GMC to reduce fitness to practise investigations to protect doctors

The GMC has committed to reducing the number of fitness to practise investigations it carries out and will allow doctors struggling with mental health concerns to 'pause' the process, under draft proposals unveiled on Thursday.

Doctors ‘particularly unwell’ with mental health issues will be able to pause fitness to practise proceedings and seek treatment, the GMC has revealed, and will be afforded interim protection during this period.

The announcement comes after the regulator faced significant criticism last year over a number of suicides among doctors under investigation.

GPC member Dr Katie Bramall-Stainer told the 2015 LMCs conference that GPs faced a 13-times higher risk of suicide during GMC investigations.

In the proposals, designed to ‘reduce the impact’ of its fitness to practise processes, the GMC committed to ‘only carrying out a full investigation where necessary’ and reducing the overall number of full investigations.

GP fitness to practise

The regulator will take steps including reviewing the current online complaints forms and directing more complaints to be resolved locally first.

The GMC currently conducts some 2,750 cases per year, meaning doctors have around a 40% chance of coming before the regulator at some point in their career.

The regulator said it would pursue a consensual approach in which the doctor and GMC agree on the course of action as the ‘preferred route within our legal powers’.

This includes exploring greater use of voluntary erasure in appropriate cases, it said.

It is also developing new guidance for staff to ensure that they can better spot the signs that a doctor may be unwell and can access expert psychiatric advice if there are concerns.

Writing in a GMC blog post, Professor Louis Appleby – who was appointed by the GMC to help reduce stress among doctors facing investigation – said: ‘Four months ago I began working with the GMC, reviewing the fitness-to-practise process with the aim of reducing the risk of suicide in doctors facing investigation.

GP stress

‘During this time many people have written to me about the effect of investigation on their emotional health, sometimes long-term, and on their careers, even when no restrictions were placed on their practice in the end.

‘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.

‘In all cases, whether or not the doctor is seen as vulnerable, the process should be sensitive. The extent of scrutiny – contacting past employers, checking case files – should be proportionate to what has gone wrong. Meetings with the doctor should help clarify what will happen next and give the GMC a human face. Agreement should be the preferred outcome.’

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