In charts: What GPs say about written reflection

Doctors' attitudes towards reflective practice have changed since Dr Hadiza Bawa-Garba was struck off the medical register in January. GPonline highlights GPs' concerns about written reflection.


Dr Hadiza Bawa-Garba was struck off on 25 January after the GMC won a High Court challenge against a medical tribunal ruling that she should be suspended for 12 months. The GMC's decision left many doctors fearful that written reflective notes could be used against them in court, despite Dr Bawa-Garba's own e-portfolio reflection document not actually being featured in her criminal trial. 

Soon after the High Court ruling was announced, former health and social care secretary Jeremy Hunt joined a wave of criticism of the GMC's handling of the case, saying he was 'deeply concerned' about the possibly unintended implications for learning and reflective practice. As a result, Mr Hunt ordered his chief clinical adviser Professor Sir Norman Williams to lead a 'rapid review' into GNM in healthcare.

The Williams review ultimately rejected calls for doctors' reflections to be given legal protection. However, according to a GPonline's pollmost GPs believe the government should legislate to prevent doctors' reflective notes being used against them in court.

Concern over the handling of Dr Bawa-Garba's case has also led to widespread change in doctors' attitudes towards reflective practice, with most GPs saying they no longer feel it is safe to record reflective notes in writing.

The case has also led to many doctors changing how they record reflective notes. GP appraiser and GPC sessional subcommittee chair Dr Zoe Norris said she had noticed the change in appriasals she had conducted. Speaking in her capacity as a trainer Dr Norris told GPonline: 'Some GPs are writing down bare outlines, and asking to discuss details in the appraisal meeting. Others haven’t written down a huge amount until we have talked through their concerns during the appraisal. There is a lot of anxiety, fear and mistrust.'

The GMC is currently working with the Academy of Medical Royal Colleges, the Conference of Postgraduate Medical Deans (COPMED) and the Medical Schools Council (MSC) to produce guidance on reflective practice, which is due to be published in autumn.

Read more
> 70% of GPs say writing reflective notes is 'unsafe'
'Anxiety, fear and mistrust' surround written reflection
> Reflective entries – what do the MDOs advise?

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