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GMC referrals should include info on whether doctors have raised patient safety concerns

Key to fairer treatment of whistle blowers is better understanding of background to allegations, says independent review

Caroline White

Friday, 27 March 2015

Organisations referring concerns about a doctor’s fitness to practise to the GMC should declare whether the doctor has raised concerns about patient safety in a bid to ensure fairer treatment of whistle blowers, recommends an independent review*.

They should also provide documentary evidence of those concerns, says the review, by Sir Anthony Hooper, a retired Lord Justice of Appeal.

The review, which took account of the recommendations made by Sir Robert Francis QC in his Freedom to Speak Up review published on 11 February this year, was commissioned by the GMC in a bid to help the regulator understand how it could improve the experience of referrals involving a whistle blower.

Sir Anthony says there is evidence that those who raise concerns may suffer, or believe that they suffer, reprisals from their employer or from colleagues.  

Key to minimising the risk that the GMC unwittingly becomes the instrument of the employer in a campaign against a doctor is an understanding of the background to the allegation, he insists.

The review proposes a series of recommendations for GMC investigations to ensure that such whistle blowers are treated fairly, including the creation of “a simple, confidential and voluntary online system” to help doctors as well as other healthcare professionals record the fact they have raised a concern with their employer.

Investigators assessing the credibility of an allegation made by an organisation against a doctor who has raised a concern should take into account any failure on the part of an organisation to investigate the concern raised and/or have proper procedures in place to encourage and handle the raising of concerns, says the review.

The review was informed by the views of those who may have suffered as a result of raising concerns, as well as the perspective and experience of employers, trade unions and professional leaders.

Niall Dickson, GMC Chief Executive, welcomed the findings, but said that the regulator was duty bound to investigate concerns about doctors reported to the body.

“We are obliged to investigate concerns about doctors which are reported to us, but [Sir Anthony] is right to say that we could do more to understand the background of the referrals that we receive from employers,” he acknowledged.

He emphasised that no organisation should refer a doctor on the basis of unjustified allegations or because that individual had raised concerns about patient safety.

“Doctors must be able to raise concerns without fear of reprisal. This is essential if we are going to have a health system that is safe, open and compassionate,” he insisted.

GMC guidance was clear, he said. “Doctors must raise concerns when the safety of patients is at risk and we are fully committed to supporting those who do,” he said, adding that the GMC would publish an action plan in due course, outlining how it proposed to take forward the report’s recommendations.

Danny Mortimer, chief executive of the NHS Employers organisation, said that the body would welcome discussions with the GMC about the report’s findings.

“Employers are working hard to remove any cultural barriers that could prevent fair treatment — or the expectation of fair treatment—for doctors who raise concerns. There is already good progress and we need to get this right for the NHS, staff and patients,” he said.

“Our new Draw the Line campaign includes an excellent barometer to help NHS organisations meet a good standard in their whistle blowing arrangements,” he added.

* The handling by the General Medical Council of cases involving whistleblowers. Report by the Right Honourable Sir Anthony Hooper to the General Medical Council presented on the 19th March 2015

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