A new communication from the General Medical Council
December 2004, Issue 8

What's New?

Welcome

Welcome to the final edition of our reforms e-bulletin for 2004.

It has been an extremely challenging and rewarding year to date for the medical profession and the GMC is committed to building its relationship with the clinical governance community in developing and implementing our reforms.

In this issue we have the latest information on the 5th Shipman report and the postponement of the Licensing and Revalidation process, which will have a significant effect on clinical governance and we will ensure we keep you abreast of developments.

Also in this issue is a report from the GMC Breakfast seminar, the opening of the new GMC Welsh Office, an update from the Education section and new publications from the Fitness to Practice section and news on the GMC PLAB review.

Please continue to send us your feedback, questions and ideas for topics you would like to see covered in future editions.

Licensing and Revalidation Postponed

The Department of Health has issued a statement confirming their intention to review all the recommendations made by the Shipman Inquiry’s 5th report. This follows agreement by all parties that there should be a considered response to the entire report, rather than implement changes piecemeal.

The government has decided to review the GMC's proposed new system of revalidation in the light of Dame Janet Smith's 5th report on the Shipman case. The review will include the role of NHS appraisal and will cover the GMC's arrangements for examining a doctor's fitness to practise within the revalidation process. This will mean the postponement of the intended launch of revalidation from April 2005.

We have warmly welcomed this review into the findings of the Shipman Inquiry, and in particular on revalidation . The whole purpose of revalidation is to create public confidence that all licensed doctors are up to date and fit to practise , and if there are ways of improving this we would of course want to include them in our plans. The report raises a number of important questions and we welcome this opportunity to consider them in detail.

The review means that the planned implementation date for licensing and revalidation is now on hold until the review completes.

We will be writing to doctors and employers in the New Year to fully explain the situation, and detail what will be happening in the future.

Shipman Report

The Shipman Inquiry 5th Report findings were announced by Dame Janet Smith DBE on the 9th December. The report considered the handling of complaints against general practitioners (GPs), the raising of concerns about GPs, the General Medical Council procedures and its proposal for revalidation of doctors.

We recognise that Dame Janet makes serious criticisms of the way we operated our procedures in the past. We accepted at the outset of the Inquiry that our past fitness to practise procedures were not adequate. New procedures were introduced on 1 November 2004, as part of the biggest reforms of medical regulation in 150 years.

We welcome Dame Janet’s conclusion that the GMC cannot be criticised or held responsible for the fact that Shipman was free to re-enter unsupervised general practice following his conviction for his drugs offence in 1976. As Dame Janet says, the GMC could not have suspected Shipman’s true nature at that time.

The public are now involved in every stage of our processes, from 40% membership of our governing body, the Council, to the public sitting on, and frequently chairing, the panels that judge cases against doctors. We also have a patient and public reference group. We will further strengthen public involvement over the next 12 months.

We are making every effort to make our own procedures accessible, streamlined and transparent, but we have long called for a ‘single portal’ that could be the confidential first port of call for people with concerns. We welcome Dame Janet’s support for this proposal.

Whilst it is too early to make specific comment on all the recommendations, the GMC welcome Dame Janet’s support for our reforms and will continue to study her recommendations in detail. We look forward to working further with the Government, Departments of Health, local NHS bodies and other regulatory organisations to continue to improve patient care.

For further information please log onto the Shipman Inquiry website.

Fitness to Practise

On 1 November 2004, the GMC introduced changes to the way in which it handles complaints about doctors.

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

The new procedures have been developed so that we can respond quickly and efficiently to concerns about doctors. When a patient has concerns about a doctor or a healthcare professional, the processes involved in dealing with such matters can seem quite daunting.

To support the changes, we have developed guidance that outlines the procedures. This guidance is currently available on our website and will be available in a published format early next year. The publications will include:

As well as these 3 publications, we have also developed 6 fact sheets that explain key parts of the reformed procedures, theses include:

  • A guide to the Fitness to Practise procedures
  • Warnings
  • Undertakings
  • Performance assessments
  • Health assessments
  • Investigating concerns

For more information about the reformed FTP procedures or our publications and fact sheets, please contact reform@gmc-uk.org.

