When is the right time to question a medical decision?
Complaints made to the GMC can take around six months to investigate and far longer to resolve if there is to be a fitness to practise hearing. Studies have shown there may be a link between the stress of these proceedings and a higher suicide rate amongst doctors. The GMC has launched two new pilot initiatives designed to reduce the impact of investigations on doctors and to speed up the process of dealing with complaints.
In December last year the GMC appointed Professor Louis Appleby (Professor of Psychiatry at the University of Manchester and Chair of England’s National Suicide Prevention Strategy Advisory Group) to provide guidance on how it might offer greater support to vulnerable doctors subject to a GMC complaint.
The two schemes are respectively aimed at: reducing the length and apparent gravity of investigations into complaints concerning “one-off” clinical incidents and ensuring that complaints raised against whistle-blowers are well founded.
Where a complaint to the GMC relates to a one-off clinical incident, the GMC will refrain from completing a full investigation, but will instead undertake an initial evidence gathering exercise in relation to the referral: an investigation-light (my words, not the GMC’s). After reviewing any evidence obtained, a decision will be made as to whether a full investigation is opened, whether the matter is referred to the doctor’s Responsible Officer*, or whether it is closed without any further action. This investigation is intended to be less serious and therefore less onerous and worrying for a doctor.
Closure of a complaint will be an option only where:
The GMC hopes that the initiative will avoid the need for a full investigation in around 230 cases a year. Cases under this pilot will be dealt with on average, in three months, whereas previously such cases may have taken six months to investigate. Will doctors really feel any different knowing that the complaint against them is being considered under this new investigation-light procedure?
Protection for whistle-blower doctors
The impact of complaints made against whistle-blowers (particularly those made for specious reasons) can be particularly deleterious to the whistle-blowing doctor given the already exposed position that they are in.
Any person or body complaining about a whistle-blowing doctor will have to make a declaration to the GMC that the complaint is being made in good faith and that steps have been taken to make sure the referral is fair and accurate. The GMC will take this into account when considering whether to launch a full investigation.
The GMC will require designated bodies, including NHS organisations to disclose whether a doctor, who is the subject of a complaint to the GMC, has ever raised patient safety issues. The information currently available about the impact that any such disclosure would have on an investigation is currently sparse.
The reality of being subject to a complaint to the GMC (whether well founded or not) can be isolating, embarrassing and incredibly stressful and resilience is something that is all too often expected and taken for granted by those on the outside. We welcome any measure that is designed to reduce the burden on doctors and will be monitoring the results of the pilots closely.
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