Good, but we want even better – our response to the PSA’s review

Susan Goldsmith standing in the GMC London officeOn 15 March 2017, the Professional Standards Authority published its annual performance review of the GMC. Here, Susan Goldsmith, the GMC’s Chief Operating Officer and Deputy Chief Executive, responds to the findings. 

Have you ever opened a letter or email and, no matter how long you look at it, been unable to grasp what its sender wanted you to know? It might be from your daughter’s school or the cable TV company – sometimes the language or even the font mean the message just doesn’t get through.

I was thinking about this recently when I had the opportunity to attend one of the meetings which the GMC now has with patients and families who have brought a complaint to us. There’s something about being in the room with our staff that patients find really valuable. I was struck by the fact that even when we have to explain that we may not take action against a doctor, people appreciate that we take the time to explain our processes face-to-face: what we can do and what we can’t. Sometimes doing that in a letter just doesn’t cut it.

This is one of a number of ways that we’re making headway in improving our fitness to practise (FTP) processes, alongside new approaches like provisional enquiries which allow us to close down cases much sooner. That was highlighted in the Professional Standards Authority’s (PSA) annual review of the GMC’s 2015-16 performance, which was published this week.

In fact, the PSA report shows that our overall performance remains strong, concluding that we meet all of its Standards of Good Regulation in each of our work areas: registration, education and training, guidance and standards, and fitness to practise.

That’s good news, but the report does raise an issue that we and the PSA agree on – we must keep working to streamline our investigations so that they are less stressful for doctors and patients.

It’s a fact that our FTP processes can be lengthy: we deal with high volumes of incredibly complex cases and we must be fair and transparent in the way that we conduct those investigations.

So while I’m pleased at the PSA’s recognition for the strong work we’ve done over the last 18 months – from issuing advice for doctors offering cosmetic interventions and joint guidance with the NMC on duty of candour, to our work to support vulnerable doctors – I know that without radical changes to our legislation we will be unable to bring our processes up to date with demand in 2017.

Our underpinning legislation is more than 30 years old, dating from a time when we dealt with a few hundred cases each year. We now handle almost 10,000 complaints each year, and that same legislation means we are obliged to investigate every complaint that alleges a doctor is not fit to practise.

That makes it pretty difficult to reduce stress on patients and doctors. Fewer than a hundred doctors are struck off the medical register each year, but our legislation means we have to spend around two-thirds of our funding and time dealing with that small minority who bring the profession into disrepute. We need the flexibility to act proportionately, and more efficiently.

I believe our role should be to better support the majority of doctors and promote good medical practice. We want to move ‘upstream’ to prevent harmful situations happening to patients and doctors, reducing the number of cases where we need to take FTP action. That’s why the government’s upcoming consultation on the future of regulatory reform cannot come soon enough.

We’ve achieved a lot and brought consistently high standards to medical regulation, as the PSA review shows, but we badly need reform to legislation if we want to do more than just pick up the pieces after harm has already happened.

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