The GMC has set itself a target to ‘eliminate’ the disproportionate complaints received from employers about ethnic minority GPs by 2026.
The GMC said it will do this through a number of steps, including ensuring that more cases are resolved locally, making workplaces more ‘inclusive and supportive’, amending the referral form and helping employers to understand the threshold for fitness-to-practise referrals.
The GMC told Pulse that, overall, doctors from ethnic minorities are twice as likely to be referred to the GMC by their employers for fitness to practise concerns than white doctors, but that the data is ‘more stark’ in general practice, as BAME GPs are ‘nearly three times’ as likely to be reported to the GMC than white GPs.
It added that GPs who gained their medical qualification outside the UK are ‘more than three times’ as likely to be reported than those trained in the UK.
To help tackle the inequity, GMC chief executive Charlie Massey told Pulse that the body will ‘step up’ its work with responsible officers, who are often placed within CCGs and refer cases to the GMC, in order to ‘to help them understand better when they should be trying to resolve things locally’.
He said: ‘The more things get chucked over the fence to the GMC, quite often, the more intractable and difficult to resolve they are, so we have been putting a lot of focus on how we can support local officers to handle more things locally and resolve those better.’
Mr Massey said the GMC has been working on this already but said ‘we want to go a lot further’, adding that the body has ‘massively increased’ its outreach capacity in recent years by positioning GMC workers locally to work with responsible officers in primary care.
The GMC said it is also working on developing an amended referral form which asks organisations to include steps they have taken to ensure that a referral is appropriate before submitting it to the GMC.
It will also focus on ‘supporting organisations in building understanding of GMC thresholds for fitness-to-practise referrals to help ensure fairer outcomes’.
Mr Massey told Pulse that the GMC is also talking to NHS England about how to improve the ‘volume and consistency’ of inductions for doctors provided locally – an issue of particular importance for GPs from overseas.
He said: ‘How you land in that role and how well supported you feel can make such an enormous difference in terms of your ability to succeed and build your confidence.’
He added that one of the advantages for primary care is that there are ‘more sophisticated and more formative appraisals’ that take place in this sector compared to many other parts of medical practise, and ‘that provides a great environment for having those conversations that enable people to learn and develop’.
The GMC also set a target of ‘eliminating discrimination, disadvantage and unfairness’ in undergraduate and postgraduate medical education and training by 2031.
One of the ways it said it will do this is through requiring action plans from education and training bodies ‘to ensure diversity is better reflected in all aspects of medical teaching and learning’.
Mr Massey told Pulse: ‘Most organisations, when they set themselves targets, they do so over the things they have complete control over. But these targets are a bit different because if you look at what we’re saying around fitness to practise, we’re not setting ourselves targets around what happens when cases come into our door.
‘We’re completely determined to ensure there is no discrimination in our own processes, but what this target forces us to do is work with others to improve what happens before cases come to the GMC.’
Responding to the GMC targets, BMA council chair Dr Chaand Nagpaul said: ‘A referral to the GMC can have a devastating psychological impact on a doctor, creating huge anxiety and stress and even mental illness, adding to the negative experience for many ethnic minority doctors within their workplace.
‘It is vital that efforts are made to address issues at an earlier stage, with ethnic minority doctors receiving fair and adequate support to avoid such issues being unnecessarily escalated.’
Dr Nagpaul added that it is ‘equally unacceptable’ that pass rates in postgraduate training are lower among ethnic minority doctors than for their white counterparts, with evidence showing this is not related to any lack of ability, but due to a lack of support for learning, and feeling excluded.
He said that while it is ‘good’ that the GMC has set these targets to end the structural inequality faced by ethnic minority doctors, ‘this cannot be achieved by simply chasing targets, but by wholesale genuine cultural transformation in our NHS, where there is a full commitment to equal opportunity and enabling each doctor to progress and achieve their full potential’.
The GMC announced in April that it was considering proposals to establish ‘measures and targets’ to mitigate bias against ethnic minority doctors in fitness-to-practise (FTP) referrals.
In 2019, a major GMC-commissioned review found that poor induction and employer support could be the drivers behind the high number of referrals of black, Asian and minority ethnic doctors to GMC investigations.
Last week, the GMC said it can become a ‘force for good’ in tackling the ‘shameful’ disadvantage ethnic minority GPs face with regard to fitness to practise investigations if proposed changes to legislation go ahead.