The stresses of the system: New proposals by the GMC on its fitness to practise procedure

The General Medical Council (GMC) has appointed an independent expert in order to address improvements that can be made to its fitness to practise procedures.

The duration of a GMC investigation into a medical professional depends on the complexity and seriousness of the concerns raised. A doctor may find themselves before an Interim Orders Tribunal at an early stage or, later, an Investigation Committee, or at a Medical Practitioners Tribunal.

It is our role to provide support and guidance at every stage of this process, which can often be prolonged and stressful for the practitioner.

Fitness to practice procedures

The GMC has now implemented 28 proposals to address concerns regarding how fitness to practise procedures affect doctors’ mental health.

Every step of the investigation process has been carefully reviewed by Professor Louis Appleby (Professor of Psychiatry, University of Manchester), in conjunction with the GMC’s policy teams, to identify the changes to be made.

One of the GMC’s core aims is to reduce the impact of their investigations on doctors, by ensuring that they only investigate where necessary, and reduce the stress of the investigations through changes to communication, duration and process.

Changes to the investigation process

Filtering the complaints the GMC receives about doctors by making ‘provisional enquiries’, which has prevented approximately 400 doctors a year from undergoing a full investigation. Whilst the GMC pushes for legislative change to speed up the investigation process, utilising the provisional enquiry stage should better ensure only more concerning cases move through the investigative process, and allow more time to be dedicated to each individual case.
Where a doctor is very unwell, investigations can now be paused to allow a doctor to seek treatment without being regularly contacted by the GMC.
Materials being provided to doctors have been reviewed and updated in order to strike a balance between clarity on the procedure on the one hand, and sensitivity to the impact of the process on the other. The GMC have sought to remove unnecessary legal terminology from correspondence and are providing information to doctors so that they can seek further information, advice and support.
There is now a single point of contact for doctors during the course of an investigation so as to reduce confusion and anxiety caused when receiving correspondence from different members of staff.
The Doctors Support Service, commissioned by the BMA, has been created. This is available to any doctor under investigation, and is operated by trained investigation and tribunal teams. Please see this video for more information about this service.

Impact of the changes

These changes are to be welcomed if indeed they will reduce the impact of such investigations on a doctor’s health. However, no professional person welcomes such scrutiny and it is inevitable that complex investigations will take many months, even if they result in the practitioner’s exoneration.

In the meantime reputational damage can be caused and the doctor may well have been unable to continue with all their professional duties.

Despite these changes, doctors will continue to need all the support they can get during what can be distressing times.

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