An Introduction to the General Medical Council. Professor Sir Graeme Catto. President

Transcription

1 Thresholds for referral to the GMC An Introduction to the General Medical Council Professor Sir Graeme Catto Joanna Farrell President Head of Investigation

2 Advice, guidance and support Paul Philip Deputy Chief Executive and Director of Standards and Fitness to Practise Joanna Farrell Head of Investigation

3 where it comes to the attention of the General Council Medical Act 1983 The Public (patients, relatives, carers) Employers - Senior Partner, Board, Trust etc, Other doctors or healthcare professionals Self referral Newspaper articles Inquiries and Reports T.V and radio Other Regulatory The Police bodies Neighbours Friends Relatives

4 What do we do fitness to practise? 7153 complaints to the GMC in Dialogue with employer, patient, other witnesses & 3 rd parties for those that become investigations Undertake around 70 performance assessments and 390 health assessments of doctors each year (780 exams) Decisions made by case examiners. Small proportion referred on to FtPP Can erase, suspend, or restrict registration or issue warning

5 Investigation of complaints Initial assessment - Are there issues for the GMC to investigate?(50% of enquiries were closed with no further action required in 2010) Possible outcomes Stream 2 usually refer to local procedures (21% of cases) Stream 1 GMC investigation (29%)

6 6 routes to impairment Impaired fitness to practise by means of: Misconduct Adverse health Conviction or caution Poor performance Determination A barring decision by Disclosure Scotland (or similar in other UK countries)

7 Thresholds closures at initial assessment Lots of categories. Examples of cases closed without any investigation: Minor motoring offences (not involving drugs or alcohol) A delay of less than 6 months in providing a medical report A minor non-clinical matter A complaint about the cost of private medical treatment

8 Investigation of complaints Initial assessment - Are there issues for the GMC to investigate? Possible outcomes Stream 2 usually refer to local procedures (21% of cases) Stream 1 GMC investigation (29%)

9 Stream 2 cases Examples of cases that go into our stream 2 procedure: Complaints about doctors poor attitude to patients Complaints about the quality of treatment received, where there is no indication of a risk to patients or that the doctor acted significantly below the appropriate standard Process: Get consent from the complainant Disclose to the doctor Write to the doctor s employer(s) The employer(s) are asked to complete a form to confirm that they have no immediate concerns about Dr X that might require action by the GMC.

10 Thresholds (Stream 1) We make a presumption of impairment in cases involving: Sexual assault/indecency Violence Inappropriate relationship with patients Cases in these categories will often arise from convictions We make a presumption that some action is required: Dishonesty (except for the most minor instances)

11 Clinical underperformance Or Misconduct? Attempts to improve performance locally have failed and the Board identifies remaining unacceptable risk to patient safety A doctor about whom the Board has developed significant concerns leaves that employment and the Board is not confident that alternative safeguards are in place A doctor has shown a deliberate or reckless disregard of clinical responsibilities towards patients A doctor has abused a patient s trust or violated a patient s autonomy or other fundamental rights The doctor s behaviour was such that public confidence in profession might be undermined if GMC did not take action.

12 Doctors who are sick Only a small number of sick doctors are referred to the GMC each year. Often no need for GMC intervention if a sick doctor has insight into their condition, is seeking appropriate treatment, following the advice of their treating physicians and/or OH dept in relation to their work and restricting their practice appropriately. We do seek to restrict a sick doctor's registration if significant concerns arise about their fitness to practise and/or patient safety, eg where a doctor s ill-health (including addiction) appears to be uncontrolled or where the doctor is not following advice. We will also take action in respect of significant misconduct issues, for example where a doctor is convicted of a drink-driving offence.

13 Conclusion of Investigative process GMC receives an allegation IOP? Initial disclosure to Dr Board disclosure Gathering evidence witness statements/expert reports, medical records, Health and Performance Assessments Final Disclosure CE Decision

14 Outcomes following full investigation doctors Refer to FtPP 20% Undertakings 8% Warning 12% Take no action/issue advice 61%

15 Who does what? Manchester Investigation Teams 4 Regional Teams National Investigation Team Triage Team London Investigation Team All Police/Criminal Prosecutions nationally Overseas Determinations

16 Further information Jane Malcolm Head of Scottish Affairs ANY QUESTIONS?