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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)

  • This is a shocking revelation of the bullying and inhuman tactics used by the GMC. I wonder who regulates the GMC and their staff, is there a fitness to work process for staff there/ IF NOT IS IT NOT HIGH TIME. Thank you Dr. Coates for this information.

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  • i had problems with severe depression but was referred to the London-based Practitioner Health Program, and Dr Gerada ( ex consultant psych).

    i cannot speak too highly of it, and as they may accept out-of London refrrals, please if you are experiencing the sort of stresses described above, ask your own GP for a referral.

    http://php.nhs.uk/

    The Practitioner Health Programme is a free, confidential service for doctors and dentists living in London who have mental health and/or addiction concerns.

    Any medical or dental practitioner can use the service, where they have

    • A mental health or addiction concern (at any level of severity) and/or
    • A physical health concern that is having a negative impact on the practitioner’s mental health.

    We have contract arrangements in place to cover all doctors and dentists living in London – please contact us to arrange an assessment.

    For patients outside of London we cannot accept self referrals. NHS referrals can be accepted on a cost per case basis. See Accessing Services for details or contact us to discuss



    The service is part of the NHS but is entirely independent from other organisations.

    Please Note: In order to cope with the unprecedented demand for our service PHP is now piloting a new telephone assessment service.

    Please call the admin team on 0203 049 4504 for more information or to refer yourself to our service.

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  • It will take massive resources to take on these sociopathic scumbags. The police will not act unless there is a public outcry. Don't count on the media to help. This 'charity' has massive resources and 'members' fees to p*** up the wall to defend themselves and their senior trougher's OBE / knighthood / parasitic ambitions. It will take hundreds of thousands of pounds to push this to a Judicial Review to force a public enquiry and then potentially a need to go to the European Court of Human Rights.

    The BMA are run by the same sort. The problem IS the BMA and GMC. That's without even mentioning the other parasites the RCGP.

    Get out if you can. Immigrate or retire. Life is too short to have to deal with these tossers.

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  • Please can this article be kept alive by PULSE until at least middle of January. Don't let them bury it.

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  • This thread is an indictment of the organisation that we, the licence fee payers, have allowed our 'regulator' to become.

    My story is referring one of my partners to the GMC... he is permitted VE, and then he fires off a vexatious, unfounded complaint about me, to the GMC.

    9 months later, the GMC finds 'no case to answer'.

    My experience? An organisation that is not fit for purpose, clearly cannot cross reference information within its own departments, likely has a high turnover of support staff and, above all, wholly arrogant.

    We have allowed this organisation to become an ersatz intelligence agency... and, from a personal perspective... this comes across in every communication.

    The sooner this 'regulator' is stripped back, reviewed and re-built from the ground up. The better.

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  • The problem is that it is not only those who have been referred to the GMC or whistleblowers who are affected, although they are clearly the most catastrophically affected group.
    There is an uncaring attitude towards doctors generally which treats us as having no human needs at all. We don't need sleep, food or drink, we should put our patients and every other person/ organisation above our own needs, and we are subjected to experiencing other's pain and suffering with no support whatsoever.
    As Clare says, we are hard wired to be unkind.
    Normal human beings are supported and given counselling when they experience something traumatic, counsellors have mentoring sessions.
    When I first qualified, there was a public understanding that the job was difficult and some sympathy. That has almost disappeared from a public perspective and the demands on us are unacceptable.
    My heart goes out to those who have suffered and lost family and friends.
    Clare, do you have any statistics for the rate of mental health generally and suicides in particular for doctors compared with other professions?
    Yes, the GMC needs to change and this would be a first step, but the bullying of doctors and total disregard for their needs has to stop across the board.

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  • I was referred to the GMC by a patient after making a safeguarding referral. I was accused of making a malicious referral and of altering patient records. The GMC could have looked at the records and found out both these were untrue but they never did. There was definitely a sense of very guilty until proved innocent. It took 18 months for me to be completely cleared. In this time, the patient attempted to blacken my name throughout the area and published my photo on facebook, her friends then commenting that I needed " a crack in the face". Eventually the police intervened and issued a warning under the harrassment act. I suffer from a chronic illness which was exacerbated by the stress. I would have to say that the case officers I dealt with at the GMC were as helpful as the rules allowed but the entire process is very flawed. With the support of my family I got through it, and my heart goes out to the families of those who didn't. BMA and RCGP, now is the time to finally get some backbone and do something to protect your colleagues.

