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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 think the message has got out that it isn't worth being a GP in the UK any-more hence the recruitment and retention crisis. The GMC actions and continued public, political response and lack of direction by BMA and RCGP adds to the general low morale. Do-gooders and bleedin hearts also don't help. It's every man (or woman) for themselves.

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  • It appears that the plan is to run primary care with Noctors and two year course people. The people who run the NHS seem to have decided this. At least there will be this enormous East German Stasi-like machine to police it.

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  • Some further thoughts on what's wrong with the GMC (beyond the obvious) and what might be done about it:

    Magna Carta Medicorum: http://badmed.net/bad-medicine-blog/2015/01/magna-carta-medicorum.html

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  • Magna Carta Medicorum:-

    Investigatory inquiries and the Tribunals of Inquiry (Evidence) Act 1921:

    Bradley & Ewing in their Constitutional & Administrative Law (Longman, 13th ed., 2003)
    wrote:

    "The task of a tribunal of inquiry is to investigate certain allegations or events with a
    view to producing an authoritative account of the facts, attributing responsibility or
    blame where it is necessary to do so. Tribunals of inquiry do not make decisions as to
    what action should be taken in the light of their findings of fact, but they may make
    recommendations for such action. The chairman is normally a senior judge, assisted
    by one or two additional members or expert assessors (p683)."

    Parliamentary Commissions of Inquiry:

    "Proper parliamentary scrutiny should include the ability to establish and undertake
    inquiries into significant matters of public concern. Parliament has, in the past,
    conducted investigations of this kind—and, as the great forum of the nation, should
    be expected to do so."

    http://www.parliament.uk/briefing-papers/SN06392/parliamentary-commissions-of-inquiry

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  • Abdul QADRI

    If GPs are faced with the hostile & toxic environment in the form of GMC, I am not surprised to see the upward trend of suicides in this noble profession. NHS has become the battlefield for the political parties & GPS are in the news headlines all the time. We are already seeing claims & counterclaims by Labour & Conservatives about the chances of seeing GPS after 5 years. Patent expectations have gone sky high & GPs are supposed to open 12 hours a day & provide designated Gp based care 24 hours a day. Family life gets messed up by increased stresses at the work places. For Heavens sake GPS are human & can make mistakes. The problem is medical negligence insurance companies are praying on vulnerable patients & advertise their services & financial incentives to the patients. GPS themselves pay heavily for their defence organisations but as soon as a compliment is brought against the doctor , tone of defence team changes. It would have been far better if GMC would behave like a BIG SUPPORTING BROTHER. For example if say X Doctor is struggling with drugs , alcohol or domestic problems, can he or she ever dare to disclose it to GMC. That is where the problem is & if GMC would act as a bridge between the patient & the Doctor in constructive manner , then we wouldn't be writing about These unnecessary loss of precious lives among the hardworking General practitioners fraternity. May their souls rest in peace & tranquility.

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  • This comment has been moderated.

  • I already wrote a post on the intolerable existence of a tribunal for doctors and how injurious to human rights it operates. In countries of Latin culture, where, by the way medical services are far better than at your NHS, the councils of Medical Boards are elected by the members; in our countries there is not a great culture of complaint (because there is more respect and we do not have stupid managers); and the cases are simply treated by a disciplinary committee, without any trial. No human right is broken.

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  • It's not just GP's who are affected and leaving in droves, it's hospital doctors too. We should be working together, as doctors from all branches of medicine, against this.

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  • Trial by Media for doctors. A doctors career and livelihood can be put at risk by false accusations. Can you imagine the effect on a doctor if a situation like with Mr Pritchard, MP occurred? I've seen it happy to a respected GP. Case dismissed in court, but by then he had no GP partnership, no job and was "sinking fast".

    BBC News re the MP:
    Referring to the allegation made against him, he said "sadly, as an MP, sometimes you have a target on your back".

    "To be falsely accused of anything is an awful thing," he told reporters.

    "Of course (my accuser) remains anonymous," he said. "The law on anonymity does need to be reviewed and fairness does need to play a far greater role in these cases."

    Mr Pritchard was arrested on 2 December following an alleged incident in central London. The MP voluntarily attended a police station for questioning and was bailed pending further inquiries.

    But police said on Tuesday that he would face no further action as there was "insufficient evidence".

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  • Una Coales. Retired NHS GP.

    I have followed John Glasspool's example and taken early voluntary retirement! A year short of turning 50. I couldn't hang on. Today NHSE has confirmed they have removed me from the NHS Perfomer's list. Working as a part time locum GP, as some mothers do (some wed to consultants or other professionals may then not be the main breadwinner) is simply too high risk, even more so for IMGs! The risk of litigation is high when the system is faulty and underfunded, and patients may not be seen in a timely manner in hospitals or for that matter by the time they see their GP!

    £80/h before taxes, MPS, GMC, etc. and additional unpaid hours spent filling tick boxes for annual appraisals and a 5 yearly revalidation, just makes it not worth the chronic stress, risk of GMC and civil litigation and migraine. I used to call my NHS work as charity work as much of the pay got swallowed up in expenses.

    I am sure other mothers who work part time and are not main breadwinners, feel similarly. Sadly for younger GP mothers and for that matter male GPs who are the main breadwinners, they face a further 20 years! How they will sustain this level of chronic stress and fear of making a mistake under pressured work circumstances, I do not know. Please explore a portfolio career or emigration if you must continue to work to raise a family. Look after yourself. Some male GP colleagues seem to hit a crisis point by 53.

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  • The GMC seems to be run by stuffed dummies for stuffed dummies.

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