Dr Christine Tomkins
In testing times, it's more important than ever that doctors can depend on the MDU to support them.
Being a doctor is still a rewarding career choice for talented and committed professionals, despite the pressures on the health service, the demanding workload and the threat of a complaint or claim.
Millions of people have benefited from the expert knowledge, technical skill and dedication of their doctor when they are at their lowest ebb, so it follows that medical professionals should be highly valued in our society. And yet many are increasingly stressed and demoralised by a barrage of changes to their working conditions and a culture which often appears to attribute blame before addressing system failures.
Most obviously, growing patient need, coupled with the financial constraints on the NHS, have stretched clinicians to the limit. As I write, NHS England revealed that A&E attendances in January 2016 had increased by more than 10% compared with January 2015 and emergency admissions were up by 4.6%.
Meanwhile, NHS England is currently trying to address a chronic workforce shortage in primary care services which is placing GPs under extreme pressure. An international survey of primary care doctors by the US-based Commonwealth Fund found that 59% of UK GPs questioned (over 1,000 respondents) found their work very or extremely stressful, the highest of the western nations taking part (only 28% of respondents in Canada said the same).
At the same time, doctors must adapt to the frenetic pace of change caused by the advent of new technology, guidance and legislation with implications for their practice. In this issue, for example, we look at how doctors should respond to the increasing use of health apps. Many of these have the potential to improve patient engagement but a few may raise people's anxiety unnecessarily and add to the demands on GPs.
And only last month (March 2016), the Health Secretary announced further measures intended to improve patient safety in the NHS, including the introduction of medical examiners to review and confirm the cause of all deaths. This follows the introduction of a statutory duty of candour for healthcare professionals and the introduction of a new criminal offence of wilful neglect in 2015. The latter will inevitably lead to more police investigations and add to the sense of medico-legal jeopardy already felt by doctors in their day-to-day practice.
My concern, which many of you may share, is that doctors are experiencing change fatigue. That is why it is so important they have somewhere to turn for support. As a doctor, I want the MDU to stand up for clinicians if they are facing a complaint or claim and I want the MDU to defend members' interests as a whole.
To that end, I'm pleased to report just a few examples of where we have been able to lighten the load:
• The MDU has long advocated changes which would speed up the stressful GMC investigation process for doctors, without compromising patient safety. We work tirelessly with the regulators on this issue and supported the GMC's introduction of a new provisional enquiry process which means cases that do not amount to fitness to practise impairment can be identified and closed within weeks.
• We are providing steadfast medico-legal representation and care for individual members when they need us most. I have previously mentioned that we successfully defended 80% of medical claims in 2015. However, I'm also delighted to note that our in-house lawyers achieved a finding of no impairment in more than 55% of GMC cases which resulted in a panel hearing in the last six years, compared to the GMC's four-year average of 23.6%. As much as these good results are important, members can also count on our lawyers and advisers to provide emotional support and wise counsel when they are experiencing the darkest moments of their careers.
• To help members understand their ethical and legal obligations, the MDU is always on the road, visiting hospitals and general practices throughout the UK. In the last year, we have delivered around 1,900 lectures and seminars about a variety of topics, including delivering bad news, telephone triage and child protection. We also answered more than 30,000 calls from members seeking one-to-one advice with a specific issue, helping to avert problems that might result in a complaint or claim.
• The relevance of our ongoing campaign to reform the civil litigation system is highlighted in this issue in our interview with Dr Paul Goldsmith. The Government's proposal to introduce fixed recoverable costs for clinical negligence claims up to £250,000 is welcome because claimants' legal costs are often grossly disproportionate, driving up claims inflation. However, the MDU will continue to make the case for fair compensation because we are all paying a heavy price for the current system.
One other notable event last year was that indemnity became a legal requirement for all doctors, contributing to a surge in MDU membership. I am confident that we can justify the trust of doctors who chose to join us over our competitors.
Of course, the MDU alone cannot alleviate the pressures that doctors are under but in this challenging climate our members can look to us to support them and be an authoritative voice on their behalf.