June 2006

A communication from the General Medical Council
June 2006, Issue 26

What's New?

Welcome

Welcome to the June edition of the GMC e-bulletin.

In this month's edition we bring you an interview from Finlay Scott, Chief Executive of the GMC, who shares his thoughts on the continued reforms and revalidation.

We also bring you an update from the GMC Wales office, with the announcement of the inaugural hosting of the GMC council meeting in Cardiff in September and the Withholding & withdrawing events to be hosted in Swansea in July.

There is an update on the Education Consultation on Strategic Options for undergraduate medical education, which has now published their report and is seeking feedback, as well as the development of new guidance for student fitness to practice.

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

Keeping up the Pace of Reform

In an interview for the June issue of GMC today Finlay Scott, Chief Executive of the General Medical Council, made clear that, while awaiting the ministers' decisions following Sir Liam Donaldson's review, the GMC are continuing to press ahead with its reform and modernisation programme.

Finlay explained that the GMC want to get started with the work involved in issuing licences to practise. This is a key part of the introduction of revalidation, which the government is likely to be announcing decisions on. The primary legislation for licences to practise and revalidation is already in place, reflecting our joint work with the government since 1998.

By issuing licences to practice, real, practical, progress will be made towards revalidation. As part of the process, we plan to collect data about doctors' scope of practice, elements of which will be published online for the benefit of patients, employers and other doctors.

The GMC will also take the opportunity to collect comprehensive equality-monitoring data, which we are not currently able to do effectively.

A staged roll-out of licensing and revalidation will help to reduce risks and produce a more manageable approach to what is the most complex reform in medical regulation for the last 150 years.

For further information please see the attached GMC today full article, which also outlines the implications of our recent annual tracking survey, as well as the current situation of international medical graduates who wish to practise in the UK.

GMC Consults on Guidance to Support Good Medical Practice

In the May E-Bulletin, we reported on the forthcoming consultation on four new pieces of supplementary guidance, which expand on or explain the principles in Good Medical Practice , the GMC's core guidance for doctors.

The new supplementary guidance that is currently being consulted on and will be published with the new edition of Good Medical Practice in November 2006 is:

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

The consultation commenced on Monday 12 June 2006 and will run until Monday 24 July 2006.

You can take part in the consultation on-line at http://www.e-consultation.net/gmc. If you are unable to access the internet, paper copies are available upon request (email gmpreview@gmc-uk.org or telephone (020) 7189 5404).

If you do not want to respond to this consultation but would like to be alerted when the results of the consultation are available, and when future consultations are taking place, please go to the website to register your interest, or email gmpreview@gmc-uk.org with your name, the email address you would like to be contacted on and, if you are responding on behalf of an organisation, the organisation name.

Further information on the consultation is available on the GMC's website at http://www.gmc-uk.org.

Disability Rights Commission Guidance to Illustrate ' Good Medical Practice'

As reported in the May e-bulletin, as part of the development of supplementary guidance outlined above, an area on which the GMC has been keen to provide examples is 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 is now consulting on a draft version of this guidance and aims to hear from disabled people and service users but also from individual doctors on how useful the examples are. If you would be interested in taking part in this consultation, please contact Heather Hunt at the DRC 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's website at http://www.gmc-uk.org (see 'Guidance on Good Practice') or contact the Standards and Ethics Team (telephone 020 7189 5404 or email gmpreview@gmc-uk.org).

Withholding & Withdrawing Life-prolonging Treatments - Wales

The GMC is entering the final stage of its series of interactive events focusing on palliative care, end of life decision making, and withholding and withdrawing life-prolonging treatment.

Having successfully completed 18 events around the UK the final week has a focus on Wales, with a clinical and patient support workshop hosted in Swansea.

The events are designed to provide a greater understanding and awareness of the GMC guidance within this area, with particular emphasis to how the guidance works in practice, as well as its accessibility. The clinical event on the 11 July is aimed at Primary and Secondary healthcare professionals with an interest in palliative.

care, end-of-life decision-making and withholding and withdrawing life-prolonging treatment. There are a limited number of places left and to register you should email diane.freimanis@Swansea-tr.wales.nhs.uk.

The patient support event on the 12 July is aimed at organisations and individuals who are working in patient support roles, rather than the patients themselves. The events will provide a forum for discussion and understanding that can be put into practice, in addition to developing a wider network of support and contacts within this field. For further information and registration please email campaign@gmc-uk.org.

GMC Council's inaugural meeting in Wales

On the 6th and 7th of September, Cardiff will host the first ever GMC Council in Wales. The governing body of the General Medical Council has met in England for 148 years, generally in London - although the work of the GMC on medical education, standard setting, maintaining the register and fitness to practise covers all of the UK.

Building on the work of our GMC Wales office, meeting in Cardiff means that members of the public can come along and see exactly what we do - and we can speak directly with the Welsh community and health sector.

One year after the establishment of the Welsh Affairs Office of the GMC - GMC Wales - Council will be meeting in the St David's Hotel and Spa in Cardiff. This will comprise a full day meeting open to public and press, on Thursday 7 September.

