Our first annual conference in Manchester brought together doctors, medical students and patient groups to consider and debate the challenges affecting medical professionalism in the 21st century. This workshop explored different themes around professionalism. It featured a panel consisting of Professor Mike Pringle, President RCGP; Nigel Acheson, Regional Medical Director (South NHS England); Professor Wendy Reid, Medical Director Health Education England; Maureen Edmondson, Chair of the Patient and Client Council for Northern Ireland and Niall Dickson, Chief Executive and Registrar of the GMC,

1. Medical Professionalism –
whose job is it anyway?

2. Introducing our panel
 Professor Mike Pringle – President, Royal College of
General Practitioners
 Nigel Acheson – Regional Medical Director
(South), NHS England
 Professor Wendy Reid – Medical Director at Health
Education England
 Maureen Edmondson – Chair of the Patient and Client
Council for Northern Ireland
 Niall Dickson – Chief Executive and Registrar, General
Medical Council

3. Setting the scene: who’s in the room?
1. Student
2. Educator
3. Doctor
4. Patient
5. Employer
6. Professional body
7. Other

4. Place in order of importance these levers to
improve/enable professionalism?

Education and training

More regulation / legal powers

Organisational culture and leadership

Greater patient involvement in care and care design

More resources

5. Theme 1 – Accountability or Improvement?
Francis
•
•
•
•
•
•
Fundamental standards
Legal duty of candour
Criminal sanctions
Regulation
Healthcare leadership
Authoritative information
Berwick
• Ethic of learning
• Patients and carers involved
at all levels
• Quality and patient safety
sciences
• Regulation to be sensitive
• Recourse to sanctions rare

6. Time to vote: Accountability or Improvement?
1. Francis……..accountability
2. Berwick ……improvement

7. Theme 2 – Raising Concerns

8. Raising Concerns – a familiar challenge

‘(We)…..should not seem over-anxious to be at work since the spreading
abroad of the shortcomings of any erring members of our honourable
profession is a proceeding to be carefully restrained within precise limit.’
John Marshall, GMC President, 1887-1891

‘The system for the investigation … has not proved capable of reconciling the
diverse objectives that have to be achieved. X not unreasonably felt that he
had to take his complaint outside ‘the system’’.
Report of the Committee of Inquiry into Ely Hospital 1969

‘A combination of inadequate systems and poor culture meant that staff were
not encouraged to … speak openly. Those who tried to raise concerns found it
hard to have their voices heard.’
Bristol Royal Infirmary Enquiry 2001

‘Staff witnesses described an atmosphere of fear … and a forceful style of
management (perceived by some as bullying). There was also evidence of a
worrying acceptance of poor care, of poor behaviour among colleagues being
condoned.’
Mid Staffordshire NHS Foundation Trust Inquiry 2010

9. Raising Concerns – a problem on the wane?
 Complaints from all sources to GMC are up - 8,109 in 2012 up
24% since 2011 and 104% since 2007
 Complaints from doctors to the GMC have risen by 113% over
the last five years
 GMC Confidential Helpline - 881 calls from Doctors (66
investigations) in the last 12 months
 GMC NTS results: ~16% of doctors in training raised a concern
in the last year
 Evidence in practice:
 Julie Bailey
 Helene Donnelly
 Colchester ‘whistle-blower’ on Cancer Care Pathway

10. Place these barriers to raising concerns in order of
significance

Systems/routes to complain are not clear

Fear of recrimination from
employers, colleagues or doctor about whom
complaint is made

Feeling nothing will change

11. Theme 3 – The Good Doctor

12. Place these characteristics of a doctor in
order of importance to you

Knowledge/expertise

Compassion/empathy

Listens and responds in partnership

Communicates well

Confidence they are up to date

Integrity

13. What patients and the public told us
(GMP Consultation 2011)

14. What doctors told us
(Sample of 90 doctors – 2013)

15. Closing question
Will, in the long run, the last year have been good
or bad for the future of medical professionalism?
1. Good – from crisis….renewal
2. Bad – its all downhill from here
3. Neither - it won’t make a blind bit of difference

16. Lunch and exhibition
Upper foyer and Exchange hall