Being fair (and being seen to be fair) is fundamental to maintaining public confidence in our work. GMC’s head of diversity, Andrea Callender, reports on our half-day conference Being Fair: challenges and opportunities.
Like many other organisations we are wrestling with a number of fairness dilemmas that cut across all of our activities. For example, our work is about setting standards and involves making daily judgements about someone’s competences and skills, their honesty and trustworthiness, and ultimately, whether or not they pose any risk to patient safety. Our assessments can fundamentally affect someone’s livelihood, whether they feel listened to or understood, whether they have faith in the system that is there to protect them.
Being Fair: challenges and opportunities conference
On 12 September 2012, we organised a half-day conference to involve senior people from across our interest groups in exploring some of the common challenges in this area, and to reflect on possible ways of making progress on some of the issues.
The day unfolded as a discussion in two parts:
- Firstly, defining some of the issues where fairness plays a role in how people perceive us.
- Secondly, exploring potential solutions and the way forward.
Speakers talked about how the challenge of being fair manifests itself in their own work:
- Dame Julie Mellor, Parliamentary and Health Service Ombudsman, chaired the event and talked about the challenges for her own organisation in being fair and transparent when dealing with complaints from the public.
- Paul Philip, the senior sponsor for our work on equality and diversity, used the opportunity to acknowledge some of the constraints we face in trying to be fair. The law requires us to treat different groups of doctors differently when they apply to go on to the register. Some groups of doctors are overrepresented in our fitness to practise procedures. When it comes down to it, we always choose protecting the safety over patients over anything else, even when it creates a conflict with balancing the rights of patients and doctors.
- Elisabeth Davies, Chair of the Legal Services Consumer Panel, talked about the growing public expectations of being treated fairly, and the consequences for the work of regulators and other organisations in our sphere.
The conference explored issues that are fundamental to maintaining public confidence in our work including:
- Dealing with concerns and complaints
Taking early preventative action to reduce the growing number of referrals to the GMC. What we and others can do to reduce the risk for groups of doctors more likely to be involved in our fitness to practise procedures. The characteristics that can influence this include where a doctor qualified, their specialty and whether they are male or female.
- Raising standards through revalidation
We know from talking to our interest groups across the UK that there are concerns that some doctors will be disadvantaged by the process and requirements of revalidation. The revalidation workshop looked at the particular needs of doctors taking breaks from practice, trainees, specialty doctors, and the role of employers and employees in appraisals.
- Progression in medical education and training
In June 2011, a GMC seminar on student selection showed that processes for student selection vary between medical schools. What’s not clear is why. The second part of the workshop looked at what more can be done to promote fairness in exams and assessments while maintaining high standards of education (and by whom?) 92% of participants in the workshop said that we should produce standards for examiner training and assessments.
We’ve published a report summarising the conference which is available to download from the GMC website.
Next steps for GMC and others
Niall Dickson summarised the next steps for GMC and others:
- 88% of adults trust their doctors to tell the truth, according to a MORI survey. As a regulator we need to be trusted by doctors, patients, employers and the society as a whole. Being fair in our actions is fundamental to securing that trust.
- We need to make sure that doctors can interpret and apply our standards consistently, regardless of where they qualified. Our induction programme for doctors new to practise in the UK will be a significant step towards this.
- We need to work with others to create better data and analysis to understand what’s happening, and to prevent problems occurring in the first place. We will continue to audit and review our processes and policies.
- We need a better understanding of the views of those people interested in, and affected by our work. To this end, we have recently commissioned an audit of the perceptions of BME doctors, an important constituency for us who make up 27% of the register.
- We will do more work to understand the rising tide of complaints and the patient perspective: who complaints to us, why they complain (and why they don’t). We will work with others to provide more help for those who want to raise concerns to navigate the system.
After the conference, we asked delegates reflect on their sessions and tell us about the challenges, opportunities and actions they saw in being fair. A short video of the interviews is available on our YouTube channel.