LMITransactions&Report2014-15

LMI Transactions and Report 2014 - 2015
that there was no risk to the public, no action to take
and no reason to proceed. However, it took just under
two years before the letter saying this arrived on desk
of the surgeon. During that time his revalidation date
was due and because the GMC file was still open, the
Revalidation Responsible Officer at the Trust could not
action his revalidation process.
Case Study Two
A consultant surgeon in his mid sixties, nationally and
internationally well known, received a GMC letter.
The complainant was the private hospital at which he
worked and where he had complained that the
facilities fell short of the required standards. The
complaint indicated 10 cases where his practice had
been found wanting and threatened the safe care of
patients.
Within 9 to 10 months of receiving this letter all of the
criticisms raised had been dismissed. However, 18
months later he got another letter from the GMC
saying it was now going to a fitness to practise
hearing. The ultimate outcome of this hearing was
that there was no case to answer. The effect on this
man's life has been considerable both personally and
professionally as a practising surgeon as well as to his
family.
Our speaker went on to say that the Medical
Protection Society have said that 93% of doctors who
go through fitness to practise processes report severe
anxiety and stress. Whistle-blowing brings with it
considerable personal risks.
Revalidation
Professor Narula changed to the subject of Medical
Revalidation. He said that in the early 2000s the GMC
was all set to institute new and improved
recertification processes and procedures for doctors in
medical practice in the United Kingdom. However,
Dame Janet Smith, the High Court judge who chaired
the Shipman enquiry, heavily criticised the ideas
behind these proposals in her third and final report.
Many lawyers criticised her for going outside of her
remit in the enquiry by making these comments but
her intervention led to a revisiting by the GMC of this
whole process.
Thus a whole new bureaucracy was designed to
respond to the criticism but in fact the only real
difference that came forth was the introduction of
processes of feedback from patients and doctors. The
main thrust of this process was to prevent another
Shipman. But, our speaker went on to say, we all
know Shipman's patients loved him so, even as a mass
murderer, he was unlikely to be picked up by this new
process. There was majority agreement for this from
the audience.
We are now in year two of the era of Revalidation. A
phased process has been introduced and it is
anticipated that all doctors in practice will have been
revalidated by March 2016. There is still much
sceptism abroad in the profession about the process
and some believe that if approximately five per cent
of doctors refused to engage, the whole system would
collapse.
Our speaker went on to say that the underpinning to
Revalidation is annual appraisal. The annual appraisal
process is meant to review the evidence of your
practice as a doctor and the evidence to support the
quality of that practice both in private practice and
NHS practice. It is meant to be both formative and
summative in supporting the continuing professional
development of you, the doctor. “In my experience”,
said our speaker, “I have been appraised since 2003
but never been asked about my private practice.”
The process of appraisal is that the doctor submits a
portfolio of evidence in line with the four domains of
the GMC standards for Knowledge Skills and
Performance; Safety and Quality; Communications,
Partnership and Team work and Maintaining Trust.
Nowadays this is an electronic repository, which can
be supplemented at the time of appraisal by paper
records and evidence. Following a successful appraisal
meeting, a summary is agreed by appraiser and
appraisee and a professional development plan (PDP)
is drawn up and this will form the framework for the
next appraisal. Our speaker went on to say that there
is a requirement in the portfolio for Reflection. He
admitted that he was not sure what this was really
about and that many felt the same way.
One of the key things for appraisal, he offered, is the
inclusion of national registry data about outcomes for
index surgical operations. This is particularly true for
surgeons. He said with considerable feeling that he
had resisted the recent desire by government for
publication of such data before individual clinicians
had had time to see their own results. He went on:
“There are in my opinion a whole lot of potential and
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