I write to you early in my second year as Chair of the General Medical Council (GMC) with the issues surrounding the first doctors’ strikes in three decades at the forefront of our minds.
I’ve met with hundreds of doctors across the UK during my first year as Chair and listened to the issues you have raised. It is clear that healthcare is changing at a scale and pace we have not seen before. This presents huge challenges, particularly for the doctors and other healthcare professionals on whom the service relies.
You will all be familiar with the themes at the heart of the dispute in England, so I do not intend to rehearse them. But it is clear to me, as someone who continues to practise in the NHS, that doctors in training feel less valued and less supported than when I was a newly qualified doctor in 1983.
We will increase our efforts to improve the experience of doctors in training wherever they work, and especially out of hours.
There are no winners here. Our first concern must be the welfare of patients and a prolonged dispute will undoubtedly cause harm. We also need to be aware of the long-term consequences on the morale and well-being of doctors. The wider pressures faced by doctors in training must be addressed and I am pleased that Professor Dame Sue Bailey is leading a review to examine these issues in England in more detail – recognising the review may be relevant to other parts of the UK. The GMC will support this review and we will increase our efforts to improve the experience of doctors in training wherever they work, and especially out of hours.
Stepping up support for medical students and doctors in training
In January we introduced new mandatory requirements to safeguard the quality of undergraduate and postgraduate medical education. Promoting excellence: standards for medical education and training will be vital in making sure that doctors in training are given the appropriate support in the right environment, both to learn and to provide safe and effective care for their patients.
Whatever the contractual position, we will monitor the quality of doctors’ training and step in where we believe patients or doctors are being put at risk. Our annual survey provides the most comprehensive feedback from doctors in training anywhere in the world, which we and others use to tackle the real problems facing this core part of the profession. This year, we will also ask doctors who deliver training to give their views – too often their contribution has been undervalued and we believe they will give important insights into the challenges and opportunities in the training environment.
Improving how we deal with complaints about doctors
The GMC is a patient safety organisation: our role is to protect the public and help improve medical education and practice, as well as scrutinising those doctors whose actions either harm patients or damage the public’s confidence in doctors. We are committed to making sure that we treat everyone with courtesy, dignity and respect – this applies to the minority of doctors referred to us for investigation, just as much as anyone else.
We are committed to making sure that we treat everyone with courtesy, dignity and respect.
We have been undertaking a major programme to reform how we deal with complaints about doctors, which has included:
- reducing the time and stress involved when we are investigating a doctor’s actions
- making greater use of provisional enquiries to avoid unnecessary investigations
- establishing an autonomous tribunal service
- launching an independent helpline to support doctors involved in our processes, run by the BMA’s Doctors for Doctors
- asking Professor Louis Appleby to help us redesign our processes to better support vulnerable doctors.
And we have made significant progress – last year we closed nine out of ten cases within six months and we are doing more than ever to make sure that issues are dealt with locally where possible. We are determined to continue this programme of improvements, but we are constrained by current legislation and the further radical reforms we are seeking need changes to the law and the political will to drive them through. I hope we can report more substantial progress this time next year.
A more transparent medical register and new resources for doctors
We are pressing ahead with other important changes. Later this year, we will publish plans to make the medical register much more transparent and useful, and we will issue new guidance for doctors offering cosmetic interventions and updated guidance for all doctors on confidentiality. We will also be launching a new app to give doctors mobile access to our standards anywhere, anytime. I am committed to making all our guidance relevant and useful in clinical practice and to finding new ways to support doctors facing difficult ethical and professional decisions.
It has never been more important that the values that unite us – commitment, professionalism, compassion – continue to define medicine in the UK.
At a time of such change, pressure and divergence, it has never been more important that the values that unite us – commitment, professionalism, compassion – continue to define medicine in the UK. I hope to play my part in making sure that doctors at all stages of their career feel they have the support and guidance necessary to provide good care for their patients.
Professor Terence Stephenson
Chair of the General Medical Council