What every physician needs to know about complaints to the GMC Royal College of Physicians and the Society of Physicians in Wales Thursday 12 November 2015 Professor Terence Stephenson BSc, DM, FRCPCH, FRCP, FRACP, FRCPI, FRCS, FHKAP, FRCGP, FRCA, FCAI

The first meeting of the GMC 1858

The roles of the GMC

Managing increased complaints

Fitness to practise process

Types of Fitness to Practise allegations

Complaints about doctors in Wales  From , we received 46,251 complaints with 1,492 from Wales.  Of the 1,492 complaints: 851 came from the public, 237 came from employers, 209 came from a doctor and 105 were sourced as other.  In Wales the proportion of complaints from doctors was marginally higher than the UK average (13% v 11%) and the proportion of complaints from the public was marginally lower than the UK average (57% v 63%).

Complaints by specialty,

Gender is the biggest single determinant of non- clinical fitness to practise risk  Overall 75% of investigations are about men  Rising to 82% of criminality investigations  In most areas of the register across generations, about 1 in 20 of complaints about men lead to a warning or sanction compared to less than 1 in 25 in the case of women  Nearly 1 in 4 male GPs over-50 are complained about SoMEP 2015

The GMC wants to reform Fitness to Practise - we are not the ‘rate limiting step’

What we are currently doing about FtP delays: 1 Preliminary Enquiries Project – making quick enquiries to avoid unnecessary investigation (median is 63 days compared to a median of 245 days for a Stream 1 investigation) 2 Speeding up triage, case review and case examiner decision making 3 Facilitated disclosure by meeting with doctors

What reforms the recent 2015 Section 60 Amendment to the 1983 Medical Act delivers: 4 Robust case management and ‘teeth’ to enforce compliance (for example disclosure of evidence) – sanctions for non-compliance including costs 5 Legally qualified panel chairs for some cases (without need for legally qualified assessors to advise the panel) 6 Paper review by single chair (or a panel) rather than current requirement that all review hearings held in person with three panel members present

The Doctor Support Service ‘It reduced my anxiety and helped me feel much less isolated…It was an open door. I don’t feel I could have got through these three years without that support.’ ‘I probably would have struggled to get through that time without that extra support’ Confidential emotional support to any doctor who has a complaint made against them to the GMC

Doctors who take their own lives  Independent review acknowledged the levels of illness among doctors referred to the GMC  Elaborate system of health assessors, supervisors and treating psychiatrists  Accepted recommendations and have gone further with a commitment to a fundamental review of our health procedures -Improved communication – new bank of letters -Independent expert to review how we handle sick doctors -Workshop in early 2016 to examine new ways of reforming the system to reduce stress

Review of how we handle whistleblowing cases  In 2014, we commissioned Sir Anthony Hooper QC to review how we handle cases involving whistleblowers  Report published in March 2015  GMC action plan published in August on taking this work forwardaction plan

What we are now working towards…  Asking referral organisations whether the doctor has raised concerns and how these have been dealt with;  Where whistleblowing is a factor, using our provisional enquiries process to carefully consider the fitness to practise allegation;  Developing a training programme for our staff to raise awareness and understanding of whistleblowing.

The Wales Office and ELS Rachel Podolak Head of Welsh Affairs Gareth Williams Liaison Adviser Liam Anstey Welsh Affairs Officer Sarah Rowntree Welsh Office Co-ordinator Sarah Sullivan Welsh Office Administrator Wales Office Kate Watkins Employment Liaison AdviserELS

Thank You