EXCLUSIVE The expert leading the GMC’s new review has questioned the number of fitness to practise investigations conducted by the regulator each year, saying there are ‘too many’ for the number of doctors in the UK.
Citing figures that show 82% of GMC investigations lead to no sanctions, Professor Louis Appleby told Pulse that there was room for a more ’consensual’ process to assess the validity of complaints against the medical profession.
Following mounting criticism of the stress the GMC puts on doctors – and following a review last year that found 28 doctors had died while under investigation – Professor Louis Appleby said that the 2,500 doctors having to go through the fitness-to-practise (FTP) process was ‘a lot’ and that he would be questioning this in his work this year.
Pulse revealed last month that renowned mental health expert Professor Appleby has been appointed by the GMC to review its FTP procedures to ensure that it is more ‘compassionate and sensitive’ to the needs of vulnerable doctors.
The GMC said that Professor Appleby had been recruited to look at ‘every stage’ of the regulator’s FTP investigation process and he would also suggest legal changes that could be made to reduce the pressure on doctors.
A review last year concluded that complaints against doctors ‘may do more overall harm than good in terms of patient care’, as the majority of doctors who are reported to the GMC are found to have no significant case to answer. But the GMC insists it is required by law to investigate.
Professor Appleby echoed this in his interview with Pulse, saying that some investigations might not be ‘necessary because every investigation carries a degree of stress for the person that is being investigated’.
He said: ’I haven’t identified a number of investigations that shouldn’t have taken place – I am looking at the pure numbers. Of the 2,500 investigations concluded in 2014… 82% don’t lead to a sanction. That to me sounds like people are going through investigations increasing their risk and distress with no outcome imposed on them.
’It makes me think that there are too many and that a consensual process and outcome should be the aim for as many processes as possible.’
Professor Appleby went on to question whether the inevitable stress a GMC investigation poses on a doctor is necessary.
He added: ’It is bound to be stressful for doctors to face investigation but there are about 2,500 investigations every year and that seems to me to be a lot given that there are 150,000 doctors in the country. So one question is bound to be whether all those investigations are necessary because every investigation carries a degree of stress for the person that is being investigated.’
Niall Dickson, chief executive of the GMC, said: ‘We agree with Professor Appleby. That is why we introduced meetings with doctors after a successful pilot to increase consensual disposal – and an independent review showed this is a much better process. It is also why we have been calling for legislative reform to take consensual disposal much further and it is why we have consistently said the process we currently have to follow is too legalistic and confrontational.
‘What is more, within the current law, that is why we have been so keen to reduce our investigation times and the number of cases referred for a hearing. In a recent pilot we resolved 70% of cases in a much faster time by making preliminary enquiries which avoided a full investigation. Speeding up cases and making the process less stressful for doctors continues to be a top priority.
‘We will work with Louis Appleby to look at anything further we can do to support doctors who are vulnerable and with him we plan to develop a set of proposals to be shared for discussion in April.’
Professor Appleby said that he hopes to conclude his review by April and pass the results to the GMC.
Are too many doctors being investigated?
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The number of doctors undergoing FTP investigation has risen significantly, by 54% since 2010. But over 80% of cases result in no action being taken against the doctor – leading to calls for the system to be reformed.
A recent Pulse investigation revealed that just one only one anonymous GMC complaint has led to a sanction imposed on a doctor in the past two years.
The BMA called for a review of the complaints system, with chair of council Dr Mark Porter telling Pulse: ’It is clear from these figures that anonymous complaints seem to be given undue weight in the complaints process.’
See more: GMC: A more ‘compassionate’ regulator?