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GMC: A more ‘compassionate’ regulator?

The GMC is taking new measures to soften its approach to vulnerable doctors, finds Joe Davis

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GMC 3x2

The GMC is trying to give itself a makeover, in the hope of becoming more ‘compassionate’ and ‘sensitive’.

Pulse has learned that the regulator has appointed an independent expert to ‘pinpoint’ ways in which it can ensure that its fitness-to-practise (FTP) processes offer greater support to vulnerable doctors.

Professor Louis Appleby – professor of psychiatry at the University of Manchester and chair of England’s National Suicide Prevention Strategy Advisory Group – has been recruited by the GMC to look at ‘every stage’ of the FTP investigation process and assess how it could be more caring towards vulnerable doctors.

And the GMC’s chief executive, Niall Dickson, tells Pulse in an exclusive interview that he recognises the regulator has an ‘absolute moral obligation’ to protect doctors as well as patients, conceding that it is time for its FTP procedures to be more ‘sensitive’.

GP leaders have welcomed Professor Appleby’s appointment as a ‘step forward’, saying it reflects a change of approach from the regulator.

The appointment follows what has been an uncomfortable 12 months for the regulator, with a handful of studies suggesting the FTP procedures must be improved.

A GMC-commissioned review at the end of 2014 found 28 doctors had died while under investigation and concluded that doctors could become ‘marginalised’ during the FTP process and receive little support or compassion from the regulator.

Another review published last year said 13 doctors died while the GMC ‘failed to act’ after concerns were first raised about the high numbers of doctors dying by suicide while under investigation.

We want to be as compassionate as we possibly can be with all doctors

GMC chief executive Niall Dickson 

It said the GMC should have ‘immediately ceased’ its fitness-to-practise cases and ‘urgently reformed’ processes after concerns were first raised in 2012.

Another study last year went as far to say that complaints against doctors ‘may do more overall harm than good in terms of patient care’, as the majority of doctors who are reported to the GMC are found to have no significant case to answer.


Toxic impact

The shocking study of 8,000 doctors by researchers at Imperial College London highlighted the toxic impact the GMC’s complaints procedure has on the mental health of doctors – with one-sixth saying they had suffered severe or moderate depression following a complaint, and many others reporting anxiety and even suicidal ideation.

Perhaps, though, the most worrying finding from the study was the adverse effect on patient care. Some doctors admitted they changed the way they practise following a complaint, with one in four saying they had suggested invasive procedures against their professional judgment.

Since then, the GMC has formulated an action plan to implement recommendations from its own review, and says it has already changed the tone of its correspondence with doctors who are under investigation.

But it intends to go further. Mr Dickson tells Pulse: ‘We’ve already started mapping our process very carefully and look at each individual stage that we go through. And what we want Professor Appleby to do is to review that process and advise us on further things that we can do within our current legal powers.’

He says that while the GMC’s core duty to protect patients will remain, there is an important role to be played in providing support to doctors who are under investigation.

‘We absolutely want to be as compassionate as we possibly can be with all doctors, not just those who have mental health problems, but all doctors who are in our FTP procedures.’

GP leaders have welcomed the move. Former RCGP chair Professor Clare Gerada, who is medical director of the Practitioner Health Programme – a support service for sick doctors – told Pulse that the announcement of Professor Appleby’s review ‘shows a shift in the last two or three years at the GMC’.

She added: ‘I think it is good news for everybody – because the pendulum of regulation that is anti-doctor is beginning to swing back to a more healthy place, where doctors can be mentally ill – yet trying their best in very difficult times.’

Professor Appleby has already tweeted that he has heard from ‘several doctors’ since Pulse revealed his appointment and that feeling ‘guilty until proven innocent’ was a common theme.

The number of doctors undergoing FTP investigation has risen significantly, by 54% since 2010. But more than half of cases result in no action being taken against the doctor – leading to further calls for the system to be reformed.

New GMC figures show the number of complaints against doctors remains high, with 8,884 in 2014 and 9,093 the previous year.

But the proportion of investigations that lead to no action being taken is increasing, reaching 48% in 2014, compared with 44% in 2013.(3)

Empty complaints

Meanwhile, figures obtained by Pulse from the GMC, reveal that only one anonymous complaint against a doctor has led to a sanction over the past two years.

The figures, which are based on complaints made from 2013 to 2015, show that of 438 anonymous complaints, 97 led to an investigation being launched by the GMC – but only one of these actually led to a sanction being imposed. GP leaders say this raises serious concerns about the weight given to anonymous complaints.

BMA chair Dr Mark Porter told Pulse he was concerned about the implications of the figures.

