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GMC to spare doctors with mental health problems from a full investigation



Exclusive Doctors who have mental health problems will be spared from full GMC investigations ‘wherever possible’, under sweeping new proposals around investigations announced today.

The proposals – to be ratified by the GMC board – will see investigations against GPs with mental health conditions carried out  ‘only where necessary’ and treatment begun instead.

The GMC has revealed a raft of new proposals in a bid to make its fitness-to-practise process more ‘sensitive to the needs of vulnerable doctors’, following recommendations by Professor Louis Appleby – who was appointed by the GMC in December last year to carry out an independent review of its fitness-to-practise (FTP) process.

They come after Pulse has published a series of articles about the pressure that GMC procedures put on vulnerable doctors, including a report that found that 28 doctors had died by suicide while under investigation and that 13 additional doctors died while the regulator contemplated action. Another study showed that complaints against doctors ‘may do more overall harm than good’.

Pulse has also revealed that thousands of complaints were being held secretly by the GMC and that only one anonymous complaint about a doctor has been upheld in two years.

In a statement, Professor Appleby said the high number of investigations but the low number of imposed sanctions ‘do not justify the impact on individuals.’

In future, he said, doctors going through FTP who are ill ‘need to be treated, not punished’ and that ‘investigations in which health is the root of the problem should avoid full investigation whenever possible, and move instead to early treatment.’ 

Professor Appleby looked at ‘every stage’ of the investigation process as part of his review, and assessed how it could be more caring towards vulnerable doctors. 

He had earlier claimed that there is currently ‘too many investigations’ – a claim that has been vindicated after his review found that only ‘13% of investigations lead to a sanction being imposed’.

Under the proposals, the GMC said it would:

  • Ensure investigations are only carried out where necessary, particularly in cases involving concerns about health;
  • Come to a swift conclusion to those cases that relate to a doctor’s health and are deemed necessary, being as supportive and consensual as possible, and pausing the process where appropriate, to allow particularly unwell doctors to get treatment;
  • Raise awareness of the need for commissioning arrangements to be developed to support all doctors (not just GPs) in accessing confidential mental health treatment;
  • Engage with Responsible Officers to ensure that concerns are dealt with at the right level, and resolved locally where possible;
  • Develop a co-ordinated approach in health from start to finish and greater co-ordination of correspondence from the GMC in all types of cases;

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.

But with these new proposals the GMC aims to make its FTP process more ‘sensitive and compassionate’. 

louis appleby v2 SUO

louis appleby v2 SUO

Writing in his blog today, Professor Appleby, said: ‘Two principles have guided my approach to this work. First, doctors who are ill need to be treated, not punished – investigation is frequently punitive in effect, even if that is not the intention. Secondly, suicide is not confined to those who are known to be mentally ill – it can be those who are thought to be coping that are most at risk – so reducing risk is a task for the system as a whole.

He went on to add that there is a 40% chance that a doctor will be invesigated, but many of these do not lead to a sanction. 

He added: ‘There should be fewer investigations – the current rate of 2,750 per year translates into a 40% chance that doctors will come before the regulator at some time in their careers.

‘Yet only 13% of investigations lead to any sanction – such a low figure does not justify the impact on individuals. Most complaints from patients about a doctor’s performance could be dealt with by the doctor’s employer.’