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. 


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