Support for doctors appearing before a tribunal

Bojana Connor, MPTS

Last year, nearly 12% of doctors attended hearings at the Medical Practitioners Tribunal Service (MPTS) without legal representation. The tribunal service runs hearings for doctors whose fitness to practise is called into question.

Bojana Connor, adjudication co-ordinator at the MPTS, is part of a team that helps doctors to use the new Doctor Contact Service at the hearing centre. 

What is the Doctor Contact Service and who offers it?

Well, this is a relatively new initiative, which we’re piloting to improve the support offered to doctors at MPTS hearings, particularly those who attend on their own or without representation.

We want to help lessen the isolation and stress that doctors can encounter, but we’re also there to signpost useful support material and services, as well as giving information about the hearing process. This was one of the proposals that came from our work with Professor Louis Appleby to reduce the stress and impact of the process.

The team involves staff from across the MPTS. We all share a desire to help and to make a difference. Doctors are free to decline our offer of support, but we’ve found that largely, they are appreciative of our assistance.

MPTS doctor contact service poster

What type of service do you offer to doctors on the day of their hearing?

A doctor is greeted by a Doctor Contact Service team member and shown to their private waiting room. We’ve recently made some improvements to doctors’ waiting facilities in order to make the waiting time more comfortable.

In the waiting room, there’s free telephone access to external support services. These include the BMA’s Doctor Support Service, which is a confidential helpline for doctors who need emotional support.

There is also a telephone information service, run by student volunteers from the BPP Law School and the University of Law, where doctors can get information on the hearings process, how to prepare and what to expect on the day of their hearing.

We communicate closely with the MPTS Tribunal Clerks, whose role includes providing administrative support to tribunals, and so we are able to update doctors on hearing waiting times and progress. If a doctor has any questions or queries about how their hearing works, we are more than happy to clarify or to point them to sources of useful information.

What made you want to take part in this service?

Ever since I joined the MPTS, just over four years ago, I have been interested in helping self-represented doctors. I am in the process of finishing a Psychology degree as well as completing a teacher training course in Mindfulness alongside my job at the MPTS.

I suppose my interests in psychology and people’s wellbeing, together with my knowledge of the hearing process, meant that I was in a good place to take on this additional role.

What has the response been so far?

So far the response has been overwhelmingly positive! We’ve received some excellent feedback from the doctors, which confirms our view that this is a worthwhile service:

I appreciate that my stress and distress had been noted and that someone was available to talk through matters.

It is nice to be welcomed by a friendly face. It is reassuring there is someone available to give you help, advice and explanations if needed.

Personally, I find it most rewarding to meet doctors and help alleviate some of the stress and apprehension on the day, simply by talking to them. And seeing unrepresented doctors now being supported by me and my colleagues is really positive.

What is the main challenge you faced as a group?

At the moment, the Doctor Contact Service is still in a trial phase. We are trying to assess how we might go the extra mile in our dealings with the doctors concerned. It’s not our role to discuss the specifics of doctors’ individual cases, but at times this can be quite challenging, as doctors sometimes want to do so.

What would you like to see in future in terms of the development of this project?

In future, I would like to see even more MPTS staff get involved in the Doctor Contact Service. Our next step is to raise awareness among doctors that the service is available.

We are also looking to see how we might engage with and support doctors during the pre-hearing stage. I really want more doctors to benefit from this kind of support and to be able to access it early in the process.

Any doctors who have a hearing scheduled at the MPTS can email the team to find out more about how we can assist.

3 responses to “Support for doctors appearing before a tribunal

  1. I want to thank GMC for providing this service and I am really proud of GMC has it has come a long way. However GMC can do lot more. Having been NCAS Adviser for 15 years and also helped many BME doctors here are my suggestions for GMC.

    GMC’s main duty is to protect patients and should be taking only serious cases and vast majority cases can be dealt locally by the employer provided employer is fair and treats all doctors fairly and equally and action taken must be proportionate.

