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Collaborating upstream - beyond fitness to practice
1. Collaborating upstream -
beyond fitness to practise
“An ounce of prevention is worth a
pound of cure”
Tista Chakravarty-Gannon
Principal Regional Liaison Adviser, GMC
2.
3.
4. Session snapshot
GMC and Education – the direction of travel
What drives the issues we see?
What can we do about it?
“An ounce of prevention is worth a pound of cure”
5.
6. Which 3 specialties proportionately receive the
most complaints?
A. Paediatrics
B. GP
C. Anaesthetics &
intensive care
D. Surgery
E. Obs and Gynae
F. Radiology
G. Psychiatry Paediatrics
GP
Anaesthetics&
intensive...
Surgery
Obsand
GynaeRadiologyPsychiatry
0% 0% 0% 0%0%0%0%
7. Proportion complained about by specialty
1. Psychiatry
2. Obstetrics and gynaecology
3. Surgery
4. General Practice
5. Ophthalmology
6. Medicine
7. Emergency medicine
8. Paediatrics
9. Radiology
10. Anaesthetics and intensive care
medicine
11. Pathology
9. What is the most common complaint from
colleagues (including employers)?
A. Clinical care
B. Working with
colleagues
C. Probity
D. Health (incl.
substance misuse)
Clinicalcare
W
orkingw
ith
colleagues
Probity
Health
(incl.substance
m
...
25% 25%25%25%
13. ‘I was told that “The GMC won’t like it if you
wear sleeveless tops”. You are always used as a
threat.’
‘We’re taught to fear you, which really builds
barriers in our understanding of your role’
‘We are put off from self-reporting even minor
things…because we think you’ll end our career’
19. 19
Welcome to UK Practice
‘’’’A nerve-calming exposure to all it entails to be a good
doctor in the UK’
96% of participants said they will
reflect on their practice as a result
of taking part
99% of participants said they will
change their practice as a result of
taking part
Engaging Interactive Impactful
20. 20
Proactive regulation in action – Duties of a doctor
‘As an education [the Duties of a Doctor Programme] was
very strategic’ (Dr Ian Grant, Responsible Officer , BHRUHT)
6 month tailored support programme
Developed and delivered in partnership with NHS
providers
100% of participants rated the programme as
“good” or “very good”
92% of participants said they will change their
practice as a result of taking part
Engaging Interactive Impactful
22. Is it all just common sense?
•The Abortion Regulations 1991 5
•The Access to Health Records Act 1990 5
•The Access to Medical Reports Act 1988 7
•Blood Safety and Quality Legislation 8
•The Census (Confidentiality) Act 1991 10
•The Children Act 2004 10
•The Civil Contingencies Act 2004 11
•The Civil Evidence Act 1995 12
•Commission Directive 2003/63/EC (brought into UK law by
inclusion in the Medicines for Human Use (Fees and
Miscellaneous Amendments) Regulations 2003) 12
•The Computer Misuse Act 1990 13
•The Congenital Disabilities (Civil Liability) Act 1976 14
•The Consumer Protection Act (CPA) 1987 15
•The Control of Substances Hazardous to Health (COSHH)
Regulations 2002 16
•The Copyright, Designs and Patents Act 1990 16
•The Crime and Disorder Act 1998 17
•The Criminal Appeal Act 1995 18
•The Data Protection Act (DPA) 1998 18
•The Data Protection (Processing of Sensitive Personal Data)
Order 2000 25
•The Disclosure of Adoption Information (Post-Commencement
Adoptions) Regs 2005 26
•The Electronic Commerce (EC Directive) Regulations 2002 26
•
•The Freedom of Information (FOI) Act 2000 29
•The Gender Recognition Act 2004 32
• The Gender Recognition (Disclosure of Information) (England, Wales and Northern Ireland)
(No. 2) Order 2005 33
•The Health and Safety at Work etc Act 1974 33
•The Human Fertilisation and Embryology Act 1990,as amended by the Human Fertilisation and
Embryology (Disclosure of Information) Act 1992 34
•The Human Rights Act 1998 35
•The Limitation Act 1980 38
•The Medicines for Human Use (Clinical Trials) Amendment Regulations 2006 39
•The National Health Service Act 2006 39
•The NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases) Directions 2000 40
•The Police and Criminal Evidence (PACE) Act 1984 41
•The Privacy and Electronic Communications (EC Directive) Regulations 2003 42
•The Public Health (Control of Diseases) Act 1984 and the Public Health (Infectious Diseases)
Regulations 1988 42
•The Public Interest Disclosure Act 1998 43
•The Public Records Act 1958 45
•The Radioactive Substances Act 1993 45
•The Regulation of Investigatory Powers Act 2000 46
•The Re-use of Public Sector Information Regulations 2005 47
•The Road Traffic Acts 49
•The Sexual Offences (Amendment) Act 1976, sub-section 4(1), as amended by the Criminal
Justice Act 1988 49
•The Electronic Communications Act 2000 27
•The Environmental Information Regulations (EIR) 2004 28
25. Capacity
There is presumption of capacity under the MCA 2005
Does the person have an impairment of, or a disturbance in the functioning of, their
mind or brain?
