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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)

  • I had a colleague who lost everything just because he used a single tablet from a bottle handed in to treat another patient and was reported by a nurse
    He died a few months after a written warning
    Despite 30 years of great service and no complaints

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  • Interesting comment by Niall Dickson that for doctors "being investigated by the GMC is a stressful experience and very often follows other traumas in their lives." Do we know this and is this evidence based? Notable that Dickson is not a doctor and makes it very clear doctors (who pay for the GMC) are not the priority here. Happy Christmas

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  • Merry Christmas GMC.

    Let's hope that some of your current and past officers, on salaries greater than that of the Prime Minister, and that of most GPs, will spend the next one in PRISON.

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  • Shocking situation. My story is not so different. Psychosis at the age of 18, sacro-iliitis forcing me to change career to general practice. Diagnosis 'bipolar 2003'. Still , somehow, you soldier on. Personally, I do not give a dam what everybody else does. What one does is a matter of their own conscience. I know I am doing and have done my best, despite difficulties. The GMC is only a collection of fallible humans, let's face it. One can only look after your fellow human doctors as best as you can. The interesting thing, however is, that the GMC feels that they could strike doctors off for the rest of their lives all over the world (...). Well , I am sorry, who has got delusions of grandeur.

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  • Sounds like the GMC has to stop. Full stop.

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  • This Article by Joe Davis has become the most commented piece of reporting on Pulse this year, by far, perhaps in its online history.

    Yet the GMC’s internal report did not make the January hard copy issue of Pulse nor is it mentioned in the Editor's blog:-

    '2014: a year to forget?'
    http://www.pulsetoday.co.uk/2014-a-year-to-forget/20008816.blog

    Does the Editor wish to forget it? As the various Ministers, Judges and MPs are going to be continuously reminded of the plight of their Doctors, as a result of this publication, in the forthcoming New Year.

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  • Wow! How did I miss this article? I saw it just now after a good friend pointed it out to me.

    Una, thank you for bravely making so many posts and letting many people here know the real facts. As someone mentioned in one of the comments , this ` Emotional Resilience coure` that the GMC is offering is like covering the brickwall with a blanket before we bash into it. Maybe no / less blood afterwords, but the pain is the same. How much better for the GMC to ensure that those found innocent are compensated for EVERY single penny of lost earnings and reinstated in their jobs. Just washing their hands Pilates style at the end is not really acceptable. I hope the newly created ResilientGP group will soon become a power to reckon with and will be areal union for doctors. Waiting to see how the action by Dr John Glasspool will be managed. I loved medicine once and stil do, but if I win the Lotto tomorrow, I am outta the swamp that medicine has become pronto. Its not worth sacrificing ones life for medicine.Be like the doctors in the US folks. Treat work as just that...work...and collect top dolars. They have Physician suicides too, but at least those that want to quit have enough of a bank balance to do so. Sad day for emdicine.

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  • Una, once again, well done on standing up to inustice and not crumbling under the immense pressure that was placed on you to silence you. The fact you are still standing is testimony to your resilience. May the rest of your life be a happy one when you manage to quit whilst you are ahead , and be able to consider having beena doctor in one part of the world as a mere bad dream .

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  • I suspect that the editor, like most sensible people, had his Christmas copy and January magazine sorted in advance so that he could enjoy the rest of the festive season like everyone else.
    Good on him!
    However, big noise needs to be made in January or the release of this just before Christmas will have had the desired effect.
    We must not allow that to happen.

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  • Imagine how much was so easily covered up before the days of the internet, now more are willing to speak out anonymously or not about all sorts of abuse ...this current campaign must not be buried! What are the common themes......one significnt one is the way those who reach positions of power move around and take their culture with them. Once part of the network individuals have difficulty speaking out for fear of consequences.and importantly they are now part of the in group, have made friends as well as colleagues .it is emotionally difficlt to speak out about then.any emotional resilience course needs to address that....will it be able to scrutinise itself?

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