Improving our communication with doctors during fitness to practise investigations

Anna Rowland, Assistant Director of Fitness to Practise Policy at the GMC, explains why we are changing the way we communicate about fitness to practise investigations to better support doctors during this difficult time.

A doctor opens a letter from the GMC

We have recently made changes to the language and tone of the letters we send to doctors

Doctors often tell us that when a letter from the GMC lands on their doormat they feel anxious about its contents. It is right that our first duty is to protect patients and that one of our fundamental roles is to look into any fitness to practise concerns. But, we must always be fair and make sure doctors under investigation have the support they need during the process.

We understand that being under investigation can be extremely stressful for doctors and their families. How we communicate with doctors during this time is critical to their experience of an investigation and how fairly they believe they are treated.

Providing clarity and understanding

We have recently made changes to the language and tone of the letters we send to doctors to strike a balance between clarity – about what’s happening and why – and sensitivity to the stress the doctor will be under.

We are speaking with organisations such as the medical defence bodies, the BMA and one of the Royal Colleges, whose feedback to these changes has been positive.

Dr Anna-Maria Rollin at the Royal College of Anaesthetists has told us: ‘I thought the changes represented a huge improvement in their tone and the increased emphasis on support for the doctor, through the medical defence organisations and the Doctor Support Service, is welcome.’

I thought the changes represented a huge improvement in their tone and the increased emphasis on support for the doctor is welcome. – Dr Anna-Maria Rollin, Royal College of Anaesthetists

Taking steps to be more supportive

Changes we have made to our letters include:

  • acknowledging the stress that being under investigation can bring. This includes putting more emphasis on the confidential emotional support available from the Doctor Support Service, which is run on our behalf by the BMA
  • providing further information on where doctors are able to get legal advice and support during the investigation process
  • removing unnecessary legal terminology and where we need to provide it, using plain English
  • ensuring we use a neutral tone to provide reassurance that we have not come to a view about what happened until the appropriate point in our process
  • personalising the tone of letters so that we don’t add to the stress doctors are under
  • revising the initial letter to doctors who tell us about a concern about their own health so that we make a point of thanking them and recognising their insight for self-referring
  • where we have made a decision, making it clear at the outset of the letter what the decision is and where the doctor is able to find further details.

Revising our investigation letters to doctors forms part of a wider programme of work following the suicide review which made a number of recommendations on what more we can do to support vulnerable doctors.

We would also like to hear your comments or suggestions on what else we can do to improve our communication with doctors. Please share your ideas in the comments section below.

Anna Rowland - headshot 1


Anna Rowland is the Assistant Director of Policy, Standards and Fitness to Practise at the General Medical Council. She is a qualified solicitor and has an extensive background in legal and regulatory policy having occupied senior positions at the Law Society prior to joining the GMC. 


Related posts

Anthony Omo, the GMC’s Director of Fitness to Practise and General Counsel, writes about our work to improve investigations for doctors and patients

Chair of the Medical Practitioners Tribunal Service (MPTS), His Honour David Pearl, outlines upcoming changes designed to reduce stress on doctors and witnesses during fitness to practise hearings

The GMC’s Anthony Omo talks about our response to the Hooper Review and the support available for whistleblowers

8 responses to “Improving our communication with doctors during fitness to practise investigations

  1. Using the approach that ‘patient reported outcome measures’ have relatively recently become central to considering clinical research, I would have thought that the key audience to seek feedback from are those very doctors who have been through the process. Even if initially you only canvass the opinions of those doctors over the past few years who were eventually found to have no case to answer, their views would be invaluable, indeed necessary, in order to form relevant ideas.
    The ideal would be prospectively to build obtaining feedback into each case anyway (as we do with the ‘Friends and Family Test’ used in hospitals re clinical care). It is almost impossible to use any other service these days without being bombarded with requests for feedback. Whilst it is certainly possible to have too much of this, at least having some would be welcome!

    • Dear Kit,

      Thanks very much for your reply to my blog and your helpful comments.

      In light of the nature of the process, we have found it difficult to obtain feedback from doctors during or immediately after an investigation. However, in 2014 we did for the first time conduct a detailed survey of doctors who had been through the fitness to practise process 12 months previously and we received a relatively good response rate.

      The feedback from that survey included comments about our letters that we have tried to address in this review. We plan to repeat the survey every few years to track improvement over time and the next survey should give us feedback on the new letters.

      When we developed the letters we shared them with the BMA, the Practitioner Health Programme and the medical defence organisations and they gave us feedback based on their close and regular contact with doctors in the fitness to practise procedures. I agree with you that it is very important for us to hear from those who know what it’s like to be investigated by us.

      Thanks again for getting in touch.

      Regards, Anna

      • Thanks for your encouraging response, Anna.
        I hope that this endeavour proves constructive for the further development of your processes!

  2. Two comments. First, the quality of the GMC’s so called ‘experts’ who write reports in FTP investigations. Where are these experts recruited from and how are they dealt with if they submit an inaccurate report? Second, referral to the GMC is often used by vindictive hospital managers to rein in doctors they have issues with. What action does the GMC take when these referrals are shown to be spurious?

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