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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)

  • Really worrying . Disproportionately high suicide rate is damning of the current GMC process. Most of us are not sociopaths and really care about our patients/reputation and thus it is easy to see why this happens.

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  • Should we have an annual health check- inc mental health and burnout issues?

    We're not good at presenting ourselves for treatment at right time. We try to keep going, delay attending, often only present after something bad has happened. Having an illness is one thing- it needs treating. Perhaps we need to be asked directly about possible symptoms?

    Putting patient's or our own safety and sanity at risk because of our illnesses isn't good for anyone.

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  • Peter Swinyard

    Do I misremember an old GMC mission statement: "Supporting Doctors, Protecting Patients"?

    Oh dear.

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  • I referred myself to the GMC when I was diagnosed with bipolar affective disorder in 2009. The GMC "stress" imposed has been the main trigger for my relapses and me contemplating suicide.

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  • Anonymous | GP Partner | 19 December 2014 11:36am

    Unfortunately all too common

    I wouldn't spend too much time pretending to have a relationship with pharmacists. I meet a lot now and there are many who would love the chance to cause trouble for a doctor. Far too many malicious types out there!

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  • Having just received the gmc letter, the time of the letter is very concerning and implies a "you are guilty and the consequences for you are very serious" despite doing nothing wrong. Vectitous complaints written well enough and in enough detail will always result in ftp investigation. 2 months and waiting. The stress is awful.

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  • Having gone through all comments, I fully agree that there are far too many malicious complaints against GPs across the boar. From colleagues, other healthcare prof and highest number from our public. The public needs to be informed about the doctor shortages, and how we are struggling to provide health care.

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  • There are some very talented, productive and safe doctors with Bipolar Affective Disorder and other illnesses.

    I know several high-functioning Consultants, GPs, Registrars and Nurses all with eminently treatable chronic illnesses. 1 in 4 people have mental health problems at some point, stress of working in the NHS must send that higher. If the GMC imposed an unnecessary and unwarranted burden of scrutiny, stress and fear in 1 in 4 doctors ask yourself in what state would the NHS be in? More importantly what is the likely effect on "patient safety" posed by working clinicians traumatised past or present by GMC investigations.

    The GMC may wish to think hard about whether they serve the public interest and patient safety by their "chosen" actions against a doctor. We choose how to treat fellow human beings and yes that means due process, but it must be proportionate.

    Could there be a fund (even a voluntarry charity) to help these doctors keep a roof over their heads and feed their children? Not all doctors are rich, the average wage of a salaried GP is £54K.

    Burying this bad news the weekend before Xmas when the report has been ready for a year is despicable. That will count against the GMC when I hope "BMA Legal" launches a Corporate Manslaughter investigation. This report should be the first step towards a full judicial review.

    Fair trials please. Compensation awards where no case to answer, cleared or disproportionate consequences.... This whole situation for doctors and their regulator must be fully revolutionised for safety and sanity of all doctors.

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  • I am reading the report:

    More than half of those doctors who committed suicide (54%) had been referred to the GMC by their employer.

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  • Una Coales. Retired NHS GP.

    Peter I spotted that too and 11% who committed suicide had self referred themselves which suggests that the GMC knew they were 'vulnerable' whether it be alcohol addiction or mental health. Even more reason to offer more support rather than treat them like a criminal?

    And to the GP who is still under GMC investigation 3.5 years and ongoing, if I were in your shoes, I would do a risk benefit analysis. Is it worth the damage to your health and wellbeing to be under years of chronic stress? Remember there is no compensation system for victims who have been cleared by the GMC after 5 years+ of investigations.

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