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  • During my paediatrics house job I was looking after a very severely handicapped boy who had never made it out of hospital. At the age of about 10 months his condition deteriorated and he died. This was expected but very sad.
    I had been on call continuously since Friday morning, had been up all night on Friday and Saturday and he died on Sunday afternoon.
    After he died, his parents complained that I had not been sympathetic enough. I am quite sure they were right and I received a severe bollocking from my consultant on the Monday morning.
    However, no one asked me if I was ok. No one recognised the fact that I had been working for about 56 hours with only 2 hours sleep and no food except a couple of slices of toast stolen from the ward. ( I believe this is now not allowed!)
    I am quite sure that many episodes like this hard wired me to ignore my own physical and mental health needs and made it entirely clear to me that my needs did not matter to other people in the hierarchy.
    I have worked with some incredibly kind and caring people individually, but the system right to the very top at DOH is culpable for the disgraceful way doctors are treated.
    Money before patients before doctors.

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  • Ps. I continued my " shift" until Monday at 7pm so a total of 84 hours with only about 5 hours sleep.
    Although these shifts have been outlawed, the effects have been permanent.

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  • Una Coales. Retired NHS GP.

    @7:11 junior doctor I am so sorry to hear of your inhumane plight. You were very brave to report the doctor to the GMC but instead the GMC appears to have used his seniority and position in the trust against you. This echoes of warnings I would hear as a junior doctor in hospital decades ago of keep your head low, be a grey man, you didn't see or hear anything and for God's sake, do not say anything for if you do you will commit career suicide! I wonder what type of doctor the system is breeding?

    It is sad that the one organisation you as a junior doctor had hoped would do the right thing has let you down and worse still seems to have targeted you for health reasons, created by the sheer frustration and injustice of their own actions.

    If you look at the big picture and view the NHS, GMC, etc as a 'communist socialist system', it all makes sense, ie that you follow the rules, work hard, report those who may endanger patients as you are told to do by the GMC codes of good medical practice but then find that some in positions of power can never be questioned, can never be brought to account, are effectively 'protected'. A sense of fear is bred and the GMC seems to become a form of thought police.

    And if you view MPS, MDU, MDDUS as for profit private companies, it too makes sense that they now wish to pick and choose who they represent (cherry pick) to ensure profits for their company directors. Doctors lives seem expendable is correct. Profits before paying clients or system users.

    Once you view this bigger picture, then you can make an informed decision. In the GMC referral letter was a number for counselling for any doctor who has been referred. I used this for the first referral and a kind doctor spoke to me and said quite astonishingly, brace yourself as this will not be the last. He was right. If you are one who speaks up and does not keep your head buried in the sand, the system will try other means to silence you. Odd as in NY, brave doctors were called Gods and Goddesses and made into consultant surgeons/attendings and you were chided if you were weak and silent! They wanted you to show leadership, character and integrity!

    Think of how to escape the system, how to live, how to walk out of your rat's cage? You did your duty by informing the GMC and that is where your duty ends. If the GMC allows an alcoholic abusive doctor to continue to treat patients, then they now assume responsibility for his actions, not you.

    Try to let this all go if you can. Decide whether you wish to stay in medicine or think of another career choice that is side by side with medicine, like teaching, medicolegal law, or be bold and learn how to plaster and do plumbing and start your own property/building business. There are 100s of jobs out there that fall outside the 'soclalist' system. One person cannot change the system. The system has to break down as communism did, due to economic collapse and it will. Or if you love medicine, then retrain in Canada or Australia.

    As for John's letter to CID. Well done for taking action. However having watched how Establishments may 'protect' each other..or as one High Court Judge said 'I have to think of the consequences of my decision', I doubt this will take off and instead it may be buried.

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