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GMC says reflection should be 'less of a tick-box exercise'

The GMC has joined forces with eight other health regulators to underline the 'common expectations' of how healthcare professionals should reflect on their practice. 

In a joint statement issued today, the regulators said teams should be encouraged to discuss incidents when things go wrong, while also stressing regulators would not request personal written reflections for investigations - but registrants can choose to offer them as evidence of insight.

According to the statement - called Benefits of becoming a reflective practitioner - reflection is also more effective if 'professionals... proactively and willingly engage in the practice – making it less of a tick-box exercise'.

The new guidance has been welcomed by the Medical Defence Union, which said it should 'help reassure doctors and medical students about some of the misconceptions about reflection and the contents of reflective notes'.

It said that while the statement explains doctors do not have to provide written accounts for investigations, the MDU believes 'it can be helpful' to show they have learnt from the experience.

The GMC released the statement alongside bodies including the Health and Care Professions Council, the Nursing and Midwifery Council and General Dental Council.

A GMC spokesperson said: ‘This joint statement sets out our common expectations for health and care professionals to be reflective practitioners, engaging meaningfully in reflection and the benefits it brings.

‘As well as expecting the people we regulate to be reflective practitioners, we also have a duty to consider our own actions, and their effect.

‘We are committed to improving how we provide assurance and protection to the public. We do this continuously in our work, through evaluation, to reflect and make changes in what we do and how we work. This statement reflects the principles set out in each regulator’s individual code of practice, professional standards or guidance on reflective practice.’

The MDU's head of advisory services, Dr Caroline Fryar, said: ‘As the new statement points out, reflections should be anonymised and focus on what has been learned, rather than the identifiable details of those involved or the event. We hope the guidance will help reassure doctors and medical students about some of the misconceptions about reflection and the contents of reflective notes.

‘For example, the statement explains that the regulators will not ask for personal written reflections in order to investigate a concern against a registrant. However, the MDU’s experience shows it can be helpful for doctors to offer evidence of their reflections when responding to a GMC investigation, for example to demonstrate they have learnt from the experience.

‘We encourage members who are completing reflective notes after something has gone wrong or those who have received a request to disclose the document to others, to contact us for further advice.’

Earlier this month, a review commissioned by the GMC found the regulator should acknowledg its relationship with doctors has been ‘severely damaged’ after the Bawa-Garba case, and ‘must learn’ from it.

Chief executive of the GMC Charlie Massey then said that he 'completely accepts' the legal advice he was given to pursue the striking off of Dr Hadiza Bawa-Garba was 'not correct'.

In the case, it was originally reported that Dr Bawa-Garba's reflections were used as evidence against her - but it was later confirmed they were not submitted to court.


Readers' comments (21)

  • It is unbelievable how badly treated the doctors are, all basic rights removed with less rights than the a typical citizen and the BMA finds this acceptable. I am still shell shocked from the pension confiscation. No trial just an accusation will do to remove all your hard earned pension if you get an accusation for any offence like Gross negligence Manslaughter. Last Friday's BMJ shows how the courts judges us without taking into account of the workload, staffing, if you are tending to other patients. Once there is a bad outcome, you are expected to split into 4/5 persons and you get blamed. Toxic UK. You get blamed for helping. Australia is much better.

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  • those commenting on this forum are often dismissed as moaners etc but as time passes their comments seem to come true remarkably often. Too much forced reflection/value of continuity/small practices/recruitment/retention/appraisal .....Those in power would do well to listen to the front line

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  • Cobblers

    I did, a few weeks back, complain that the GMC charged the doctors for the bullet to the back of the head.

    Little did I know.

    Now, it seems, the GMC are going to compel you to take the gun, shoot yourself and charge you for the hire of the gun and use of the bullet.

    GMC = Not fit for purpose

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  • Wow, nine regulators for each GP.
    We'll soon have the extra 5000 regulators the health secretary promised by 2020.

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  • This is what happens when doctors and their unions get into bed with the government. You end up being owned by some government agency or two, in the UK's case the GMC and NHSE who have the power to 1. remove your license without a court of law's decision 2. impose their own working conditions on you and impose that you pay for the privilege of being regulated by the CQC and adhering to their draconian rules 3. dictate what you should be paid

    It's the same in all socialist countries but the UK is quite bad admittedly. Of course the government will claim you can work privately but that misses the point that they still own your licensing/revalidation and can impose fines on you through CQC if they dont like your practice. This is called tyranny

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  • DecorumEst nails it perfectly.
    I lost 2 hours sleep last night "refecting in the wee small hours"
    Damned if I'm intending to write it down for anyone else to discuss.

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  • Doctors have always reflected. It now needs to be written down to prove it exists.
    Proper reflection in writing can be useful and interesting but it’s time consuming.
    My reflection is typically done in the car on the way home and in discussion with my husband and colleagues. We are an oral profession.
    When will Massey resign? He is a disgrace to his profession. Ahhhh. There lies the problem. He is not part of a profession with ethics and morals.

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  • Does anyone know if Charlie Massey is a medical doctor? If not, how can we get a plumber to critic an electrician's work? This might answer the mess and the lack of confidence in this self serving organisation. £250K annual salary thanks to us, for doing what?

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  • Compulsory reflection will always become a tickbox exercise, as does compulsory anything.

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  • Please be very careful

    I avoid any real reflection; I do the bare minimum for appraisals. I never reflect on anything that could be used against me

    Avoid all social media if you can. Decline interviews with the media.

    Risk is high, reward is minimal.

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