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‘No evidence’ that GPs’ race, sex and age affect tribunal decisions, finds GMC study

There is no association that doctors’ characteristics influence the seriousness of regulatory sanctions, new GMC research has evaluated.

The GMC peer-reviewed research, published in BMC Medicine, looked into the regulatory process of 1,049 doctors – 29% of which were GPs – referred to the Medical Practitioners Tribunal Service (MPTS) between June 2012 and May 2017.

The cross-sectional research concluded that contrary to ‘long-held beliefs’, there is no ‘systematic’ association between a doctors’ characteristics, such as age, race, sex, domestic/international primary medical qualification (PMQ), and the seriousness of the MPTS case.

However, the outcome of MPTS decisions was ‘consistently’ linked to doctors’ engagement during hearings, and those who failed to attend or did not have legal representation led to more serious outcomes.

A high court previously said negative conclusions can be drawn if doctors do not testify or give evidence in their disciplinary tribunal.

The study said that the relationship between age or location of PMQ and the seriousness of the MTPS outcome disappeared once the factor of attendance was included.

Researchers also said that the area of practice for doctors did not influence the severity of sanctions, apart from specialists, who tended to receive milder outcomes.

The study evaluated: ‘There was no systematic association between the seriousness of outcomes and the age, race, sex, domestic/international qualification, or the area of practice of physicians, except for specialists who tended to receive outcomes milder than suspension or erasure.

‘Crucially, an apparent relationship of outcomes to age or domestic/international qualification disappeared once controlling for hearing attendance. Both non-attendance and lack of legal representation were consistently related to more serious outcomes.

Researchers concluded: ‘All else equal, personal characteristics or first qualification place were unrelated to the seriousness of regulatory outcomes in the UK. Instead, engagement (attendance and legal representation), allegation type, and referral source were importantly associated to outcomes.’

Responding to the research, GMC chief executive Charlie Massey said: ‘Given the strong link between more serious outcomes and doctors not attending or having no legal representation at tribunals, we are exploring how we can encourage doctors to engage with the hearing process more.

‘We are also continuing our work to tackle the disproportionate representation of some groups of doctors in referrals to a tribunal hearing. We know that doctors who are black and minority ethnic, male, older or non-UK graduates continue to be referred more often to our processes.’

Multiple medical defence organisations responded to the study, highlighting the need for GPs to register for memberships to cover them during MPTS hearings, with one MDO saying membership should be made ‘compulsory’.

The GMC’s major Fair to Refer report evaluated that the high number of BME referrals to GMC investigations was likely to be driven by poor employer support, isolation and poor induction.

The regulator’s other commissioned report recently found that GPs’ working conditions are often ‘lonely’ and is harming relationships with patients.