Government sets out plan to speed up fitness to practise cases and halt GMC appeals

Plans to speed up fitness to practise decisions and to strip the GMC of its power of appeal could be approved by next spring under plans set out by the government.

A consultation document published on 24 March confirmed that the government plans to remove the GMC’s right to appeal fitness to practise panels decisions in line with recommendations in the 2018 Williams review.

The GMC has told GPonline that the proposals, if approved, could be passed in legislation by Spring 2022 - but that it will hold its own consultation before these reforms are introduced.

GP leaders have previously welcomed plans to speed up fitness to practise decisions - but medico-legal experts have called for assurances over how the changes will work. The Medical Defence Union (MDU) warned that plans for a new three-tier fitness to practise process must be ‘fair’ on doctors.

Fitness to practise

Proposals outlined in the document say an ‘amended set of powers’ will be handed down to regulators including the GMC to allow them to ‘conclude cases earlier’ and deliver protection more quickly - reducing stress on people going through fitness to practise processes.

The new three-tier process will involve an initial assessment, a case examiner stage and a final fitness to practise panel stage. Where registrants accept the findings and agree with sanctions imposed by the case examiner, moving on to a full fitness to practise panel will not be required.

On rules relating to fitness to practise procedures the document said: ‘The regulators will have more flexibility to set out their own rules, under parameters that will be set out in legislation. This will ensure that all regulators are working under a consistent legal framework, but with freedom to adapt their processes to the specific needs of the professions they regulate.’

The GMC will also be given the power to suspend doctors from the register for reasons including; failure to pay any relevant fees, to provide reasonable information or meet revalidation and renewal requirements.

Medical practice

GMC chief executive Charlie Massey said: ‘It’s been nearly 40 years since the legislation that underpins how we operate was passed and clearly, reform is long overdue.

‘Medical practice, and expectations of care, have changed beyond recognition over the last few decades, which means the need for regulation that can respond quickly and flexibly to changing environments has never been greater.

‘This reform agenda gives us a once-in-a-generation opportunity to deliver real change - reforms that will allow us to work with less bureaucracy, provide a wide range of resolutions delivered faster - making sure our focus is even sharper on the needs of patients, clinicians, and employers.’

MDU head of advisory services Dr Caroline Fryar supported the government proposals to reform the fitness to practise process but warned the changes must be fair.

Case examiners

She said: ‘Doctors are to be the first healthcare professionals subject to a new three-tier fitness to practise regime. We will be working closely with the regulator over the coming months as it creates new rules in readiness for this legislation.

‘Among the changes, it is proposed that case examiners will now have considerably more power in the fitness to practise process – including issuing what they deem to be appropriate sanctions. The MDU will be seeking assurances about how this process can be established in the relatively short timeframe that is proposed by the government. Fairness to registrants is a paramount concern.

‘These are complex issues, so we will be considering the fine print carefully and responding to the consultation on behalf of members.’

Proposals to remove the GMC’s powers to appeal fitness to practise decisions come after medico-legal experts said they were 'deeply concerned' that the government had failed to do so a year after the landmark Williams review.

A review of gross negligence manslaughter in healthcare by Professor Sir Norman Williams, triggered by the high-profile case of Dr Hadiza Bawa-Garba, recommended removing the GMC's power to appeal against fitness to practise rulings by the Medical Practitioners Tribunal Service (MPTS).

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