Last week we published the results of an independent research study exploring how the online medical register can be improved to make it more useful and accessible. Dr Judith Hulf, Senior Medical Adviser and Responsible Officer at the GMC, explains why we commissioned the research and, as a doctor herself, shares her views on what the changes could mean and how they could be of benefit.
Since the first list of registered doctors was printed in a hard back book in 1859 the medical register – now published online as the List of Registered Medical Practitioners (LRMP) – is the only up-to-date, publically accessible database of all doctors eligible to practise in the UK. It plays a fundamental role in protecting patients from those who are not fit to practise as doctors.
If you look at my entry (search here using my name or reference number 1419102) it tells you when I first qualified as a doctor and which body awarded my qualification – the University of London in my case, with additional qualifications from the RCP and RCS, the old ‘conjoint examination’, taken by many students at the time as a practise run for university finals. The register also tells you that I am on the specialist register as an Anaesthetist and that I continue to hold a licence to practise.
But, other than some additional basic information about me there, is no detail about my practice. In many ways the register of 2015 is very similar to the register of 1859.
This appears out of step with trends for openness and transparency. We are facing an explosion of information about every aspect of medicine. We know that more and more people are seeking information about doctors. Last year, there were over 7 million searches of the online register and the number of searches has more than doubled compared to this time last year.
Employers are checking to see if a doctor is eligible to work. Patients are seeking reassurance that the doctors are fit to practise and, in some cases, looking for information to help them make choices about who to see.
And the register has not kept up with the expansion of the GMC’s functions. The introduction of revalidation and our expanded responsibilities for the quality assurance of post graduate education means that we hold much more information about where doctors work and if they are in training or not.
So the time has come to consider if our register needs to change to ensure it stays relevant.
The GMC is starting a significant piece of work to see if the register should be expanding to include more of the data that we hold and possibly information from other sources.
What do doctors and users think of our register?
Over the last few months we have been asking people what they think. Our commissioned research involved a survey of over 3,000 users of the LRMP, two rapid evidence reviews, a survey of international regulators, interviews with experts and focus groups and interviews with patients and the public, doctors, employers and educators.
The research drew heavily on qualitative analysis to explore the range of views rather than to be representative in a quantitative sense. Nevertheless, a number of themes emerge:
- the LRMP offers limited information compared with some other jurisdictions
- most stakeholders are keen to see it offer a greater range of information. However although there was a consensus on what some of that extra information should be, there are mixed views and a need for more discussion on other areas
- some stakeholders find the site difficult to use and think the navigation and search function could be improved
- while the majority of current users are professional stakeholders (for example doctors, employers and educators) and the register meets many of their needs in its current form, it needs to carry more information in order to meet the needs of patients and the public.
The research also raised important issues such as the balance between doctors’ privacy concerns and the trends towards greater openness and transparency, how the information should be collected and where from and the extent to which it can or should be validated. These issues featured strongly during workshops held as part of our recent conference [PDF].
Individual doctors will have different views about the regulator publishing more information about their practice. As the research and subsequent discussions show these issues need to be carefully weighed and a clear rationale for change set out. At least the GMC should be looking to ensure the information on the register reflects better the information it currently holds.
Over the coming months we will publish a discussion document on options for longer term development. We will be asking for views from a wide range of current and potential users.