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GMC decisions ‘fair and consistent’

Independent report finds no evidence of bias or discrimination due to race or gender

Mark Gould

Monday, 16 March 2015

Decisions made about doctors during GMC investigations are "fair and consistent" according to an independent report. Previous GMC research has found that some doctors are more at risk of receiving a complaint and having that complaint investigated. Risk factors that increase the chance of a doctor being involved in an investigation include their age, gender and specialty, as well as their place of qualification and ethnic background.

But an independent review, commissioned by the GMC and carried out by Plymouth University, says it can find no evidence of direct or indirect bias or discrimination in the wording of GMC guidance that might account for the over-representation of some groups of doctors in fitness to practise procedures.

The research did identify some areas for improvement. While all the decisions about a doctor’s case were appropriate, the researchers found that in some cases the regulator could have given more detailed reasoning for their decision. Furthermore, the distinction between concluding a case and concluding a case with advice was also found to be unclear in a small number of cases.

GMC chief executive Niall Dickson said the GMC had taken the recommendations on board and delivered training for decision makers on improving reasoning for decisions.

"We are doing all we can to reduce the stress for doctors and indeed for patients and relatives, and to make sure our investigations are fair, transparent and in line with our guidance, " he said.

The Plymouth University undertook a review of decision-making during its investigations into doctors who have been subject of a serious complaint. The researchers looked at 187 randomly selected cases during different stages of a GMC investigation. It assessed the decisions made against the GMC’s published decision making guidance, and went onto evaluate the wording used in that guidance as well as reviewing how the GMC presents allegations to doctors under investigation.

The review found that the decisions made in all 187 cases were appropriate as well as being in line with the guidance and criteria set out for GMC investigation teams.

The review also involved a detailed study of whether the GMC’s decision making guidance could be a factor in the over-representation of some groups of doctors in the fitness to practise procedures. It found that any references to doctor characteristics - such as their age, place of qualification or ethnicity - related to matters which may genuinely impact on a doctor’s fitness to practise or seek to ensure doctor’s with those characteristics are not disadvantaged during the process.

"There are more than a quarter of a million doctors on our register and relatively few are subject to a GMC investigation, but we recognise that the process can be extremely stressful for anyone involved," Mr Dickson said.

"We commissioned this research to make sure our decision-making is fair and consistent and to see what lessons we could learn to improve our procedures. Independent evaluation is essential to ensure that we remain effective and fair. While the findings of this report have been positive, we accept that this will always be a controversial and sensitive area and we know there is more we can do. We will take forward the learning points identified, and we will continue to do everything we can to speed up our processes, reduce the stress of our investigations, and support those who are subject to our processes."

Mr Dickson said the GMC is doing more work to understand better the reasons that some groups of doctors are over-represented in our procedures, and especially why some groups of doctors are more likely to be referred by their employers. Following a major consultation, in August the GMC will also publish and update the guidance that MPTS panels and GMC decision makers use in reaching their decisions about a doctor to ensure that those decisions remain fair and consistent.

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