The General Medical Council has suggested that EU regulations related to checks carried out on doctors are still severely flawed.
This is despite the fact that the existing legislation was examined after a patient safety scandal seven years ago.
At that time it was acknowledged that there were catastrophic flaws in the system.
Yet despite new European legislation having been passed, the General Medical Council suggests that there are still fundamental problems with the existing regulations.
Niall Dickson, chief executive of the General Medical Council (GMC), indicated that it is essential for the organisation to be handed appropriate powers to check the competence and medical skills of doctors emanating from the Eurozone.
The GMC already assesses medics from other countries in this regard.
Dickson suggested that the desire to introduce digital “passports to practise” for EU doctors will only worsen the existing situation.
The chief executive went as far as to suggest that this move would jeopardise the ability of the GMC to protect patients in the UK.
One positive aspect of the existing legislation is that the General Medical Council reserves the right to check the language abilities of doctors as a last line of defence.
But Dickson believes that the current powers afforded to the GMC are far from sufficient, and has indicated that the GMC will request for further provisions from the government.
“We are also calling on the UK government to include patient safety considerations in their negotiations on the future UK membership. A commitment to improve patient safety should be part of any continued membership of the EU,” Dickson stated.
Among the GMC’s concerns is that the system of checking doctors’ skills, competence and medical background could be made worse with the proposed European professional card (EPC).
The organisation asserts that this will significantly reduces the amount of time taken to register doctors.
This new legislation will be introduced for nurses, pharmacists, physiotherapists, estate agents and mountain guides from January. Doctors will follow shortly in 2018.
“It must be right that every country in the EU should be able to check that those coming to work within their borders have the competency, skills and cultural understanding to treat its patients safely,” Dickson asserted.
Reports have already indicated that existing checks on doctors hailing from the European Union revealed a significant problem.
Nearly half the total seeking a UK licence to practise have failed English language tests.
And the GMC is already taking action against EU doctors working in the UK.
Last month, one practitioner was suspended and another forced to work under supervision and retake an English test by the Medical Practitioners Tribunal Service.
An Italian doctor has been suspended from practising medicine in the UK after he failed a series of English language tests.
Dr. Alessandro Teppa will face disciplinary action over language skills following a change to legislation relating to the issue back in 2014.
Although the situation is yet to be fully resolved, it is certain that his existing suspension will last for at least nine months, as determined by the Medical Practitioners Tribunal Service (MPTS).
Elsewhere, a Polish doctor who failed language tests on three occasions has been allowed to work under supervision.
Dr. Teppa had been granted a licence to practice medicine in UK in 2012. This followed 14 years of practising in Italy.
Teppa then failed an English assessment in 2014, and was subsequently placed under an interim suspension order.
Although Teppa claimed to have been taking English lessons at his home in Italy, it was evident to the panel assessing his ability that it was insufficient to practice medicine in the UK.
The General Medical Council (GMC) endorsed the decision of the MPTS, with Niall Dickson, Chief Executive of the GMC stating that “this doctor should not be able to practise in the UK again until he can demonstrate he is able to communicate effectively.”
A separate case involved a second doctor, Dr Tomasz Fryzlewicz, who qualified in Poland and has held a licence to practise in the UK for the last nine years.
Fryzlewicz failed separate English assessments in October and December 2014, with a third failure following in February 2015.
The panel assessing the Polish doctor’s capability ruled that he must work under only direct supervision over the next 12 months.
There was also a stipulation that the doctor must pass an English language assessment in the next year.
However, the Chief Executive of the GMC did not support this particular verdict.
Dickson instead suggested that more stringent sanctions should have been taken against the Polish GP.
“We are disappointed that the MPTS panel did not suspend Dr Fryzlewicz as we had requested but we are satisfied that the panel has placed sufficient conditions on his clinical practice to make sure that patients will be protected,” Dickson commented.
Colleagues that work with the Polish doctor provided evidence stating that he seemed to be lacking in English comprehension.
New powers allowing the medical regulator to check doctors’ English language skills came into force in June 2014.
Previously only doctors from outside Europe could have their language skills tested by the GMC.
A review by healthcare experts from across the UK has highlighted a number of key principles for improving services for doctors with mental health and addiction problems.
The experts considered one of the recommendations outlined in the 2014 independent review of doctors who take their own lives while under investigation by the General Medical Council (GMC).
The review recommended establishing a national or nationally co-ordinated support service for doctors with mental health or addiction problems.
The review highlighted key principles for the development of services in this area: (i) all such services should be separate from the GMC and seen to be separate; (ii) there must be some liaison with the GMC where there is a risk to patient safety; (iii) there should be clear rules around information disclosure and the relationship with the GMC so that doctors are not discouraged from accessing help; (iv) there need to be systems in place within organisations to encourage early; and (v) awareness and early intervention, as well as making sure there are support services for doctors with complex issues.
“The case for better support for vulnerable doctors has been clearly demonstrated by the amazing work that is already underway”, said Niall Dickson, chief executive of the GMC. “The challenge facing the system as a whole is that such services are not found everywhere. We will certainly work with experts in this area to encourage the development of better support as well as seeking their help as we reform the way we deal with this group of doctors within our procedures.
