May 2006

A communication from the General Medical Council
May 2006, Issue 25

What's New?

Welcome

Welcome to the May edition of the GMC e-bulletin, which marks the second anniversary of this service. In that time the ebulletin has grown from an initial distribution of less than 50 people to currently just under 3,000.

In this month's edition we bring you news of the GMC reference number campaign, aimed to ensure that doctors are protected from identity theft and to provide greater security to patients.

We also publish information from the GMC standards team on the current consultation on guidance to support Good Medical Practice including Good Practice in Prescribing Medicines and the news that the Disability Rights Commission is to produce guidance to illustrate Good Medical Practice .

There is an update on the Education Consultation on Strategic Options for undergraduate medical education, which has now been approved by the GMC Council. We also provide news on the Healthcare Professionals Crossing Borders conference in Brussels and an update from the GMC Scotland office.

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

GP Reference Number Campaign

For almost 150 years, doctors in the UK have been identified by their names and registered addresses. This is no longer either satisfactory or sufficient. An increasing number of doctors are known to their patients and other healthcare workers by names, which differ from those under which they are registered. The publishing of doctors' addresses as a means of identifying them has led to personal security concerns in some sections of the profession. As a result, some doctors have made their registered addresses PO Box numbers, solicitors' offices or banks, which renders them of little value as identifiers. And the system is susceptible to identity theft, a crime which has recently become commonplace.

As a result, the GMC has decided that it will no longer publish registered addresses. Instead, doctors will be expected to make their names and their unique GMC reference numbers readily available to patients, other healthcare workers, healthcare institutions and other authorities as a basis for accurate identification. These details will be easily accessible to all via the GMC's website. The GMC already operates rigorous identity checks before registering doctors. As a result, a doctor's registered name combined with a unique GMC reference number confers a high degree of confidence as to the identity of a particular doctor.

Guidance for doctors on how to use their registered name and number was included in the April edition of GMC today. Further guidance, for employers, is also available on the GMC website.

Presidents of the GMC and Royal College of Physicians and the chairman of the Academy of Royal Colleges display their GMC reference numbers

Pictured left to right: Professor Sir Alan Craft, Chairman of the Academy of Medical Royal Colleges, GMC President Sir Graeme Catto and Professor Dame Carol Black, President of the Royal College of Physicians.

GMC Consults on Guidance to Support Good Medical Practice

Following an extensive review process beginning in June 2004, the new edition of Good Medical Practice (GMP) will be launched in November 2006. GMP is the GMC's core guidance to doctors and all other guidance flows from and expands upon the principles set out in GMP.

One objective in revising GMP was to provide links to further guidance and sources of information to illustrate how doctors can apply these principles in practice. The online version of GMP will therefore be an interactive document with links to the GMC's core ethical guidance (guidance on confidentiality and the recently reviewed Management for Doctors for example), as well as supplementary guidance which the GMC issues from time to time (including recently reviewed Good Practice in Prescribing Medicines, or supplementary guidance on performing intimate examinations). There will also be links to external guidance (issued by the Royal Colleges and government agencies for example), relevant legislation in the four countries and to Fitness to Practise Panel Cases.

Starting next month, the GMC is consulting on drafts of supplementary guidance exploring some of the principles in GMP in more detail. These include:

  • Raising the alarm
  • Maintaining boundaries (to include revised guidance on conducting intimate examinations)
  • Conflicts of interest
  • Reporting convictions

This supplementary guidance will not be introducing new principles but will instead, expand on some of those already explored in the formal consultation, which ended in January 2006. However the guidance will be out to consultation next month and the GMC is interested in hearing your views. Further information on the consultations including how to respond will be available on the GMC's website in June 2006.

Good Practice in Prescribing Medicines

The GMC have recently revised the guidance on prescribing medicines. The key changes and additions include:

  • a specific requirement that doctors should only prescribe drugs to meet patients' identified needs
  • renewed emphasis on objectivity in prescribing and exceptional circumstances in which doctors might prescribe controlled drugs for themselves or those close to them
  • guidance for dispensing doctors, who should not prescribe differently for patients to whom they also dispense for their own financial benefit
  • guidance on 'direction' - doctors should inform patients about their own and their employers' interests in pharmacies and should avoid conflicts of interest, which can impede patient choice.

