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Medical CouncilSeptember 3 2014

The General Medical Council is consulting on the sanctions that should be imposed on doctors who are in breach of fitness to practise requirements.

Among the proposals are to give hearing panels the power to require a doctor to apologise. It also aims to give clearer guidance on how long a sanction should apply, and what sanctions are appropriate where the concerns solely relate to the doctor’s health.

Describing the consultation as a “major review”, the consultation relates to the guidance the GMC gives to hearing panels run by the Medical Practitioners Tribunal Service.

The GMC wants to ensure that MPTS fitness to practise panels continue to make decisions which are independent, fair and consistent, and uses an approach similar to the sentencing guidelines used in law courts.

Sanctions range from warnings and restrictions on what doctors can do, through to suspension and erasure from the medical register. This could happen for example, if “it is shown that they knew or should have known they were causing harm to patients in serious cases. This could happen even if they had subsequently improved their practice.”

The GMC’s consultation runs until November 14 and is seeking views on

•    Imposing sanctions where doctors make serious clinical errors, even where they have successfully retrained and improved their practice, if they failed to heed concerns and take steps to protect patients sooner.
•    Whether panels should require a doctor to apologise where he or she has previously failed to do so.
•    Imposing more serious action in cases where doctors fail to raise concerns about a colleague’s fitness to practise or take prompt action where a patient’s basic care needs are not being met.
•    Improved public protection in cases where a doctor has bullied colleagues and put patients at risk or discriminated against others in their professional or personal life.

Niall Dickson, Chief Executive of the General Medical Council, said: “In the vast majority of cases one-off clinical errors do not merit any action by the GMC. But if we are to maintain that trust, in the small number of serious cases where doctors fail to listen to concerns and take action sooner to protect patients, they should be held to account for their actions.

“‘There have been occasions when we have been prevented from taking action in serious cases because the doctor has been able to show that they have subsequently improved their practice. We believe that doctors and patients want stronger action in these serious cases.”

The GMC also believes that patients or their families should also have an explanation as to what went wrong, and where appropriate receive a full apology from the practitioner. This would be taken into account by the fitness to practise hearing panel when deciding what level of sanction would be appropriate.

The guidance will also be used to the GMC’s case examiners, who decide whether to refer a doctor under investigation to a hearing.

The consultation will include events for patient groups, doctors, their representatives and lawyers. The GMC will publish the outcome in 2015 and the findings will be used to inform a new version of the GMC’s Indicative Sanctions Guidance.

“We are also publishing a microsite with case studies to bring the consultation to life,” says the GMC. “We will be asking people to tell us what action they think should be taken against a doctor’s registration in four scenarios, and to let us know the factors that influenced their decision. These are decisions which MPTS panels make regularly about doctors during a hearing.”

Link:

GMNC consultation

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