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Independents' Day

GMC calls for doctors' reflections to be legally protected

The GMC has told the Goverment's rapid review into gross negligence manslaughter in medicine that doctors' reflections are 'so fundamental to their professionalism' that UK and devolved governments should consider providing legal protection.

The evidence submitted to the Williams Review, launched by health and social care secretary Jeremy Hunt in light of the GMC's successful bid to strike off junior Dr Hadiza Bawa-Garba in the High Court in January, also said the GMC will consider 'how human factors training can be incorporated into its processes'.

The news comes as GPs have called on the BMA to advise GPs to 'disengage from written reflection in both appraisal and revalidation' until new safeguards are put in place. The LMCs Conference motion, carried earlier this month, also saw doctors passing a no-confidence vote in the GMC.

GMC chair Professor Sir Terence Stephenson said: 'We have made it clear that the GMC will not ask for doctors’ reflective records as part of the fitness to practise processes. But we do not control the actions of the courts and recorded reflections, such as in ePortfolios or for CPD purposes, are not subject to legal protection.

'Therefore disclosure of these documents might be requested by a court if it is considered that they are relevant to the matters to be determined in the case. The likelihood of records needing to be produced in court may be reduced if reflective records focus on reactions to, and learning from, an incident.

'For our part, we have concluded that because doctors’ reflections are so fundamental to their professionalism, UK and devolved governments should consider how to protect them in law, if they see fit to do so.'

The GMC has commissioned a fundamental review of the application of the law concerning gross negligence manslaughter and culpable homicide to doctors which will be led by Dame Clare Marx.

The GMC also said its own review, which will look at why there are fewer cases involving healthcare organisations compared with individuals, is expected to report conclusions at the start of 2019.

It also said that the outcome of the Williams Review, due to report next month, will 'help to inform Dame Clare’s work when she reports her conclusions at the start of 2019'.

Dr Chaand Nagpaul, BMA council chair, said: 'Doctors’ personal reflections encourage openness and improvement through learning, and it is vital they are protected. This call by the GMC is in line with the BMA’s position and will form part of our own submission to the Williams Review shortly.'

RCGP chair Professor Helen Stokes-Lampard said: 'We welcome the reassurance by the GMC that they will not ask for doctors’ reflective records as part of their investigations – and we support their recommendation that reflective records should be protected by law.'


Readers' comments (21)

  • AlanAlmond

    There’s some pretty marked cognitive dissonance in the GMC position. What exactly is their role? I don’t think they actually know. They are prepared to take courses of action they fully admit they have little control over and which may lead to unintended adverse consequences and yet they do it anyway. They seem organisationally confused and lacking direction. What a sorry state they have got themselves into. You have got to ask yourself where is the leadership in this organization. Who is running this outfit? Are they up to the job? I would suggest that is in question.

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  • AlanAlmond

    Prof Stevenson is basically saying, we are quite happy to take the decision to pursue individual Drs through the courts, in conflict with our own tribunal service findings, but we completely obsolve ourselves of any responsibility for the outcome, that bit is apparently, nothing to do with the GMC and all the legal professions fault. This is muddled thinking and totally lame. And yet there he is taking this position. Embarrassing.

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  • AlanAlmond

    ...Absolve not obsolve

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  • AlanAlmond

    Prof Stevenson, it is for the very reasons you outline that the GMC uses a tribunal system to adjudicate these issues..and yet you’ve chosen to ignor the tribunal system. Can you not see the idiocy of your argument?

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  • I think anyone with half an ounce of sense will be very selective about what they say in there reflections. I think I should focus on what went well in future and build positively on that and plan to expand that to other areas on my practice...... anything that went wrong? mmmmh...I can't seem to recall anything...... nope, nothing written down anywhere....... must have been a good year!

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  • I bet my million dollar that the lawyer will be able to demand and produce the reflective evidence in criminal or even in negligence cases.
    I don’t believe in a word of holllow reassurance from the GMC that it would be protected.
    GMC in this article seems to be contradicting its own position.

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  • I’m happy to reflect, in person. No smart phones, no Mics.
    ‘I was not involved officer but I saw the whole thing and I learned a lot from it.’.If in doubt....refer. If in doubt....investigate.....if unsafe.....walk away. They hoped for an accelerated collapse of the NHS. Well, they’re getting it.

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  • I think the in this day of witch hunt and fault finding society ready to pin blame on some one, it is becoming very difficult to practice medicine especially as a GP where our very strength of managing risk and working with safety netting is becoming a problem when something goes wrong.
    Increasingly the Mantra of our work will be as what WTF! Said above; ’.If in doubt....refer. If in doubt....investigate.....if unsafe.....walk away
    Already most of us have started to work on this mantra.

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  • It is extremely disappointing that the legal position on Drs professional reflections for revalidation purposes was not considered appropriately before it was made a component of the compulsory appraisal process.

    The leadership of the GMC etc must reflect and feedback on the damage that had been done to the standing of the medical profession and the fact that the profession is feeling so victimised.

    It' is incredulous that only now the legal vulnerability that has been placed on Drs is being considered given that the appraisal process has been in place for years.

    How can this have been allowed to happen?

    I don't think any clinician disagrees with the need to do our upmost to protect patients to the best of our ability and thankfully the Shipmans are a rare breed.

    There is also an equally pressing need to take care of the professionals who work extremely hard in often inhumane working environments. Considering Dr BG - where was the heath and safety at work?

    The GMC question as to why so few cases are against the organisation compared to the individual surely doesn't need an expensive review process to find the answer. It is far easier to scapegoat one individual and close the case.

    In this era of blame and compensation there is no excuse for this to have been allowed to pass without proper legal consultation.

    I guess what we have to think now is better late than never.

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  • The popular press will not permit legal protection of reflections.....if reflections are protected "there must be something fishy going on".
    Courts will always have power to force disclosure in fatal cases.

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