“We have found this discussion enormously helpful. We have heard a number of important messages from across the UK and we will publish a short report following this discussion. We are also keen to hold another similar event to consider how we are taking forward the other recommendations from the independent review.”
A major evaluative research study into the regulatory impacts of medical revalidation has been commissioned by the General Medical Council (GMC).
The study involves almost 160,000 licensed doctors who will be asked to undertake a survey about the revalidation process to help researchers assess where improvements need to be made.
The evaluation is being overseen by a UK-wide collaboration of researchers (known as UMbRELLA). The GMC/UMbRELLA collaboration was set-up specifically to undertake the independent evaluation of medical evaluation.
Following the survey, there will be interviews with senior NHS staff as well as feedback from patients.
Doctors not invited to take part in the survey include trainee doctors, those who are provisionally registered and those who do not hold a licence with the GMC. Doctors in foundation or specialty training go through a different revalidation process to fully licensed practitioners. They will be asked to give their opinions on revalidation through the National Training Survey.
The findings of the research are expected to be published in 2018.
More information about the revalidation evaluation survey can be obtained on the UMbRELLA website.
A consultation aimed at making doctors better professionals, communicators and leaders has been launched by the General Medical Council (GMC) and the Academy of Medical Royal Colleges (AoMRC).
The consultation will seek views on a proposed framework for generic professional capabilities sought, including the outcomes that all doctors will have to demonstrate by the end of their postgraduate specialty training.
The framework clarifies the core knowledge, skills and behaviours which doctors need and which are common across all medical specialties, such as effective communication, team-working and patient-centred decision-making.
These and other key capabilities described in the framework are essential for safe, high-quality clinical care and will support doctors’ development as high performing, compassionate and caring professionals.
“UK trained doctors are valued and recognised across the world for their technical expertise”, said Niall Dickson, Chief Executive of the GMC. “But alongside this it is vital that every senior doctor has the personal and professional insights and capabilities to deliver, lead and manage high-quality care in complex teams, often in stressful environments or rapidly changing clinical circumstances.
“Patients rightly expect doctors to be good team players, have situational awareness and where necessary to provide effective leadership – they also expect their doctors to be professional, principled and expert communicators.
‘There is evidence that an awareness of human factors and associated generic professional capabilities improve professional practice. By acknowledging, encouraging and embedding the development of these high level professional insights, skills and capabilities into medical training, there is an expectation that we can promote and enable a higher and more consistent level of care for patients. Clinical skills are absolutely vital – they are necessary but on their own not sufficient to guarantee excellent care for patients.”
The GMC/AoMRC consultation is due to run until 22 September 2015.
The General Medical Council (GMC) has announced proposals for new time limits for how long sanctions on a doctor’s registration are published online or made available to the public.
According to Niall Dickson, Chief Executive of the GMC, the consultation is about making the information more accessible and making the decisions taken by the GMC clearer for patients and the public.
Under current rules, when a doctor receives a sanction the outcome is published on the GMC’s website and disclosed to anyone who asks. It also remains online indefinitely even after any restrictions have been lifted.
“Patients and the public have a right to know if there have been serious concerns about their doctor”, said Mr Dickson. “However, we also want to be fair to those doctors who have been through our procedures. Under Human Rights law we have to be proportionate and we have also reflected on changes in the law around the disclosure of criminal convictions. As a result we have concluded that publishing sanctions indefinitely in some situations could be disproportionate, if it happened a long time ago or if the doctor is no longer practising.”
The GMC proposals includes details of doctors who have been suspended, had restrictions on their practice, agreed undertakings such as retraining or been erased from the medical register altogether.
Mr Dickson continued: “We want to strike the correct balance between the rights of patients to know and a doctor’s right to privacy. We are keen to hear from patients, doctors and others with an interest in our work so that we can get this important balance right.”
An independent review into creating an open and honest culture in the NHS has been welcomed by the General Medical Council (GMC).
The review, led by Sir Robert Francis QC, provides many recommendations as to how to create a culture in which NHS staff feel safe to make disclosures about any aspect of the quality of care, malpractice or wrongdoing at work without fear of recrimination.
The team undertaking the review spoke to individual NHS workers, as well as with employers, trade unions, professional and system regulators and professional representative bodies.
Niall Dickson, Chief Executive of the GMC, said: “Doctors are much more likely today to raise concerns about standards of care than they were a generation ago but, as Sir Robert has shown, in too many institutions and departments fear and hierarchy still inhibit honest and open reflection. And a system where staff are frightened to raise concerns is not a safe system.
“The answer is simple to say, less easy to achieve – a culture where doctors and other health professionals feel empowered and supported when they speak up.
“We have made it abundantly clear that doctors have a duty to act when they believe patients’ safety is at risk, or that patients’ care or dignity are being compromised. But this is not so much about requiring staff to speak up, as it is about creating the conditions where they feel comfortable and encouraged to do so. We have required doctors’ leaders to support those who do raise concerns. Above all, changing the culture is a task for local managers and clinical leaders.
“That said, while national regulators of healthcare professionals such as the GMC have a limited role, it is a significant one and we are determined to play our part.”