He said: ‘Doctors strive to deliver the best possible care to patients and it is right that we have a robust system that ensures any problems that do occur are addressed. However, it is clear from these figures that, in the vast majority of cases, doctors are exonerated when complaints are made.

Dr Porter added: ‘Complaints procedures need to be efficient and fair. At present, doctors who are the subject of a GMC investigation can be left in limbo for months, or even years, before an outcome is reached. The stress that this causes to those affected can have life-changing effects.

‘While doctors always want to learn from clinical mistakes, it’s also important that the GMC learns from the way its systems operate. It is clear from these figures that anonymous complaints seem to be given undue weight in the complaints process.’

But Mr Dickson points out that the GMC is often legally obliged to act on every single complaint, even if in many cases no action is subsequently taken by the regulator.

He explains: ‘From the doctor’s point of view, that’s awful, because we’ve subjected [them] to all this anxiety over a period of time. From our point of view, we do it because the law says we have to do it, so what we have to do is try to find every way we can to reduce that amount of time.’

Mr Dickson adds that Professor Appleby will be tasked with recommending any legal changes that the GMC can lobby the Government to bring forward to ‘make the system better’.

The medical profession will be hoping he does a thorough job.

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Readers' comments (29)

  • If you are Black Ethnic Minority, irrespective of country of qualification, a complaint against you will lead you to a Fitness to Practice investigation. This adds to the stress if you are working in a deprived area. GMC has not appeared to be a fair organisation in all the years I have worked in the NHS

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  • @ Dr Menon above

    100% agreed; The GMC is in serious need of an attitude adjustment. BME doctors have been complaining about this vile institution for decades and its largely fallen on deaf ears...... however it seems over the past few years that the GMC have begun persecuting any doctor regardless of race, colour creed etc and hence the issues have been more in the headlines. We are now seeing doctors dying and enough is enough;

    There needs to be change now!!

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  • Always shocked me that anonymous complaints are given any credence at all.
    They should be treated like graffiti- something to be removed and ignored.

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  • 1% of anonymous complaits and 5% of non anonymous complaints leads to sanctions of any sort! The hit rate should itself clearly tell anyone who is not an idiot
    1) your investigating to many doctors
    2) this needs to stop
    3) you need to increase the bar A LOT before an investigation is triggered
    4) ignore all anonymous complaints
    But no one said anyone with brains worked at the GMC. Just witch hunters. Anyone who has read The Crucible by Arthur Miller will see a straight reference.

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  • the cynic in me wonders if the GMC are worried that there may be personal legal action against them after that damming report which suggests they failed to act and so are trying to make efforts to appear reasonable.
    it doesn't fool anyone. we need more investigations into the way the GMC has been operating as they are not a fair organisation at all.

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  • There is no turning back. The doctors have died. It is a done deal.
    Every year we are gathering more evidence.
    Every year we are getting nearer to justice.
    Evidence is being prepared on EVERYONE that has supported the perpetrator.
    The conspirators are just as guilty.
    This includes any and all acts contributing to conceal the truth or otherwise protect the system causing these deaths: Censoring whistle-blowers; bowing to pressure from the establishment and selective reporting.
    Or getting involved in attempts to create mitigation for the accused (see new sentencing guidelines) by pretending to assist or support the victims: Setting up fake programs purported to be for the health benefit of doctors, or employing Psychiatrists under a Pinocchio delusion.

    Part of the DECEPTION is making this an issue about “vulnerable doctors”.
    You cannot fool everyone any more.
    It is not about doctors at all, it is about an Agent of the State that has killed Citizens of the State.
    Plain and simple.
    This is a legal issue.
    It is against International Treaties.
    It is illegal and someone will have to answer for this in Court.
    FIFA got away with it for some time, so did the Nazis …
    but the deeds have been done, the evidence are there, the GMC will never spin out of this one.
    They have gone too far.

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  • Editor, be careful what you do. It is being noted.

    There are many families now who do not share Christmas with their loved ones.

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  • Can pulse get the names of all drs who committed suicide? or if we can start a charity to support their families. Also talk to their children, tell them that their parents did a great job saving lives. Its the system that killed them. People who are responsible for their deaths are still enjoying their lives and getting pay rise. Or we can all do eprayer (online prayer) to get justice from God. If God exist they will get justice, otherwise stop promoting 5 stars churches, 5 stars temples, 5 star mosques, 5 star Gurudwaras.
    We dont need a God that bring no justice to their followers.
    In the same way we dont need criminals in our lives and in our society. I am glad I dont work in NHS anymore. But I still hope and want to work for a healthy society.
    can you please boycott all the big bosses who are the source of our pain and boycott their families where ever you see them.

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  • I would contribute to such a charity to support those families left. I have also left the clutches of the GMC but we need to remember the way they have utterly betrayed our profession and those working in it.

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