    1. GMC must give explicit guidance to ROs and MD as to what should be referred and what they can deal locally. This must be given in explicit and any MD or RO follows this advise should not be investigated by GMC it he/she is referred to GMC by the doctor, provided MD or RO is about to show the evidence.

    2. GMC investigation drags on for months to years and this has to change.

    3. GMC must deal with those MDs and ROs who refer cases unnecessary to GMC which they should be dealing locally. But GMC ELA should make sure doctors are dealt fairly by HR and Medical Directors.

    4. GMC should publish ethnicity of doctors referred by the Trust and this should be published on the website and this way BME doctors can see which Trusts refer disproportionately more BME doctors to GMC.

    5 Some of the GMC experts are not fit for the purpose. Some are retired academics, some do not do any clinical practice and this is simply not acceptable. I know at least 3 cases where GMC expert gave an opinion ‘Doctors fitness to practice is impaired just with one case whereas the expert from Defence Organisation strongly supported the doctor! All 3 doctors are from BME background! These experts must be removed from being an expert.

    • Thanks for sharing your feedback with us.

      We want to make our investigations more streamlined, supportive and proportionate for all those involved. As it stands, we have a legal obligation to investigate all allegations that a doctor’s fitness to practise is impaired. If we identify there is no future risk, we may close the complaint with no action following an investigation. But, as you have mentioned, investigations take time to complete, they are stressful and they can impact on a doctor’s career. Even when there are no complications, completing all the steps required by the legislation takes a minimum of six months.

      We need the law to change to give us more discretion when we’re carrying out an investigation – we have been campaigning for this for several years and continue to do so. Until then, we’re using our existing powers in new ways by:

      • referring lower level concerns to the doctor’s Responsible Officer for them to review and manage with the doctor
      • increasing the amount of information we have to make a decision whether or not to open an investigation, in particular by making provisional enquiries. These early stage enquiries are helping to filter out less serious complaints and avoid unnecessary investigations. The time it takes to make these enquiries is much shorter than carrying out a full investigation – around two months.

      We’ve also recently introduced a number of other changes, which aim to address some of the areas you have mentioned:

      • We’re piloting a new way for healthcare organisations and employers to raise a concern with us, so that we have more information about the concerns up front, to help us make a more informed assessment. This involves a new form, which also includes a section around whether the doctor being referred has ever raised any patient safety issues locally. They now also sign a declaration to confirm that they have taken steps to make sure the referral is accurate and fair.

      • We don’t have control over the local systems and processes for dealing with doctors where concerns have been raised. However, our referral guidance provides information and advice on when it is appropriate to refer a concern to the GMC and as part of our Employer Liaison Service our advisers provide advice to ROs and MDs about when cases should be referred to the GMC.

      We also publish data on referrals broken down by ethnicity, as part of our annual state of medical education and practice in the UK report – you can see the reference tables on our website. There may be risks that some doctors could be identifiable if we presented the data at trust level.

      With regards to expert reports, when we instruct an expert, they are required to have had a licence to practise and to have been in active medical practice in the last 12 months. We publish the standards for GMC experts on our website [PDF] and these will continue to be reviewed and updated.

      We have made significant improvements to our quality assurance arrangements to ensure the consistency and quality of expert reports. Individual expert reports are reviewed against our standards and where reports fail to meet these standards, we cease to use the expert. The new approach has enhanced our quality controls, however, we must acknowledge that, having taken these steps, we have to rely on the medical profession for specialist expertise (expertise that is not available to those outside the specialty) and there will remain areas where individual experts have differences of opinion. As is the case throughout the court system and other tribunals, occasionally those differences have to be explored at hearings.

      We hope this information is helpful. Over the course of this year, we are going to be sharing more regular information on our work to make the fitness to practice process more sensitive, less stressful and fair to all those involved.

  2. Reblogged this on NHS Doctor and commented:
    Another plastering approach by the GMC to control symptoms. However willingness to tackle and treat the cause from the GMC, BMA, BAPIO, etc remains to be seen.

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