Harold Shipman would be caught in today's NHS, says Sir Keith Pearson

Serial killer GP Harold Shipman would have been caught by the governance mechanisms put in place since the inquiry that followed his trial in 2000, according to the author of a review of revalidation.

Shipman was found guilty in 2000 of murdering 15 of his patients. He was later identified as the killer of 218 patients throughout his career, although his victims are now thought to number over 250.

Medical revalidation has often been criticised since its introduction in late 2012 on the basis that it would not pick up another Shipman. GPonline reported in January last year that four out of five GPs responding to a survey did not believe the process had made general practice safer, with several respondents specifically suggesting that the serial killer GP would have passed.

But Sir Keith Pearson, the Heath Education England chair asked by the GMC to review revalidation, has said that in tandem with other governance processes now in place, he believes today's NHS would have picked up on Shipman's crimes.

GP revalidation

At the launch of a report on his review, published today, Sir Keith said: 'When you look at the cluster of changes in clinical governance that have taken place as a result of the Shipman inquiry what you will find is that revalidation is but one of a whole range of new governance checks, and these lead me to believe - if Shipman was around today - I don't believe that Shipman would have got through the processes that are in place.

'I think he would have been picked up in appraisal, in certification of deaths - there's a whole suite. He would have been caught. But he was a serial murderer who happened to be a doctor.'

The review of revalidation makes clear that 'contrary to a commonly repeated myth, [revalidation] was never intended to catch another Shipman'.

Sir Keith points out that revalidation was not drawn up in response to the Shipman inquiry, but 'proposed by the GMC in 1998, before Shipman was even arrested'.

'Its rationale was not to uncover criminality but to fill a gap in the regulatory framework whereby, barring serious concerns being raised, a doctor could practise from registration to retirement without any check on their performance or competency,' the report says.

Fitness to practise

Revalidation is however among an 'array of governance changes' that have come into force since the Shipman inquiry. In addition to revalidation, Sir Keith identifies changes to the death certification process and coroner system; safer management of controlled drugs; monitoring of prescribing data, mortality rates and unexpected deaths; better guidance for police; better complaints handling; and GP practice inspections - all of which come on top of the requirements in Good Medical Practice for doctors to report concerns about colleagues who may not be fit to practise.

The report says: 'Shipman was a serial killer responsible for the deaths of more than 200 people.He was also a family GP. Much has been said about whether he would have been caught earlier if revalidation had been in place. It is impossible to say for certain, but my view is that the array of governance changes put in place since Shipman, including those established as part of revalidation, makes it much more likely that his behaviour would have been detected.'

GMC chief executive Charlie Massey warned that it was 'very hard' to say that any system could prevent a 'determined, heinous murderer' but agreed that many more checks on doctors were in place compared to the time of Shipman.

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