GMC reshapes procedures on fitness to practise
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《英国医生杂志》
The medical profession抯 regulatory body, the General Medical Council, has developed a new warning system for doctors whose performance falls below acceptable standards, but is not serious enough to warrant restrictions on their practice.
The move is part of a substantial overhaul of the council抯 fitness to practise procedures, designed to streamline the complaints process and boost transparency.
Under the terms of the new framework, the three separate committees on performance, conduct, and health will be abolished. Instead, a doctor抯 fitness to practise will be assessed "in the round."
The complaints process will be divided into two stages of investigation and adjudication, with council members no longer permitted to sit on fitness to practise panels.
"Case examiners," recruited from among the public and healthcare professionals, will decide on the course of action once the investigation stage has completed, applying a new test in a bid to clarify the adjudication criteria.
The test takes account of whether "there is a realistic prospect of establishing that a doctor抯 fitness to practise is impaired to a degree justifying action on registration."
Doctors will no longer be charged with "serious professional misconduct," although the exact wording for those found to be unfit for practise is still undecided.
A warning can be issued at either of the two stages, if a doctor is considered to have deviated substantially from the tenets of Good Medical Practice or an assessment of performance indicates serious cause for concern.
The written warning, detailing the nature of the concerns will remain on a doctor抯 file for five years and will be included in revalidation. Current employers will be copied in.
Doctors will have the right to refuse to accept the warning and can instead call for a public hearing under the aegis of the Investigation Committee. But the committee could still decide that a warning is warranted.
Prospective employers and patients will also be entitled to find out whether a warning has been issued, provided it remains current. As yet, the GMC has not decided whether information on previous "spent" warnings should be made available.
Dr Matthew Lee, medicolegal advisor at the Medical Defence Union told the BMJ that prospective employers might still ask doctors about previous warnings. "Doctors who are extremely good at what they do might end up being disadvantaged in future as a result," he said.
The union was also concerned that written warnings would be issued before doctors had had a full chance to refute the concerns.
The new complaints route, which officially started last month after consultation with the public and the profession, is unlikely to take full effect until next spring. But it is hoped that it will cut the average time it takes to complete a case from 18 months to 15.(London Caroline White)
The move is part of a substantial overhaul of the council抯 fitness to practise procedures, designed to streamline the complaints process and boost transparency.
Under the terms of the new framework, the three separate committees on performance, conduct, and health will be abolished. Instead, a doctor抯 fitness to practise will be assessed "in the round."
The complaints process will be divided into two stages of investigation and adjudication, with council members no longer permitted to sit on fitness to practise panels.
"Case examiners," recruited from among the public and healthcare professionals, will decide on the course of action once the investigation stage has completed, applying a new test in a bid to clarify the adjudication criteria.
The test takes account of whether "there is a realistic prospect of establishing that a doctor抯 fitness to practise is impaired to a degree justifying action on registration."
Doctors will no longer be charged with "serious professional misconduct," although the exact wording for those found to be unfit for practise is still undecided.
A warning can be issued at either of the two stages, if a doctor is considered to have deviated substantially from the tenets of Good Medical Practice or an assessment of performance indicates serious cause for concern.
The written warning, detailing the nature of the concerns will remain on a doctor抯 file for five years and will be included in revalidation. Current employers will be copied in.
Doctors will have the right to refuse to accept the warning and can instead call for a public hearing under the aegis of the Investigation Committee. But the committee could still decide that a warning is warranted.
Prospective employers and patients will also be entitled to find out whether a warning has been issued, provided it remains current. As yet, the GMC has not decided whether information on previous "spent" warnings should be made available.
Dr Matthew Lee, medicolegal advisor at the Medical Defence Union told the BMJ that prospective employers might still ask doctors about previous warnings. "Doctors who are extremely good at what they do might end up being disadvantaged in future as a result," he said.
The union was also concerned that written warnings would be issued before doctors had had a full chance to refute the concerns.
The new complaints route, which officially started last month after consultation with the public and the profession, is unlikely to take full effect until next spring. But it is hoped that it will cut the average time it takes to complete a case from 18 months to 15.(London Caroline White)