We have sought to promote communication and partnership, which is essential if patients are to get the most out of their medicines. Guidance about repeat dispensing has also been included along with additional advice on prescribing for overseas patients. Good Practice in Prescribing Medicines is available in our online guidance library.

Disability Rights Commission Guidance to Illustrate 'Good Medical Practice'

As part of the development of supplementary guidance the GMC has been keen to provide examples of accessibility to health services.

The GMC has therefore been working with the Disability Rights Commission (DRC) to decide the best way of doing this and as a result, the DRC has agreed to produce guidance, which would interpret and apply the principles in GMP from a disability rights perspective. The guidance aims to provide practical examples in the form of case studies to illustrate ways in which doctors can work to ensure that disabled service users can access good quality care.

The online version of GMP will link to the full DRC guidance but will also include links to the case studies from the relevant sections of GMP.

The DRC will be consulting on a draft version of this guidance from June-July 2006 and aims to hear from disabled people and service users but also from individual doctors on how useful the examples are. At this stage, the DRC is inviting expressions of interest for focus groups that they hope to run to seek views on the guidance. If you would be interested in taking part, you can get further information by e-mailing heather.hunt@drc-gb.org or by writing to:

Heather Hunt
Practice Development
Disability Rights Commission
2nd Floor, Arndale House
Arndale Centre
Manchester M4 3AQ

For more information on the GMP review, visit the GMC website or contact the Standards and Ethics Team via email.

Strategic Options Consultation Approved by Council

The Education Committee conducted a facilitative consultation on the strategic options of undergraduate medical education in 2005. It looked at possible changes to undergraduate medical education including whether or not we should have a national licensing examination at the end of medical school, whether or not we should introduce a student register and what themes or principles should be embedded into Tomorrow's Doctors.

The GMC received over 150 written responses, and over 150 people attended regional seminars in addition to the GMC meeting with more than 30 key stakeholders. In order to ensure that the responses were considered objectively, we asked two external researchers to produce a qualitative analysis of the written responses. We also identified themes and common positions from the seminars and meetings. The responses were categorised into broad groups to reflect the divergent voices and opinions that came out of the consultation.

The final report on the strategic options consultation was approved by the Education Committee and Council.

Healthcare Professionals Crossing Borders

In late May and early June a wide number of medical and healthcare regulators will meet in Brussels to begin implementing approaches to better fitness to practise and registration information sharing across national boundaries in Europe.

As more doctors move from one European country to another it becomes an imperative of patient safety that we know about their background and practice history.

The initiative, known as Crossing Borders, began in 2005 as a Department of Health project during the UK Presidency of the EU, when the scope and approach was agreed. Since the end of last year the GMC has been coordinating and leading the implementation and has organised the forthcoming meetings in Brussels. These will focus on proactive information sharing between regulators, and implementing a new European Certificate of Current Professional Status.

For more information please email reform@gmc-uk.org.

GMC Scotland Update

The issue of regulation is high on the political agenda in Scotland with the Scottish Parliament debating possible reform to the regulation of lawyers. As part of the wider discussion around the issues, Shepherd and Wedderburn hosted a seminar in May entitled Accountability and Transparency: Challenges in Professional Discipline and Regulation . The GMC and regulators from across the professions attended, with keynote speeches from Professor Alice Brown, the Scottish Public Services Ombudsman, and Philip Yelland, Director of the Law Society of Scotland.

Debate around regulation in the health sector was brisk with other professions keen to look at revalidation type models. More general themes were the implications of moving from a criminal to a civil standard of proof, the perception of the regulator as dispensing retribution and the need for consistent, proportionate sanctions. Current GMC consideration of 'Consensual Disposal' generated much interest, as did discussions around the need for professionals or organisations to feel able to apologise without opening themselves up to the possibility of litigation. Professor Brown highlighted Australian legislation that provides an explicit framework for 'saying sorry' and proposed that this could provide a good model for Scotland.

For further information on the GMC Scotland office visit their website.

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