GMC to update GMP with pledge to take context into account in FTP investigations

The GMC has proposed a number of amendments to its Good Medical Practice guide, including a commitment to consider which ‘context’ a doctor was working in if a complaint arises.

The updates also include replacing existing doctor duties with 12 statements registrants should ‘commit’ to, such as being ‘open and honest when things go wrong’.

The GMC said that ‘if medical professionals apply the guidance, act in good faith and in the interests of patients, they’ll be in a good position to explain and justify their decisions and actions if a concern is raised about their practice’.

It also proposes to remove the ‘threshold’ statement for when it would launch a fitness-to-practise investigation, which currently says: ‘Only serious or persistent failure to follow this guidance will put your registration at risk.’

Instead, the GMC explains it will act ‘where there is a risk to patients or public confidence in medical professionals, or where it is necessary to maintain professional standards.’

The updated document also attempts to give ‘a fuller account’ of ‘factors considered by GMC decision-makers when they’re assessing risk’, including ‘the context in which the registrant was working in’, the GMC said.

The new draft of GMP says: ‘The professional standards describe good practice, not the thresholds at which medical professionals are safe to work.

‘When assessing the overall risk to public protection posed by a medical professional, through our fitness-to-practise process we consider the extent of their failure to meet the professional standards, factors that increase and decrease the risk to public protection (including the context in which they were working), and how they responded to the concerns raised.’

The proposed changes to GMP, which was last updated in 2013, are subject to a 12-week consultation, starting today.

The GMC said the proposed changes were the result of ‘months’ of working with GP and patient representatives and other stakeholders to bring the guidance up to date.

Launching the review last year, it had said ‘patients’ expectations and the way medical professionals deliver care has evolved’ since the last update of the GMP in 2013.

The GMC had also set out to see ‘if we can do more to address the inequalities and systematic issues that exist in medicine’.

This followed the high-profile case of Dr Hadiza Bawa-Garba, who has now been fully reinstated to practise medicine after the GMC took legal action to have her struck off – despite working amid overwhelming systemic pressures when a child died.

The proposed changes also include:

• a new ‘zero tolerance’ policy for sexual harassment;
• a duty for doctors to act if they become aware of workplace bullying; and
• a new duty for doctors to make ‘reasonable checks’ that information they give out in all ‘written, spoken and digital communication’ is not ‘misleading’ (including via social media).

Urging GPs to respond to the consultation, GMC chief executive Charlie Massey said it is important that the guidance is ‘as relevant and realistic for doctors working in primary care as for those employed elsewhere’.

He said: ‘For that reason, we really want to hear from GPs as part of our consultation. 

‘We know that GPs continue to face huge workload pressures and we want our guidance to provide a helpful framework to navigate professional and ethical challenges, without creating any additional burdens.’

GP indemnity provider the MDU said it would ‘scrutinise’ the proposed changes before responding to the consultation.

‘Good Medical Practice is at the core of everything the GMC does – setting the professional behaviours and care standards it expects of all doctors practising in the UK,’ MDU director of medical services Dr Caroline Fryar said.

‘It is one of the central tools used by the GMC in its fitness-to-practise processes, so every paragraph and every single word in the guidance document matters.’

Dr Fryar noted that the consultation ‘is proposing significant changes whilst also making a number of additions’, adding that ‘regulations, sets of rules and guidance documents must be compatible with the realities of doctors’ daily working lives, and support them to get on with the job of safely caring for patients’.

‘The MDU will scrutinise this proposed revision of the guidance very carefully,’ she added.

In January, the GMC updated its temporary pandemic guidance to take into account ‘sustained fatigue’ experienced by GPs when assessing fitness-to-practise complaints.

Last year, doctors requested clarity after the GMC said criticising the Covid vaccine or other pandemic measures via social platforms could leave them ‘vulnerable’ to investigation.

The GMC also warned last year that GPs are the most likely to be at a high risk of burnout compared with other doctors.