Pandemic should be a catalyst for change in UK healthcare, says GMC Chair

NHS leaders should use the coronavirus pandemic as an opportunity to improve workplace cultures, or they risk failing to retain their workforce and even threatening patient safety, the Chair of the General Medical Council (GMC) has warned in a speech today (Tuesday, 17 November).

Dame Clare Marx told the Leaders in Healthcare conference that poor working environments were a major factor in doctors leaving UK practice, and could put patients at risk.

She said that while the pandemic was a tragedy for many, it was also a rare opportunity for health services to re-focus, and to centre efforts where they would make a difference.

‘Environments that promote collaboration, communication and accessible leadership produce better outcomes,’ she said. ‘Environments where those factors are absent are, at best, unpleasant to work in and, at worst, downright dangerous.’

Dame Clare, an orthopaedic surgeon who became GMC Chair in 2019, said doctors’ workplace experiences were crucial in many deciding to leave the profession, and why those who had already left were often reluctant to come back.

"Environments that promote collaboration, communication and accessible leadership produce better outcomes. Environments where those factors are absent are, at best, unpleasant to work in and, at worst, downright dangerous."

Dame Clare Marx

GMC Chair

She cited new research – to be published in full early next year* – in which more than 35% said dissatisfaction with their working environment was a reason for leaving; and 25% said it was a reason why they did not want to return.

‘The environments in which doctors work – the support they receive, the way they communicate with those around them, the ability they have to influence outcomes – have a material impact. Compassionate culture matters.

‘Patterns of behaviour become baked into the system, not because they improve outcomes, but because “that’s the way things have always been done”. But the Covid pandemic has freed us to think the unthinkable and change the unchangeable.

‘Without change, there is no progress. The context in which we work is evolving constantly. To deliver excellent patient care, we have to evolve with it.’

Dame Clare said many doctors had reported positive experiences around teamwork, support and feeling valued in their role, despite disruption cause by the pandemic. But, she said, it shouldn’t be assumed that such benefits were felt equally.

She said leaders had to learn the art of leadership, and that it should be considered a ‘core competency’ as it was vital to providing first-class care.

‘We all came into medicine to make a difference, to use our knowledge and skills to care for patients. But to do this we also have to care for those with whom we work. Doctors must lead by example – valuing each other, reflecting on mistakes and speaking up when something’s not right. Ultimately it’s how we treat each other that makes the difference.’

The full text of Dame Clare’s speech delivered to the Leaders in Healthcare conference is available online.