Dr Christine Tomkins
The GMC's report on the state of medical education and practice offers some positives, but there is still much work to be done.
For more than 130 years the MDU has defended its members when they need our help, but in recent times our assistance and expertise has been called on more and more due to the dramatic rise in the number of complaints and claims.
The MDU has repeatedly made it clear that the drivers for this increase are external and are no indication of a decline in clinical standards, which remain very high. This has been backed up by independent research as highlighted in previous issues of this journal, and we are now pleased to see our position further underscored recently by the GMC's annual report, 'The State of Medical Education and Practice'.
The report's introduction begins with the assertion that, 'Patients should be assured that the standard of healthcare provided by doctors working in the UK remains among the best in the world… The international standing of British medicine and medical education is among the best, with strong contributions made from both UK and overseas doctors in every part of our healthcare service.'
The GMC also noted that, '…after years of rising complaints, the number of GMC investigations fell in 2015, a pattern that is more marked in 2016.' And while the number of cases that resulted in a sanction remained low, at 355 in 2015, and the number of cases investigated dropped by 18 per cent since 2014, there were still 1,943 cases investigated with no sanction. The GMC recognises the impact of its investigations on doctors and it could be said that 1,943 is too many.
We use our knowledge and experience gained in assisting members with GMC investigations to feed back to GMC staff at all levels about the impact of its FTP investigations on doctors. We are constantly suggesting ways to speed up the process, to identify cases that are inappropriate for investigation as early as possible and to lessen the stress and distress they cause for doctors.
To highlight the work we do on behalf of our members to influence the legislative environment in which they work, we have added a new section to our website. The 'Our impact' pages outline such initiatives as our response to consultations on changes to guidance and legislation, our position on key issues such as fairer compensation, and the results of our efforts and the effects and benefits they have on doctors' working lives. You can visit our website to find out more about our impact and influence, with more information available in this issue.
The GMC is receptive to our input and uses this information to inform changes. A positive example is the provisional enquiry initiative it introduced over a year ago to enable its staff to judge more accurately at the initial triage stage whether a case merits further investigation. It is a good start and the GMC extended the criteria for this procedure in July, which should mean fewer doctors will be subject to formal investigation.
Of course, despite our continued efforts to improve the medico-legal environment for doctors, our members inevitably do still face complaints and claims from patients. Thankfully we have an excellent record of defending claims, as shown in our most recent annual report. Over the last year 80% of medical claims were successfully defended without a compensation payment, and in 2014 over 96% of GMC cases handled by our in-house lawyers were resolved without a formal hearing, compared to the GMC's non-referral rate for that year of 91%.
We're not alone in supporting doctors through difficult times. We have previously worked with the Royal Medical Benevolent Fund to highlight the work they do to help clinicians in need of financial support. In issue three of this journal I spoke with RMBF President Professor Parveen Kumar about the issues doctors face, and I'm pleased we're now able to highlight their Vital Signs guide. Recently updated with a new version that focuses specifically on primary care, this free guide helps doctors recognise the key stress points of their work and encourages them to get help early on if they're feeling the strain. You can read more about it here.
We are positive about the GMC's most recent report, and the fact that they are receptive to our input. It's also good to know that organisations like the MDU and the RMBF are dedicated to supporting doctors should the worst happen, but similarly we know there is still much work to be done. The MDU will continue to guide, support and defend our members' interests at every level.