GMC to trial scheme to expose behaviours that threaten patient safety

Author: Caroline White

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The professional regulator, the GMC, has launched a pilot training programme to help doctors call out colleagues’ behaviours which could threaten patient safety and health outcomes.

The evidence-based training has been developed in response to mounting evidence that unprofessional behaviour has a direct impact on patient safety, says the GMC.

A 2008 study on the impact of disruptive behaviours among healthcare professionals found that 14% of doctors and nurses said they had been aware of specific adverse events related to an episode of disruptive behaviour by colleagues.

The difficulties of challenging and managing these behaviours in the workplace have featured in several major health inquiries in recent years, and they emerged as a key theme in the GMC’s Medical Professionalism Matters workshops held over 18 months in 2015 and 2016.

A GMC survey of more than 1,000 doctors found that 40% of respondents felt that other doctors undermine respect and prevent effective collaboration. But well over half (nearly 60%) said they didn’t feel that they’d be supported by clinical leaders and other managers if they raised a concern.

Consequently, the GMC worked with the Royal College of Physicians, Royal College of Surgeons of Edinburgh and Royal College of Obstetricians and Gynaecologists to develop resources to equip doctors the skills and confidence to deal with unprofessional behaviour.

The Professional behaviours and patient safety training will be delivered face to face with doctors across the UK in at least 14 sites by the GMC’s Regional Liaison Service, which provides guidance and standards advice to doctors on the frontline.

It will be formally evaluated to see how effective it is, and what impact it has on individual doctors, and the wider teams they work in.

GMC chair Dame Clare Marx said: “All of the evidence shows us that when clinical environments are poorly-led unprofessional behaviour goes unchallenged and patient safety suffers.

“We are acting on the evidence we have heard from clinicians and their experiences of unprofessional behaviour to give doctors the skills and confidence to lead the changes needed now and in the future to continue to deliver great patient care.”

She continued: “The vast majority of doctors act with great compassion and professionalism. If we equip them to challenge poor behaviour in others we will enable them to deliver the care they want to provide. Our aim is to create the right environment for safe professional practice and to support a profession under pressure to deliver good care – we want this to be a practical tool for developing a just culture for the NHS.”

The programme has the backing of patient health safety leaders, including Sir Robert Francis, who chaired the public inquiry into deaths at Mid Staffordshire and is now chair of Healthwatch England.

“Bullying and undermining stops everyone talking to each other. It makes people afraid so that they don’t share confidences and concerns, and that’s really dangerous for patients because unsafe practices are allowed to carry on,” he said.

“We all need to role model the behaviours we can be proud of, but there needs to be training in how to have difficult conversations with each other.”

The work is part of the GMC’s strategy to bolster harm prevention and drive improvements in patient care, by working with employers to influence the workplace culture for doctors, and to help them continue to be good professionals for their patients.

It also supports the aims of the Anti-Bullying Alliance, convened in 2018 by the Royal College of Surgeons of Edinburgh and Royal College of Obstetricians and Gynaecologists to share good practice and initiatives to tackle bullying and undermining behaviours.

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