on Professional Performance and Health Committee will be replaced by a generic Fitness to Practise Panel adjudicating upon the question of whether a doctor’s fitness to practise is impaired and with the power to impose a range of sanctions accordingly.

We are currently updating guidance for Medical Directors and other clinical governance leads and plan to make this available on our website prior to the implementation of the new procedures.

Competition Update

The GMC’s essay competition, aimed at 16-18 year olds and entitled, ‘What will doctors be doing by 2050?' has enjoyed an excellent response with over 110 entries being received. The judges are presently short listing the best entries and we will be announcing the winners towards the end of October.

Events

Our reforms road show is out and about again in October and November with appearances at the following events:

20-21 October, NHS Alliance Conference, Bournemouth

9-10 November IHM Glasgow

12 November, NCAA, London

At both the NHS Alliance and IHM events the GMC will be delivering fringe sessions on our fitness to practise reforms. While our president, Sir Graeme Catto, and Paul Phliip, Director of Fitness to Practise, will also be attending the NCAA conference.

If you are planning to attend any of these events please come and see us on our stand.

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Published by The General Medical Council
Copyright © 2004 All rights reserved.