Working with doctors working for patients: the 21 st century GMC Professor Terence Stephenson BSc, DM, FRCPCH, FRCP, FRACP, FRCPI, FRCS, FHKAP, FRCGP Royal Medical Benevolent Fund, 21 September 2015
The Royal Medical Benevolent Fund For the relief of medical men and their families under severe and urgent distress, occasioned by sickness, accident, or other calamity 1836 establishment of the RMBF Financial assistance Information and advice Medical students Refugee doctors
The General Medical Council A patient safety organisation Independent regulator of UK s medical profession Established in law with statutory powers in 1858. Our powers are given to us by Parliament through the Medical Act 1983. Funded mostly by doctors registration fees. But we are An independent organisation Accountable to UK Parliament with oversight from the Professional Standards Authority.
The General Medical Council Set and maintain education standards for ~40k Undergraduate and ~ 50k postgraduate doctors We decide which doctors are qualified to work here and maintain entry and exit from the public register Ensuring licensed doctors demonstrate on a regular basis that they are up to date and fit to practise We take action when we believe a doctor may be putting the safety of patients, or the public s confidence in doctors, at risk. Set and maintain professional standards
Numbers in our Fitness to Practise procedures
Types of Fitness to Practise allegations
Complaints where health of doctor is concern The your health matters website Links to the Practitioner Support Service
If we think a doctor may be vulnerable we: encourage them to see GP and use the Doctor Support Service can put a case on hold until we are sure that the doctor is well enough to engage can arrange for an appropriate individual to act as a liaison between us and the doctor can agree for the doctor to remove their name from the register where continuing with the investigation would have a significant adverse effect on their health.
The Doctor Support Service Run by the BMA Funded by the GMC Confidential emotional support to any doctor who has a complaint made against them to the GMC This service will support colleagues through a very stressful time, which not only affects their professional lives but also impacts on their personal lives. Dr Mike Peters, BMA Doctors for Doctors Unit
GMC confidential helpline Launched in 2012 Advice service for doctors Staffed by specially trained advisors Can also be used to raise serious concerns about patient safety when unable to do this at a local level We have had over 2000 calls. 400 about doctors leading to 140 investigations.
The suicides review Why? we review every suicide Concerned so we initiated research published in 2014 We have accepted the recommendations and are now implementing them
Progress on implementing recommendations of the suicides review Improved communication with doctors new bank of letters for our fitness to practise investigations Independent expert to review all our Fitness to Practise processes to improve them for vulnerable doctors Workshop early next year with other organisations about how we can continue to improve
A National Support Service for Doctors Core principles agreed at July roundtable: Separate from the GMC Services must be accessible and confidential only contact with GMC where concern for patient safety Different models for different nations / regions Shared standards for services across the UK Since, NHS England have committed to a new nationally-specified occupational health service for GPs suffering from burnout and stress
Challenges ahead
Fitness to Practise: Enhancing our process and the experience of patients and doctors Better communication with patients 2011-2013: Launch online complaints - improve access 2013 and 2015: Review of the tone of correspondence with patients and witnesses 2015: Establish the Patient Liaison Service to meet with patients to check concerns and explain process following successful pilot
Fitness to Practise: Enhancing our process and the experience of patients and doctors Reducing impact on doctors 2015: Reduce hearings through meetings with doctors to encourage early sharing of information and better understanding of concerns. 2015: Establish confidential support for all doctors under investigation following successful pilot 2015: Two reviews following independent reports of how we handle: health cases and cases involving whistleblowers.
Streamlining Fitness to Practise 1 Preliminary Enquiries Project making quick enquiries to avoid unnecessary investigation 2 Speeding up triage, case review and case examiner decision making 3 Facilitated disclosure by meeting with doctors
Revalidation Revalidation aims to: Bring all doctors into a governed system specialist doctors, locums Help to identify problems earlier Encourage self reflection
Revalidation Revalidation must be seen as part of the wider quality movement within healthcare in the UK Revalidation can: lead to better support for doctors to engage in PDP foster belief in doctor s own development give greater transparency and assurance for patients deliver safer and better care be a driver for quality improvement
We want to Continue reforming of Fitness to Practise for the future Develop a UK-wide medical licensing assessment Create a more useful register
Frequent Questions Does the GMC help get doctors back to work after sanctions? Next year we will be developing guidance for doctors on keeping their clinical skills up to date whilst suspended. Does the Employer Liaison Service have a role? Once a doctor returns to unrestricted practice, unless further concerns are raised, the ELS would not be involved. Does the MPTS or GMC review the doctor s situation when the period of the sanction is up and make recommendations? There may be a review hearing to consider whether the doctor s fitness to practise remains impaired. The GMC is currently piloting assurance assessments as a mechanism for obtaining objective evidence about doctors who we believe may be ready to return to unrestricted practice.