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May 2008

A communication from the General Medical Council
May 2008, Issue 45

What's New?

Changes to age exemption regulations
GMC seeks to appoint new Council members
New consent guidance launched
Confidentiality guidance review - an update

Welcome to the May edition of the GMC e-bulletin

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

Changes to age exemption regulations

The GMC has been told by leading counsel that it is unlawful to discriminate on the grounds of age and that the age exemption from the Annual Retention Fee for doctors over 65 is almost certainly contrary to provisions contained in the Employment Equality (Age) Regulations 2006.

The GMC's Council has agreed that exemption from the ARF on the grounds of age must be ended in order to comply with the law. The Council has also agreed that no new exemptions from the ARF on the grounds of age should be granted after 30 June 2008, and that those who are currently exempt from the ARF on the grounds of age will be liable to pay the fee after 31 October 2008 if they wish to remain on the register.

We have written to doctors who are currently exempt or about to become so, to advise them of this decision. We will also be writing to these doctors again in August, when we will ask them whether they wish either to make arrangements to pay the ARF or to relinquish their registration. In the meantime they are not required to take any action.

GMC seeks to appoint new Council members

The GMC is seeking to recruit new members to form its Council from early 2009.

Following the 2007 White Paper, Trust, Assurance and Safety, which recommended changes to medical regulation, the GMC is moving to a smaller Council with equal numbers of lay and medical members. The reconstituted Council will begin work in January 2009 with 24 members, of which 12 will be doctors and 12 will be lay. The membership of the Council will be reflective of its key interest groups: patients and the public, doctors, the NHS and other healthcare providers and the medical schools and medical Royal Colleges.

The current recruitment campaign is the first time that all Council members will be selected by an external body, the Appointments Commission.

The Council is the governing body of the GMC, and is responsible for overall control of the organisation, setting its strategy, business plans and budget as well as holding the executive to account for the operation of the GMC's functions and processes.

The current Council comprises 35 members: with 19 elected members, 14 lay members and two appointed members.

For an application pack visit the Appointments Commission website www.appointments.org.uk or www.gmc-uk.org

New consent guidance launched

New GMC guidance launched in May urges doctors to rethink their approach to discussing medical issues with their patients. The guidance encourages doctors to actively engage patients in discussions, allowing them to make decisions based on their individual needs and circumstances.

Consent: Patients and doctors making decisions together, which replaces Seeking patients' consent: the ethical considerations, focuses on the importance of the doctor-patient partnership. It sets out the key principles of good decision making.

The new guidance will have an impact on all patients, but in particular on those who cannot make decisions for themselves, or where their ability to do so is impaired or fluctuating. This reflects recent legislation which protects those who lack capacity to make particular decisions but also recognises the need to maximise their ability to make decisions for themselves.*

For the first time the GMC provides advice for doctors on how to approach discussions with patients about the risks and possible side effects of treatment. The guidance emphasises that risk should be explained in a way a patient can understand.
Jane O'Brien, Head of Standards and Ethics at the GMC said:

"We hope that this new guidance will prompt doctors to think about their approach to discussions with patients. The relationship between a doctor and a patient should be about partnership not paternalism. This means that doctors should work with patients to allow them to make decisions tailored to individual views, needs and circumstances, and respect the choices which they make."

To download a copy of the guidance please visit www.gmc-uk.org
The guidance has been circulated to all registered doctors in GMCtoday, and came into effect on 2 June 2008.

* Mental Capacity Act 2005 (England and Wales) and Adults with Incapacity (Scotland) Act 2000.

Confidentiality consultation - an update

In the January e-bulletin, we indicated that the GMC has begun a review of its guidance to doctors, 'Confidentiality: Protecting and providing information'.

The current guidance, which was published in 2004, develops the advice in Good Medical Practice (2006) and sets out the standards of practice expected of doctors when they hold or share information about patients.

In conducting this review, we aim to ensure that our guidance is up-to-date and reflects important changes in the way that doctors practice. A working group, chaired by Dr Henrietta Campbell, former Chief Medical Officer for Northern Ireland, has been established to lead the review on the GMC's behalf.

Early in 2008, we held an initial consultation to seek views on the existing guidance. We wrote to individuals, a range of professional, public and patient-oriented groups, and employers to raise awareness and encourage participation.
Respondents generally felt that the duty of confidentiality was fundamental to ensuring good doctor-patient relationships, but recognised the difficulties that requests for disclosure often raised for doctors. There also appeared to be some misunderstanding of some of the principles in the guidance - particularly regarding disclosures in the public interest - which we will aim to address in the revised guidance.

Click here to view a summary of responses to the initial consultation.

There will be a further opportunity to contribute to the review when we issue a revised draft of the guidance for a three month consultation period starting in the autumn.

For more information about the review, contact the Standards and Ethics Team (020 7189 5404 or standards@gmc-uk.org).

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