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GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

The GMC will introduce ‘emotional resilience’ training and a national support service for doctors after an internal review found that 28 doctors committed suicide while under investigation by the regulator.

The report, Doctors who commit suicide while under GMC fitness to practise investigation, also recommends the appointment of a senior medical officer in charge of overseeing health cases and establishing a culture where doctors feel they are treated as ‘innocent until proven guilty.’

This comes after calls from former RCGP chair Professor Clare Gerada and the BMA among others to publish the findings of the internal review after it was launched in September last year in an effort to see if the GMC can do more to support vulnerable doctors who are undergoing fitness-to-practise investigation.

The internal review identified 114 doctors who had died during 2005-2013 inclusive and had an open and disclosed GMC case at the time of death, and found that 28 had committed suicide.

While it found that the GMC had instigated ‘significant improvements’ to its processes over the past few years, such as using more sensitive language in its letters, it said there was a perception that the GMC focuses on ‘protecting the public’ and that the doctor can become ‘marginalised’ – subsequently receiving little support or compassion.

It said there were a series of recommendations that the GMC could implement to improve processes further, including:

  • Making emotional resilience training an integral part of the medical curriculum;
  • Exposing GMC investigation staff to frontline clinical practice;
  • Supporting the establishment of a National Support Service (NSS) for doctors;
  • Reducing the number of health examiners’ reports required for health assessments;
  • Introducing case conferencing for all health and performance cases;
  • Setting out pre-qualification criteria for referrals from NHS providers and independent employers;
  • Developing a GMC employee training package to increase staff awareness of mental health issues.

Chief executive of the GMC Niall Dickson, said the GMC understands that a fitness-to-practise investigation is a ‘stressful experience’ but he is determined to make sure the regulator handles such cases with sensitivity.  

He added: ‘We know that some doctors who come into our procedures have very serious health concerns, including those who have had ideas of committing suicide. We know too that for any doctor, being investigated by the GMC is a stressful experience and very often follows other traumas in their lives. Our first duty must, of course, be to protect patients but we are determined to do everything we can to make sure we handle these cases as sensitively as possible, to ensure the doctors are being supported locally and to reduce the impact of our procedures.’

Mr Dickson said that a GMC referral will ‘always be a difficult and anxious time for the doctor involved’, but the regulator were determined to make sure they are ‘as quick, simple and as low stress as we can make them’.

He added: ‘We have made some progress on this but we have more to do, and that includes securing legal reform. We will now review our current process for dealing with doctors with health problems and identify any further changes that may be needed.’

Professor Gerada, who leads the Practitioner Health Programme (PHP), which supports doctors with mental health issues, said she ‘applauded the GMC’s openness in putting in the public domain the issue of doctors’ suicides whilst under their process’.

She added: ‘Going forward they need to continue to show their commitment to reducing the impact of fitness to practise investigations on vulnerable doctors whilst always maintaining patient safety - a substantial task.

‘Doctors are sometimes patients too and supporting vulnerable doctors is a shared responsibility. It is important that in taking forward the recommendations in the review the GMC works in partnership with everyone who has an interest in this area including the Practitioner Health Programme, the Royal College of Psychiatrists and the BMA.’

The report states that many of the doctors who committed suicide during this period suffered from a mental health disorder or had drug and/or alcohol addictions.

Meanwhile, other factors which followed on from those conditions that may also have contributed to their deaths include marriage breakdown, financial hardship, and in some cases police involvement as well as the stress of being investigated by the GMC.

Last month, Professor Gerada argued that the GMC’s recent consultation on new sanctions guidance focused too much on ‘maintaining public confidence’ was about basing its decisions on ‘what the tabloid newspapers might think’. 

Related images

  • GMC plaque  Ralph Hodgson - online

Readers' comments (375)

  • To anonymous, you talking about anymously, you have no idea about those doctors who committed suicide and you seem like a scared guy who is failing to reveal yourself even in a forum discussion.

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  • To Una C again congratulations on your bravery and waving anonimity. To anyone else who opens the GMC letters, dont do it alone. By sheer fluke my CPN was with me when I did the first one. Sounded like hanging would have been to good for me. After that Health Issue it was FTP, note these ran consecutively not concurrently.

    I accept I was unwell and needed help (something that is very difficult for the medical profession to do) but the punishment needs to fit the crime.

    There is more but even this posting still hurts the psyche, and yes if and when released its 2 fingers to the NHS.

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  • I am saddened by this report. If you look closely there have been 9 deaths in 2013 - and these don't include accidents (remember many solo car accidents could be suicides). So - one a month of a doctor undergoing GMC investigations. Only 75% had preexisting mental health problems - so these are young (half under 40yrs), married men>women with their lives ahead of them. We must change the system and I am trying that. Its not just GMC its all the systems that as I said this morning are hard wiring cruelty into our NHS. So CQC, F&FF, NHS Choices etc. Help me to address this.

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  • If we can't look after our colleagues in difficulty, how can we look after our patients?

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  • just prayed for those late doctors.

    its SAD

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  • Took Early Retirement

    Help you Clare? Yes, delighted to.

    However, I AM going to write to the CID in Manchester, which seems to be the GMC's main hub now, with reference to this report and the Civitas one, asking them to see if the GMC can be prosecuted for corporate manslaughter. I shall probably post a copy of the letter on the "General Practice has become a cesspit" Facebook page.

    DOI- none personally, but a good friend drank himself to death a couple of years after exoneration at a full hearing, the patient's complaint having been found to be unfounded. Also daughter now studying Medicine and I don't want her to have this SHI*E organisation being in control of her life.

    Please note: ANY OF US can write a letter to the Police asking them to look into it. It doesn't have to be a long one.

    And to the GMC- who I am sure lurk here: A Merry Christmas. I hope for some of you that your next one will be behind bars.

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  • Cruel is right Clare but so has been the college's failure to act.why should anybody trust it now? Exactly WHAT are you doing to change the system though, and how much support have got from within

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  • I know two colleagues who have both been investigated by the GMC and both were diagnosed with cancer in the following year. I wonder if this might be worthy of further research too.
    Regulators are capable of wreaking enormous havoc within health care systems as well as in the lives of individuals. The whole urgent care system is driven by the sense of professional risk. Patients die and the whole health care system threatened by responses to professional risk that occur as a consequence of complaint and regulation. Suicide is the tip of the iceberg that is the unintended consequence.

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  • Nobody cares.You are on your own. Admission of weakness is a suicide note. There are no votes in it and politicians can push us around at will..We have not the shred of an effective propaganda campaign.We do not protect our own and never have.We are an unnecessarily macho and arrogant profession which partially creates some of our own problems and allows some doctors and society to abuse other doctors.
    The caring profession?.Cum scientia caritas,and all that crap. What hypocrisy.

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  • We must care. We must care for our own. When I see horrid posts on DNUK and here I feel traumatised. We must all work towards creating a more compassionate nhs and ensure that those in power remove and address the toxic destructive forces

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