Wednesday 6 September, GMC President, Professor Sir Graeme Catto, will host a Council dinner in the Grand Hall and Impressionists Gallery, National Museum of Wales. Guests will include senior figures from across the Welsh medical, health, education, patient and political landscape.

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

GMC Education Consultation report

In 2005, the Education Committee consulted on strategic options for undergraduate medical education: how the GMC could ensure patient safety and promote medical education. The consultation focused on:

  • Whether or not we should develop a national assessment or retain the present arrangements whereby the 27 medical schools are individually responsible for assessing their own graduates
  • Whether or not we should introduce a UK-wide student register alongside the existing register of doctors
  • Whether or not our standards for undergraduate medical education, set out in 'Tomorrow's Doctors', are appropriate in relation to patient-centredness, interprofessional learning, learner-centredness, equality and diversity and the permanence of change

The final report on the outcomes of the strategic options consultation is now available on our GMC website. It sets out the general themes and opinions that emerged from the three streams of the consultation. It consists of a summary report on the consultation and a qualitative analysis by external researchers on the written responses.

In general, there was support for:

  • Developing a more robust assessment system in the UK
  • Developing more consistency in student fitness to practise in the UK
  • Considering the balance between clinical and non-technical knowledge and skills in Tomorrow's Doctors
  • Making sure that many of the themes in the undergraduate curriculum, such as patient-centredness and interprofessional learning, are reinforced in practice settings
  • Developing effective educational mechanisms to prepare students to deal with uncertainty

Education feedback

The Education Committee has begun a period of informal feedback on some of the key areas raised by the strategic options consultation. There is significant support for reform to assessment systems and student fitness to practise arrangements in UK medical schools, recognising the room for more consistency and accountability. These documents move beyond the debates set out in the strategic options consultation and suggest possible policy implications in these areas.

We will use the feedback from this stage to inform a subsequent formal consultation period on worked-up proposals. The documents will be available on the GMC website in early July or if you are interested or would like more information, please contact us at edconsultation@gmc-uk.org or 020 7189 5287.

We are seeking feedback on:

  • Strategic proposals for assessment - a potential direction of travel for the GMC in relation to assessment including the possibility of a national assessment examination
  • Strategic proposals for student fitness to practise - a potential direction of travel for the GMC in relation to student fitness to practise including if the GMC should be more involved in local determinations or develop a student register
  • Tomorrow's Doctors: Curricular Outcomes - a working paper that suggests possible changes to the undergraduate guidance with regard to outcomes and curricular content
  • Tomorrow's Doctors: Curricular Delivery - a working paper that suggests possible changes to the undergraduate guidance with regard to how the curriculum is delivered by medical schools

Student Fitness to Practise Guidance

The GMC Education Committee and the Council of Heads of Medical Schools are jointly developing guidance on student fitness to practise. This guidance will set out information on good professional behaviour expected of medical students, areas of misconduct that may raise concerns, key elements that should be covered in student fitness to practise arrangements and the importance of sharing information appropriately.

We are starting a period of informal consultation on the draft version of the student fitness to practise guidance. It is geared towards students, medical schools and those involved in student fitness to practise arrangements, and we hope that many others will be interested. We would welcome comments and thoughts on the guidance in order to make it an effective and useful tool for ensuring that students will be fit to practise as doctors and do not put patient at risk.

The draft guidance will be available on the GMC website in early July or if you are interested or would like more information, please contact us at edconsultation@gmc-uk.org or 020 7189 5287. Again, this informal process will help us to develop a formal consultation draft of the guidance with a view to the final version being published in time for the 2007 intake of students.

Quality Assurance

The Education Committee and the Postgraduate Medical Education and Training Board (PMETB) are working together to ensure that the Foundation Programme has both consistent standards and outcomes and a coherent Quality Assurance mechanism. Three Quality Assurance pilots have been operating this year throughout the UK, more information is available on our QA microsite.

GMC Scotland expands personnel

The GMC Scotland team is expanding as we welcome Jackie Bell as the first Scottish Projects Officer. Jackie's work will focus on the establishment of a Scottish public and patient forum and wider outreach work. Her strong background in public and patient involvement and patient support in the NHS ideally equips her to progress this strand of our work in Scotland. Dan Wynn has joined as Scottish Affairs Officer, having worked as a researcher at the Scottish Parliament. His previous experience also includes several years working in housing, as a homelessness adviser and as Parliamentary Officer with Shelter Scotland.

Withholding & Withdrawing Life-prolonging Treatments - Scotland

Two Withholding and Withdrawing Life Prolonging Treatment events were held in Scotland in June. In partnership with NHS Education for Scotland, GMC Scotland arranged a full day educational seminar, which attracted clinicians from across the country. Kindly hosted by the South East Deanery in Edinburgh, the meeting was addressed by members of the GMC Standards and Ethics team and Mr John Griffiths,WS, partner at Shepherd and Wedderburn. Chaired by Professor Kenneth Boyd of Edinburgh University, the 105 attendees worked through a series of case studies and discussed the key themes. These themes were mirrored the following day at a well attended patient support event in Glasgow. Chaired by Dr Isabelle Low, Scottish Consumer Council and Audit Scotland, voluntary sector representatives engaged in a lively conversation with the GMC and Dr Mairi Scott, Chair of RCGP Scotland.

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