Encouraging engagement from practitioners during a fitness to practise investigation
What were the key findings?
- Many doctors think GMC investigations are adversarial and biased towards patients
- In comparison, medical associate professionals (MAPs) described the GMC as a ‘comfort blanket’ which would provide clear policies and procedures to follow
- Most doctors first seek advice from their medical defence organisation when a concern is raised about them.
Factors that motivate a practitioner to engage with the GMC:
- To speed up the process
- To reduce the stress of being under investigation
- The moral obligation to accept responsibility if things go wrong and learn from mistakes.
Factors that prevent engagement:
- Emotional distress of being investigated.
Practitioners’ expectations from the GMC during an investigation:
- To conduct a fair, robust and transparent investigation
- To provide or signpost to support resources.
What are the ‘tipping points’ for not accepting conclusions made by GMC?
- If wider contextual factors have not been considered
- If practitioners do not fully agree with the terms of the conclusion.
Why did we commission this research?
As part of work to prepare for proposed changes to legislation we are developing changes to the fitness to practise (FtP) process that may include extending the use of consensual disposals (also known as accepted outcomes). This is where a registrant can accept the outcome proposed by the GMC at the end of an investigation without needing a tribunal hearing which would speed up the process and encourage a less adversarial process.
We wanted to identify what lessons we can learn from behavioural science to help us design a fitness to practice process that encourages maximum early engagement from registrants (doctors and medical associate professionals), including in the consensual disposal process.
What did the research involve?
This research was delivered by an independent research consultancy, ICE Creates LTD, and included 42 in-depth telephone interviews with doctors and medical associate professionals and facilitated online workshops with 10 GMC and Medical Practitioner Tribunal Service team members.