Does the impairment or disturbance mean that the person is unable to make a
specific decision when they need to?
Understand > Weigh > Retain > Communicate
Presumption of incapacity
37%
28. Talia is 32 yrs old. She was diagnosed with HIV 2 years
ago but lost to follow up. She has just re-engaged with
GUM services
Partner of 4 years is unaware of diagnosis
History of violence from partner- evidence of healed
rib fractures on C Xray
Does not want to go to the police regarding abuse
Does not want to reveal her status to partner
Does not want to tell her GP
29. You are the GUM clinician. Do you explain to
Talia that you must disclose to her GP?
A. Yes
B. No
Yes
No
64%
36%
30. Talia is a competent adult. Would you disclose
information about domestic violence?
A. Yes – to police
B. Yes – to social
services
C. No
Yes–to
police
Yes–to
socialservices
No
17%
59%
24%
31. You have counselled Talia re telling her partner about her
HIV status. She won’t. Do you arrange partner notification?
A. Yes
B. No
Yes
No
43%
57%
32. Public Interest test?
Benefits to
an individual
Public interest in
+ confidential
medical service
Possible
harm to the
patientor society
93%
33. What would be most useful to help colleagues
keep up to date with GMP? Multiple responses
A. More monitoring
B. Local GMC
teaching support
C. Guidance for NHSE
D. Explicitly built into
curricula and CPD
E. More time! M
ore
m
onitoring
LocalGM
C
teachingsupport
Guidance
forTrustBoards
Explicitlybuiltinto
curricula
M
ore
tim
e!
20% 20% 20%20%20%
34.
35.
36. Medicine is a tough career; we need doctors trained to be
resilient and better capable to deal with adversity. Do you…?
1. Agree – current selection and undergraduate
programmes do not produce students who are
adequately prepared for a challenging career
2. Agree – but most of the problems lie in the
organisations in which or with which doctors
have to work
3. Disagree – doctors are already resilient – the
focus should instead be on providing proper
levels of support for hard pressed practitioners
4. Disagree – resilience comes largely from
experience
5. Not sure
Agree–
currentselection...
Agree–
butm
ostofthe
...
Disagree
–doctorsare
al...
Disagree
–resilience
com
..
Notsure
0% 0% 0%0%0%
37. 20%
49%
9%
14%
9%
If I were struggling to cope as a result of pressures on the
service, I am confident that I could ask for and receive help
without being penalised.
1. Strongly agree
2. Agree
3. Neither agree nor
disagree
4. Disagree
5. Strongly disagree
44. The GMC and quality
“Professional regulation should be as much about
sustaining, improving and assuring the
professional standards of the overwhelming
majority of health professionals as it is about
identifying and addressing poor practice or bad
behaviour”
The Rt Hon. Patricia Hewitt, MP
Secretary of State for Health, Trust Assurance and
Safety, 2007
