Fitness to practise improvements made
The General Medical Council (GMC) has made a catalogue of improvements to its fitness to practise processes.
Changes include increasing support available to doctors and obtaining key information after receiving a complaint. This is to help decide whether to investigate and is known as provisional enquiries. It has already prevented around 400 cases from going to a full investigation.
If a doctor, who is being investigated, is very unwell, the GMC is now also able to pause the process so they can receive medical treatment.
"Investigations can be punitive in effect, even if that is not the intention. Being able to see things from the point of view of the hardworking, perfectionist, sometimes distressed and probably remorseful doctor was key to reforming the process."
Professor Louis Appleby
Professor of Psychiatry
The improvements follow the appointing of leading psychiatrist Prof Louis Appleby. He will advise on how to reduce the impact and stress of investigations on doctors. His experience includes leading the Centre for Mental Health and Safety, the largest research unit in this field.
Prof Appleby worked with policy teams to look at each step of the investigation process. From when a complaint is received to when the case closes or, in a minority of cases, gets referred to tribunal.
Prof Appleby said: ‘Recognising the vulnerability of any doctor facing a fitness to practise investigation, whether they are known to have poor mental health, was a priority when I was appointed to advise the GMC on making improvements to its investigations.
‘Investigations can be punitive in effect, even if that is not the intention. Being able to see things from the point of view of the hardworking, perfectionist, sometimes distressed and probably remorseful doctor was key to reforming the process.”
Former General Practitioner Dr John Smyth oversees investigation decision makers known as Case Examiners at the GMC. He said: ‘Being complained about is never going to be pleasant. I’ve been complained about while working as a doctor and it can be a very stressful and worrying time.
‘With Prof Appleby’s expertise we have tried to put ourselves in the shoes of doctors. We have introduced a series of improvements that will be more compassionate. We have improved our communications and staff have been trained by medical professionals. This is to help recognise the signs of doctors who may be vulnerable.
‘We have also revised our guidance for employers to encourage them to deal with matters locally. We continue to call for legislative change to further reform our processes and deal with cases consensually. Especially when both parties are in agreement on the outcome.’
Prof Appleby was approached by the GMC after it commissioned an independent review into cases. These included cases where doctors had died from suicide while subject to investigation over an eight year period.
Work to ease the pressure on doctors will continue as a Medical Advisory Board will meet twice a year to provide expert advice. They will look at how the GMC can continue to support doctors and make further progress. It will consist of representatives from several organisations.
