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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)

  • Una Coales. Retired NHS GP.

    @Alison I feel your pain and trauma. It does stay with you but think of it as surviving a time in NHS medical history when training was brutal and inhumane. Now we have an EWTD which is supposed to protect junior doctors but from what I hear, some managers may find ways around this directive and threaten juniors if they speak out.

    In the early 1990s, New York training residencies had rules that no resident worked more than 24 hours on call which really meant up to 36 hours (7 am to 7 pm the next day) as one then worked the next day operating and treating admitted patients until one was allowed to go home around 7 pm. I had a kind female chief resident and her rule was that her surgical team would go home at 1 pm post a night on call and not 7 pm like other teams (so 30 hours).

    This system worked except when the hospital suddenly found itself short staffed if a junior resident who was supposed to be on call, called in sick and there was no second junior on call. Then the only other junior surgical resident in the hospital would end up covering the entire hospital for 24 hours on a Saturday or Sunday shift and this immediately put all patients in wards and ICUs at risk as the senior surgical resident was covering trauma and ER and could not help out either. One junior resident could not physically cover 100 acute surgical patients! Needless to say that experience (bleep constantly going off, running around like a headless chicken, no time to even write any patient notes in that 24 hours) will live for me forever.

    And then I was a private patient in a private hospital in London and was amazed to see one nurse cover 2 patients! Postop vitals were taken on time. Pain meds were requested and received within minutes. Food was 3 courses. The attention to detail was incredible. And most of all patients got to pick their consultant surgeons and google them as much as they liked to be reassured of their experience.

    We are seeing medicine in transition. The old system has to collapse.

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  • Great to see the action being taken by John Glasspool.hope you will post the outcome here later. Clare Gerada is still not altogether getting it,,it's ,right to support individuals who are unwell, her psychiatric background would probably favour psychological means but where is the support specifically for those going through the GMC and other organisational nightmares.....is the PhP going to take on those cases or are they too 'toxic'....Clare says 'those in power must remove and address toxic destructive forces'.how?are they going to remove themselves from power....they have consolidated their power for many decades ....a start has been made from the outside but many more need to resign from membership of toxic organisations and join totally independant ones......ones which refuse funding from the NHS which is itself a major cause of the catastrophe

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  • Thank you Una.
    My point is that my experience was just a minor example of treatment which every single doctor will have experienced in one way or another. Those who are " resilient" learn to suppress their emotions and become hardened. Our current leaders in the BMA, RCGP, CQC and GMC are of the same generation as me and will have experienced the same. Are they hardened to the suffering around them? Can they appreciate that not all doctors develop this hard shell to protect themselves? Will " resilience training" harden them up and do we want hard, unemotional doctors?
    Or do we need to look at the entire picture?
    Why do doctors sometimes do things which normal people object to? How do we look after our doctors within the system when they are showing signs of stress, rather than labelling them as mentally ill and investigating them? Why don't we prevent the causes of these problems rather than punish the victims?
    We have a system at present which creates some doctors who are unable to care or cope, put them in a situation where they will make mistakes and then punish them for doing so.
    This merri-go-round must stop for the safety of vulnerable doctors and their patients.
    We must stop expecting doctors to be all things to everyone except themselves and their families, perfect every single time and do twice more than is physically possible.

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  • The GMC should check the accusations before launching a full investigation on doctors,and puting them to their standard reassessment of doctors involved. Manty accusations by employing bodies like PCTs are based on bullying the doctors to submission,which unfortunately GMC deciding without considering the adequate response from Doctors is unjust and unfair.That will lead to depression of doctors and suicides.High Court says everyone is innocent until proved guilty

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  • The GMC introducing emotional resilince training is just admitting their inadequacies in checking on the complaints by malicious bodiesbefore exposing the doctors to their demeaning resassesment and further investigations.Everone is not guilty until proved guilty!

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  • I do not want to be trained to be emotionally resilient. I want to have my normal and expected emotions considered as normal and expected and to have doctors cared for.

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  • Someone responsible at the GMC needs to read this thread.

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  • The internal review report has been posted on the GMC website. It can be found through this link:

    bit.ly/1GxNPPi

    I have today asked the GMC for an ethnicity breakdown of those who died and killed themselves under FTP.

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  • Has anyone got any advice for alternate non clinical work for a GP that is too old to retrain within medicine but too young to retire?

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  • Anonymous | Sessional/Locum GP | 20 December 2014 1:39pm
    Whatever you do, you will be asked why you are changing careers, and then before you know, you will be dismissed; noone would take any risks hiring a 'doctor in difficulty'.

    After 3 years of investigation, even after being cleared of the charges against me by the Crown Court, the GMC decided that I should be struck off. I tried teaching English, volunteer work for ADDACTION and so many others, but even with a clear enhanced CRB, I am not employable.

    I suggest you look at either self employment/enterpreneurship or immigration.

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