GMC
Don’t turn a blind eye
Solicitor Andrea James looks at revised GMC guidance on reporting concerns over patient safety
E
ARLIER this year the General Medical Council released a wide range of new guidance which came into force on 22 April 2013. Te main development
was the publication of an updated version of the GMC’s core guidance, Good Medical Practice (GMP), which had not been revised since November 2006. Te GMC also published 10 pieces of “explanatory guidance” to demonstrate how the principles set out in GMP might be applied in practice. One key aspect of the updated guidance is the GMC’s
strengthened focus on raising and acting on concerns about patient safety. Tis is entirely separate to the new contractual duty of candour in the NHS, which applies to providers of services to NHS patients. A doctor’s GMP obligations are broader than this and apply to all doctors holding GMC registration, whether they work in the public or private sectors. Within my recent practice I have encountered a
number of instances of the GMC opening investigations into doctors who, in its opinion, failed to take sufficient action in respect of colleagues who posed a risk to patient safety. Here are some examples.
A locum registrar was appointed to cover a period of holiday leave in an extremely busy A&E Department. Te registrar had GMC conditions on his registration following a previous fitness to practise case. He disclosed his conditions to the trust prior to his appointment and stated he was complying with them. When a serious clinical incident involving the registrar occurred, the patient’s family complained to the GMC. At that stage, it became apparent that the registrar had not, in fact, been fully complying with the existing GMC conditions on his registration. Te GMC took further action against the registrar. However, the GMC also opened fitness to practise investigations into the trust’s medical director and the clinical director for A&E, alleging they were at fault for failing to independently verify that the registrar was complying with his GMC conditions.
Dr X and Dr Y were the medical director and deputy 14
medical director of a trust where the Care Quality Commission (CQC) uncovered serious patient safety issues. A number of doctors and nurses at the trust were referred to the GMC and Nursing and Midwifery Council by CQC. Tere was no evidence that Dr X or Dr Y had specifically been informed of the patient safety issues. However, the GMC commenced fitness to practise investigations into both of them on the basis that the errant conduct had happened on their watch.
Dr Z was the senior partner of a four-partner GP practice. He heard receptionists gossiping about one of the practice’s GPs being involved with a patient. Several years later, when it transpired that the GP had been involved in a sexual relationship with a vulnerable patient, Dr Z told the GMC about the gossip he had heard but had done nothing about. Te GMC opened an investigation into Dr Z’s conduct.
Te message from the GMC is clear: if you fail to raise
and/or act upon concerns about patient safety when necessary, you are placing your own professional registration at risk. Ignorance of the guidance will not serve to protect your position, as the updated version of GMP specifically refers to doctors’ responsibility to be familiar with and follow both GMP and its supporting guidance. Of course, many doctors feel extremely reluctant to
raise concerns about their colleagues. A 2011 study published in BMJ Quality & Safety found that, of nearly 3,000 doctors questioned, approximately 40 per cent did not believe they should report “all instances of significantly impaired or incompetent colleagues”. Te purpose of this article is to draw together the
various strands of guidance set out in GMP and its explanatory guidance to ensure that you are aware of your responsibilities relevant to the thorny issue of problem colleagues and patient safety.
Duty to act Te key message is that set out at paragraph 1 of the GMC’s Raising and Acting on Concerns about Patient
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