Fitness to practise cases may remain unresolved after COVID-19 disruption

Some fitness to practise cases may ‘prove impossible to resolve’ following delays to hearings caused by COVID-19 disruption, the UK’s super-regulator has warned.

Virtual fitness to practise hearings to continue post-pandemic (Photo: undrey/Getty Images)

A report by the Professional Standards Authority for Health and Social Care (PSA) - which watches over the GMC - said regulators had found it ‘more difficult to obtain information from employers’ to conduct investigations.

The PSA warned that some regulators would ‘continue to face a significant backlog of cases’ following disruption during the pandemic, while some deliberately reduced or delayed cases.

The report said virtual hearings should play a ‘significant role’ in the future and the super-regulator recommended that the GMC and others should ‘formally evaluate’ virtual hearings to ensure they deliver ‘appropriate protection of the public’.

Fitness to practise

The report found that staff burnout could have been alleviated and normal services resumed quicker if returning practitioners were used more appropriately by providers and regulators.

Fitness to practise investigations were paused last March during the first COVID-19 wave and were resumed in July. The PSA said that the backlog of cases was ‘unavoidable’, but it had inevitably ‘increased the overall stress on all participants’.

The report said: ‘The pandemic has affected the timescales of regulators in different ways, as might be expected from the different environments in which their registrants work. Some initially saw a decrease in the number of referrals, others an increase.

‘It is likely that some cases will prove impossible to resolve, because the delay means that evidence becomes less accessible, memories fade and witnesses may disengage. It is too early to say overall how this will have affected the backlog of cases or how regulators are able to address this.’

Temporary registration

Although the report identified issues with virtual hearings, including security and data ownership, it concluded that there were ‘clear benefits’ of continuing with this method.

‘We would expect virtual hearings to continue to play a significant role and, while they will not be suitable for every case, they appear to have substantial advantages for registrants and witnesses,’ the PSA said.

Although regulators boosted workforce numbers during the pandemic - with 30,000 doctors given temporary registrations - the report suggested better use could have been made of these staff.

It said: ‘Using this workforce more fully might have helped to alleviate the burnout and exhaustion being reported by the workforce as the pandemic continues. It may also have provided an opportunity to reinstate some normal services for patients and service users earlier,' the report said.

Doctors' wellbeing

A GMC spokesperson said: ‘We know that going through an investigation can be stressful for doctors and we have committed throughout the pandemic to taking a proportionate approach to cases which balances public protection with the wellbeing of all involved.

‘We continue to work closely with the Medical Practitioners Tribunal Service to progress cases as swiftly as possible within current COVID-19 guidelines, using a combination of virtual and in-person hearings.’

Guidance issued by the PSA last September said there was ‘no evidence’ that regulators should not use online hearings ‘as a major part of their approach’ to address the challenges posed by the pandemic.

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