The GMC and Medical Regulation
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The GMC and Medical Regulation Sir Graeme Catto Wednesday 4 February 2009 Hailsham Chambers, Old Hall, Lincoln’s Inn. Our purpose. To protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine

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The GMC and Medical Regulation Sir Graeme Catto Wednesday 4 February 2009

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The gmc and medical regulation sir graeme catto wednesday 4 february 2009

The GMC and Medical Regulation

Sir Graeme Catto

Wednesday 4 February 2009

Hailsham Chambers, Old Hall, Lincoln’s Inn


Our purpose

Our purpose

  • To protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine

    Medical Act 1983 (as amended in 2000)


Our interlocking functions

registration

education

fitness to practise

standards

Our interlocking functions


Our recent history

Our (recent) history

  • 1858: The ‘General Council of Medical Education and Registration’ established

  • 1995: Good Medical Practice

  • 1998: Bristol case ends, Shipman arrested

  • 2004: Fifth Shipman report

  • 2006: Good Doctors, Safer Patients

  • 2007: Trust, Assurance and Safety

  • 2009: A reconstituted Council


Our aim

Our aim

  • To secure a regulatory system that is…

    • Independent

    • Fair

    • Efficient and effective

    • Enhances patient safety

    • Fosters the professionalism of doctors

    • Commands the confidence and support of key interests


Some common themes

Some common themes

  • Ineffective local systems

  • Patients uncertain how to register concerns

  • Reluctance to report dangerous colleagues

  • Poor co-ordination across systems

  • Management by exception


Our response a four layer model

Our response…a four layer model

  • Personal regulation

  • Team-based regulation

  • Workplace regulation

  • National regulation

    Plus...

  • International co-operation


State of the nation

State of the nation

  • Personal regulation

    …alive and kicking

  • Team-based regulation

    …must do better

  • Workplace regulation

    …good in parts, but room for improvement

  • National regulation

    …getting better, but not there yet


Future issues revalidation

Future issues…Revalidation

  • A set of procedures operated by the GMC to secure the evaluation of a medical practitioner’s fitness to practise as a condition of continuing to hold a licence to practise. (Adapted from the Medical Act 1983)

  • To create public confidence that all licensed doctors are up to date and fit to practise. (GMC, 2005)

  • Introduction of the licence to practise – in 2009 - as a first step towards Revalidation


Future issues standards

Future issues…Standards

  • Good Medical Practice as a framework for appraisal and assessment

  • Guidance on, for example:

    • 0-18 years: guidance for all doctors

    • Consent: patients and doctors making decisions together

    • Personal beliefs and medical practice

    • Acting as an expert witness

    • End of life issues

    • Confidentiality


Future issues education

Future issues…Education

  • The merger of PMETB with the GMC:

    • A single continuum of all stages of medical education and training

    • A more strategic approach

    • A single point of contact for key interests

    • Bringing together best practice from both organisations

    • Greater resources (250,000 registrants v 50,000 trainees)

    • An integrated approach across regulatory functions


Future issues affiliates

Future issues…Affiliates

  • Government proposed a network of GMC Affiliates, appointed to work at local level to provide support, advice and guidance to employers in managing concerns about doctors.

  • Intended to bridge the gap between national and local regulation

  • Pilots taking in place in North London and West Yorkshire

  • Responsible Officers - to bolster local clinical governance

  • Regional Medical Regulation Support Teams (RMRSTs) - to focus on macro issues relating to complaints handling.


Future issues adjudication

Future issues…Adjudication

  • Establishment of a new adjudicator, the Office of the Health Professions Adjudicator (OHPA), to replace adjudication on fitness to practise cases by the GMC

  • GMC to have a right of appeal against unduly lenient fitness to practise decisions by OHPA

  • OHPA to take account of the GMC’s Sanctions Guidance based on Good Medical Practice.

  • Chair to be a senior lawyer of ten years’ standing


What do people think

What do people think?

Source: GMC Tracking Survey conducted by GFK-NOP


A final thought

A final thought…

  • Regulation for the majority;

  • Regulation of the minority


The gmc and medical regulation sir graeme catto wednesday 4 february 2009

ANNEX A – a four-layer model


1 personal regulation

(1) Personal Regulation

  • Regulates own practice

  • Shows commitment to a common set of values,

    behaviour and relationships that underpin the trust

    the public has in doctors

  • Puts patients first

  • Uses knowledge, clinical skills and judgement to

    protect and restore human well-being

  • Protects patients from risk of harm posed by a

    colleague’s conduct, performance or health


2 team based regulation

(2) Team-based regulation

  • Accepts responsibility for the team as a whole

  • Accepts responsibility for others in the team

  • Works in partnership with members of the wider

    healthcare team

  • Protects patients from risk of harm posed by a

    colleague's conduct, performance or health.


3 workplace regulation

(3) Workplace regulation

  • Ensures that doctors are fit for their roles

  • Operates effective clinical governance

  • Creates an organisational infrastructure to support

    doctors in the exercise of their professional

    responsibilities

  • Assigns clear responsibilities

  • Takes prompt and effective action if actual or

    emerging impairment puts patients at risk.


4 national regulation

(4) National regulation

  • Controls entry to profession and to specialties

  • Fosters good medical practice, setting out generic

    values, ethics and principles

  • Determines standards for education and training

  • Ensures continuing fitness to practise

  • Deals firmly and fairly with doctors whose fitness to

    practise is or may be impaired

  • Grounded in research; and risk based

  • Independent

  • Commands confidence and support of key interests


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