Education

Modernising training

The Education Committee and Section are taking a keen interest in the Health Departments’ initiative on Modernising Medical Careers (MMC). The Committee has a statutory responsibility to co-ordinate all stages of medical education.

A top priority is ensuring that MMC’s two-year Foundation Programme is effective in ensuring that new graduates have a grounding in generic skills before going into specialist and GP training. The Education Committee sets the standards and outcomes for the first year (the PRHO year) in The New Doctor. A revised text has been finalised with a Crystal Mark awarded by the Plain English Campaign. A draft Curriculum for the second year has been issued for consultation by MMC and the Academy of Medical Royal Colleges. The Education Committee discussed this draft at a seminar on 9 December 2004.

Roadshows

Meanwhile, the Education Section is supporting a series of roadshows that were set up by the MMC team to explain the Foundation Programme and reforms to specialist and GP training. The roadshows follow a national conference on ‘Selection into Specialty Training’ at which Dr John Jenkins, a member of the Education Committee, described the revision of The New Doctor. Education Section staff have given presentations at roadshows in Leicester, Northampton and Kettering.

PMETB

From September 2005, the Postgraduate Medical Education and Training Board (PMETB) will take over responsibility for specialist and GP training. The GMC and PMETB have together set up a Co-ordination Group to oversee the relationship between the two ‘competent authorities’. At the same time, the Education Section is working closely with PMETB to make sure that the Foundation Programme is a cohesive whole.

Decisions Circular

Following the volume of interest in the GMC fitness to practice decisions we have published our second decisions circular, which you can access via a secure area on our website.

The decisions circular is updated monthly at the start of each month. Due to the Data Protection Act this information is not for public dissemination, so we ask that you do not give out the login details.

Welsh Office

The GMC will be opening its new Welsh office at the end of January 2005. The move continues the GMC’s commitment to build our relationships with the profession and the public in Wales and ensure that we are effectively responding to the challenge of devolution and follows on from the success of the GMC Scottish office and Manchester Office openings.

The GMC has appointed Natalie Drury as the Head of Welsh Affairs, who most recently worked as an advisor to Shadow First Minister and Plaid Cymru Leader, Ieuan Wyn Jones. The office is situated in Cardiff Bay, close to the Welsh Assembly and other health organisations.

GMC considers the PLAB review

The GMC received a report and recommendations from the PLAB Review last month. The PLAB Review Group, chaired by Lord Patel and comprising members of the Professional and Linguistic Assessments Board (PLAB), members of GMC Council and external representatives, began work in December 2003. It made a series of recommendations on the following areas:

  • the standard and scope of the test and testing method
  • the recruitment, training and assessment of examiners and role players
  • the size and composition of the question and station banks
  • possible alternative examinations that could be accepted in place of the PLAB test
  • administrative systems for the test
  • English language testing.

The GMC approved the recommendations with the exception of those relating to the method of testing English language, which will be considered by the Registration Committee at a later date. The PLA Board, which has responsibility for the PLAB test, will begin work with the Part 1 and Part 2 Panels on the implementation of the review recommendations.

Breakfast seminar

The GMC held the first, of what is anticipated will be a series, of panel discussions on topical issues in medical regulation on Wednesday 1 December in London.

This initial discussion was on patient and public involvement and was chaired by Niall Dickson of the Kings Fund, with panel members including Harry Cayton, Director of Patients and the Public at the DoH and Fiona Freedland from Action Against Medical Accidents and the GMC President, Sir Graeme Catto.

In addition, there were around 30 senior representatives from other regulatory bodies, health sector organisations, Royal Colleges, patients' and consumer organisations, SHA’s, PCT’s, politicians and the media.

Supplementing the debate, which lasted for around an hour and a half, was the launch of a booklet of essays on regulation in healthcare, published by the policy think tank the Social Market Foundation. The booklet summarises issues raised in the debate and is being circulated widely to relevant stakeholders nationwide. Authors of the essays include Sir Graeme Catto, Frances Blunden from the Consumer’s Association, Lord Hunt of Kings Heath, from the National Patient Safety Agency, and Janet Paraskeva from the Law Society.

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