Human Factors training to be rolled out for investigators

All of the General Medical Council’s fitness to practise decision makers, case examiners and clinical experts are to receive Human Factors training, and advice on modifying investigation processes, as part of a collaboration agreed with Oxford University’s Patient Safety Academy.

Human Factors is a social science which studies and attempts to optimise the interactions of humans, technology and the environment at work.  It is a standard tool of safety investigation and improvement in several industries such as civil aviation, nuclear power and military planning which seek to balance high risk and high reliability.

"This collaboration will make sure that Human Factors are hardwired into our investigations so that the role systems and workplaces play in events is fully and evenly evaluated in assessing context following serious failings."

Charlie Massey

Chief Executive and Registrar

The GMC’s Fitness to Practise directorate investigates complaints or concerns about doctors which raise a risk to patients or public confidence in the wider profession. The work paves the way for the GMC to draw on Human Factors experts when it chooses to investigate doctors, and where systems issues need to be better understood in order to do so.

In future, the GMC is aiming to work with responsible officers to make sure the same approaches are also consistently applied locally when they are dealing with concerns around doctors’ conduct and performance, before those issues are referred to the GMC.

Charlie Massey, Chief Executive and Registrar of the GMC, said: 

‘This collaboration will make sure that Human Factors are hardwired into our investigations so that the role systems and workplaces play in events is fully and evenly evaluated in assessing context following serious failings.

‘That will guarantee consistency in how we investigate after things have gone wrong and give doctors the assurance that their actions will be seen clearly against the backdrop of any system failings. Coupled with the responsibility royal colleges and faculties have to equip doctors in training with basic Human Factors training, this will help to embed a greater understanding across the health system of how environments contribute to patient safety incidents.’

The Patient Safety Academy team will also work with the GMC’s Employer Liaison Service in our work to help strengthen investigation at local level, so concerns about a doctor’s fitness to practise medicine can be resolved locally wherever possible.

The Academy is funded by Health Education England and hosted within the Nuffield Department of Surgical Science at Oxford University. It carries out training, research and project support for improvement initiatives on patient safety. The Oxford University side of the project is led jointly by Prof Peter McCulloch, Co-Director of the Academy, and Dr Lauren Morgan, Chief Human Factors Scientist for the group.

Prof McCulloch said:

‘Integrating Human Factors into the fitness to practice process will involve both staff training and modification of procedures and documentation, to ensure that the knowledge acquired is embedded into the investigative process. Our aim in this work is to ensure that context and systems issues are always fully taken into account when evaluating a doctor’s performance, allowing doctors to have confidence in the fairness of GMC procedures.

‘We believe that patient safety will be improved by a just culture for healthcare workers, and that this collaboration represents an important advance.’

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