Serious Untoward Incidents -The role of the GMC -

Dr Colin PollockGMC Employer Liaison Adviser (Y&H)

Y&H Deanery School of Surgery Conference 26th April 2013

Our functions

Education &Training

Standardsand Ethics

Fitness to Practise

Registration

Our statutory duty is to “protect, promote and maintain the health and safety of the public”

Trends - fitness to practise?

Trends - fitness to practise?

Initial handling of complaints / referrals

Initial triage assessment - Are there issues for the GMC to

investigate?

Possible outcomes Closed at the initial triage

assessment stage (56% of cases) Stream 2 – usually refer to local

procedures (18%) Stream 1 – GMC open

investigation (27%)

Outcome of referrals / complaints (2011 data)

Opening a case based on an SUI

“An adverse outcome (in particular the death of a patient or serious harm) will undoubtedly be a factor in assessing the possible seriousness of an alleged failure or breach. However, such an outcome needs to be considered in the context of the case as a whole. An adverse outcome does not, in itself, indicate any error on the part of the doctor. Often the outcome will simply be the unfortunate consequences of the particular condition or an inherent risk of the particular treatment. Similarly, ‘errors’ in diagnosing or treatment are an inevitable fact of medicine and will not necessarily raise questions about a doctor’s fitness to practise. There will be many cases, therefore, where notwithstanding an adverse outcome, it is still more appropriate for the matters to be considered initially under local procedures.”

Opening a case based on an SUI

Referral from Trust / Deanery Complaint from patient / family Press cutting Coroner’s inquest Police investigation Ombudsman referral CQC A colleague Which doctors are involved?

Principles of Investigation Process

The doctor has every opportunity to respond to the allegation at any time

Employers involved (and Deanery for trainees) throughout

Take appropriate interim action to minimise any risk to patient safety

Explain clearly our process and decision making Transparency Acting as quickly as is possible whilst maintaining

fairness to all parties.

Overview of Investigation Process

Initial ‘disclosure’ to the doctor Employer ‘disclosure’ (includes Deanery) Collecting information:

• witness statements

• medical records

• expert reports

• health assessments

• performance assessment [Interim Orders Panel – no order made / suspension /

conditions?]

Overview of Investigation Process

Final ‘disclosure’ to doctor for their response

The doctor’s response (tone and content) is critical

Two Case Examiners (medical / lay) decision

Four options• close (+/- advice)• warning• undertakings• FTP Panel

Factors taken into account during an investigation

…..it is important that the outcome of the incident should not be considered in isolation....

….consider the circumstances in which the incident occurred. ….the doctor’s actions fell below what could reasonably be

expected of a doctor at his or her grade and level of experience ….a death will have a bearing on the consideration of the case....

(but)…. needs to be considered along with all the other factors. ….ensure that any local inquiry has been sufficiently rigorous

before relying on this when concluding a GMC investigation. ….some cases which do not result in the death of a patient, but

which, nonetheless, raise questions about the standard of the doctor’s practice.

….a serious failure to meet the standards in Good Medical Practice.

Outcome of referrals / complaints (2011 data)

Further information

Dr Colin Pollock

GMC Employer Liaison Advisor

(Yorks & Humber)

cpollock@gmc-uk.org

Any Questions?