With almost 26,000 doctors, 7,400 GPs, 8,300 specialist doctors, 14 territorial health boards, five medical schools, a population of 5.5 million and a government with devolved powers – Scottish healthcare is a broad landscape.

The GMC opened its first office in Scotland in 2003. Here Nicola Cotter, Head of GMC Scotland, looks back at the 20 years since, and just a few of her team’s achievements.

Establishment

GMC opened its office in Scotland in 2003 in response to devolution through the recent re-establishment of the Scottish Parliament. It was set up to enable the GMC to better know and support doctors and healthcare stakeholders in Scotland, as well as allowing the organisation to function well within the new constitutional set-up.

It started as a small team of three. Fast forward twenty years and there are now ten of us, which I have led since 2018.

How we operate now

We are responsible for delivering the GMC corporate strategy in Scotland and representing the needs and concerns of doctors and healthcare stakeholders in Scotland to the wider GMC. But this is by no means a one-way flow, we discuss with wider GMC colleagues nationwide updates and information that we need to share with the profession and stakeholders, such as the updated professional standards in Good medical practice (GMP).

The GMC has offices in all the UK’s devolved countries, and we work closely and share information and ideas with our colleagues in England, Northern Ireland and Wales. We also have one GMC Council seat reserved for a Scottish representative, currently Professor Paul Knight OBE, honorary professor of medicine at Glasgow University.

Policy and external affairs

The central function of our office is to work with Scottish stakeholders, including doctors, medical students, government, and healthcare organisations. We raise awareness of the GMC and share data and insight to help ensure doctors in Scotland are supported to help them work safely and provide good care for patients.

Our engagement with the Scottish Government is positive, putting us in a good position to support policy development and delivery. Over recent years this has included work including the introduction of an organisational duty of candour in 2018, safe staffing guidance, workforce planning and the Patient Safety Commissioner for Scotland Bill.

We engage with our Scottish stakeholders through the UK Advisory Forum (UKAF), which we set up in 2013 and have run twice a year since. Stakeholders, including government representatives, medical leaders, educational bodies, and patient organisations, come together to speak openly and honestly, on mutual priorities, policy development, and on issues that require debate and collaboration.

Pressures of the current environment

In 2019, on the back of a GMC commissioned report Caring for doctors, Caring for patients, authors Professor Michael West and Dame Denise Coia took advice from an advisory group in Scotland to help inform their publication, and there was great interest in working together to deliver on its recommendations.

In 2020 however, like every country in the world, attention turned to dealing with the pandemic. The wellbeing of the workforce, supporting the NHS through the pandemic, was brought into even sharper focus and we continued our discussions on this with BMA Scotland and the Academy of Medical Royal Colleges and Faculties in Scotland. This led to the creation of the Medical Workforce Wellbeing Stakeholder Group (MWWSG). The group focused on several areas including improving consistency of appraisals, senior doctor retention, and the wellbeing of trainee doctors and medical students.

We are acutely aware of the intense challenges that doctors in Scottish health services, as well as across the rest of the UK, continue to face. Our studies show high workplace pressure, doctors’ decreasing satisfaction and heightened risks of burnout, as demonstrated in the GMC’s 2023 The state of medical education and practice in the UK.

We are now piloting a workshop called Caring for a workforce under pressure, which looks at supporting doctors to improve their wellbeing and working environments.

Outreach

Since 2010 we have developed more specific support for employers, firstly through our Employer Liaison Adviser and their relationships with Responsible Officers, supporting them with their revalidation and fitness to practise responsibilities. Then, in 2015, we introduced our Liaison Adviser role, who work with doctors and medical students to help them understand our professional standards and our expectations of them in putting these into practice.

These roles have been pivotal in improving the understanding of the role and perception of the GMC across Scotland (and the wider UK).

Currently our Liaison Advisers are running important sessions for doctors in Scotland on what is expected of them as outlined in Good medical practice 2024 helping them to navigate GMC data to inform how they can tackle cultural and equality issues. Our ELA is also speaking to responsible officers about fairness in local processes to help us towards   our targets to address areas of inequality.

Twenty years

In 20 years, I am proud to say I believe we have made a positive difference to doctors’ working lives, patient safety and the healthcare landscape in Scotland. But there is plenty more to do. and we are certainly ambitious to do it.

The team has worked with determination, insight, and with collaboration at the heart of everything we do, and we will continue to play our part in protecting patient safety and supporting the workforce.

If you would like more information on the work we are doing or have any questions, please get in touch at gmcscotland@gmc-uk.org.

The 2022 national report Our work in Scotland illustrates our work and results last year, as well as providing some statistics on registered doctors in Scotland.