- GMC will no longer be allowed to appeal tribunal decisions against doctors
- Jeremy Hunt to set out watered down proposals for medical examiner service
- New national programme to provide consultants with personal performance data
The General Medical Council is to be stripped of its right to appeal tribunal decisions on doctors’ fitness to practise, less than three years after it was granted the power.
Health and social care secretary Jeremy Hunt is set to announce the change later today as part of a raft of new patient safety measures.
Mr Hunt is expected to set out the government’s much delayed response to plans for an independent medical examiner service and a new national programme to provide NHS consultants with data on their personal performance and outcomes benchmarked with their peers.
The removal of the GMC’s right of appeal comes in the wake of the GMC’s pursuit of paediatrician Dr Hadiza Bawa-Garba who was struck off by the High Court in January. GMC chief executive Charlie Massey appealed a tribunal decision not to strike her off when recognising wider systemic failings in the care of six year-old Jack Adcock who died in 2011.
Dr Bawa-Garba was convicted of gross negligence manslaughter in 2015.
The GMC was only granted the right of appeal in 2015 amid concerns the regulator had no ability to tackle tribunal decisions which the watchdog felt left the public at risk. It has successfully used the power in a number of cases, including doctors allowed to continue working after sexual misconduct against patients.
Following widespread concern over the Bawa-Garba case Jeremy Hunt asked former president of the Royal College of Surgeons Professor Sir Norman Williams to conduct a review into gross negligence manslaughter in healthcare.
The review’s findings are due to be published today with Mr Hunt expected to make a statement to MPs.
He will set out a series of steps designed to promote a learning culture and to head off concerns by clinicians that they could be prosecuted or struck off for genuine human error even in cases of wider systemic failings.
Among the proposals Mr Hunt will set out include:
- The GMC right to appeal tribunal decisions will be removed. The Professional Standards Authority will retain its right of appeal.
- Reflective notes by doctors and nurses will not be able to be used by regulators in fitness to practise cases. But the announcement makes no mention of protecting reflections from use by the police or courts which is what happened to Dr Bawa-Garba.
- A clearer understanding of where the bar is set for bringing gross negligence manslaughter cases with an emphasis on very poor performance rather than “honest mistakes.” The announcement offered no detail on how this would be achieved.
Mr Hunt is also expected to announce proposals for the rollout of a medical examiner service with experienced clinicians examining all deaths not referred to a coroner. An independent medical examiner service was a key recommendation of the Shipman, Francis and Kirkup Inquiries but despite legislation being passed in 2009 a system has never been implemented.
In April HSJ revealed the government was planning to water down the proposals with medical examiners no longer independent but based in acute hospitals and will not cover community, mental health or primary care deaths.
Other proposals include the launch of a new National Clinical Improvement Program, developed by the Getting It Right First Time team. This will see all consultants provided with confidential data on their own clinical performance including how they compare with colleagues. It will initially be rolled out to consultants in general surgery, paediatric surgery and urology.
Mr Hunt is also expected to say GPs and ambulance trusts will be next to focus on reviewing deaths after acute trusts were required to publish avoidable death rates. The policy has been described as “misconceived” by experts.
Ahead of his statement Mr Hunt said: “When something goes tragically wrong in healthcare, the best apology to grieving families is to guarantee that no-one will experience that same heartache again. I was deeply concerned about the unintended chilling effect on clinicians’ ability to learn from mistakes following recent court rulings, and the actions from this authoritative review will help us promise them that the NHS will support them to learn rather than seek to blame.
“Combined with our medical examiners, learning from deaths and clinical improvement programme, these measures are the next phase in our patient safety reforms, supporting the NHS to seize every opportunity to learn vital lessons when tragic errors occur.”
The GMC said in a statement it was a missed opportunity not to legally protect reflective statements from use by the police.