Serious Untoward Incidents
-The role of the GMC Dr Colin Pollock
GMC Employer Liaison Adviser (Y&H)
Y&H Deanery School of Surgery Conference 26th April 2013
Our functions
Education &
Training
Registration
Fitness to
Practise
Standards
and Ethics
Our statutory duty is to “protect, promote and
maintain the health and safety of the public”
Trends - fitness to practise?
Trends - fitness to practise?
Initial handling of complaints / referrals
Initial triage assessment 
Are there issues for the GMC to
investigate?
Possible outcomes
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Closed at the initial triage
assessment stage (56% of cases)
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Stream 2 – usually refer to local
procedures (18%)
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Stream 1 – GMC open
investigation (27%)
Outcome of referrals / complaints (2011 data)
Opening a case based on an SUI
“An adverse outcome (in particular the death of a patient or
serious harm) will undoubtedly be a factor in assessing the possible
seriousness of an alleged failure or breach. However, such an
outcome needs to be considered in the context of the case as a
whole. An adverse outcome does not, in itself, indicate any error
on the part of the doctor. Often the outcome will simply be the
unfortunate consequences of the particular condition or an
inherent risk of the particular treatment. Similarly, ‘errors’ in
diagnosing or treatment are an inevitable fact of medicine and
will not necessarily raise questions about a doctor’s fitness to
practise. There will be many cases, therefore, where
notwithstanding an adverse outcome, it is still more appropriate for
the matters to be considered initially under local procedures.”
Opening a case based on an SUI
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Referral from Trust / Deanery
Complaint from patient / family
Press cutting
Coroner’s inquest
Police investigation
Ombudsman referral
CQC
A colleague
Which doctors are involved?
Principles of Investigation Process
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The doctor has every opportunity to respond to the
allegation at any time
Employers involved (and Deanery for trainees)
throughout
Take appropriate interim action to minimise any risk to
patient safety
Explain clearly our process and decision making
Transparency
Acting as quickly as is possible whilst maintaining
fairness to all parties.
Overview of Investigation Process
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Initial ‘disclosure’ to the doctor
Employer ‘disclosure’ (includes Deanery)
Collecting information:
•
witness statements
•
medical records
•
expert reports
•
health assessments
•
performance assessment
[Interim Orders Panel – no order made / suspension /
conditions?]
Overview of Investigation Process
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Final ‘disclosure’ to doctor for their response
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The doctor’s response (tone and content) is critical
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Two Case Examiners (medical / lay) decision
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Four options
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close (+/- advice)
•
warning
•
undertakings
•
FTP Panel
Factors taken into account during an investigation
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…..it is important that the outcome of the incident should not be
considered in isolation....
….consider the circumstances in which the incident occurred.
….the doctor’s actions fell below what could reasonably be
expected of a doctor at his or her grade and level of experience
….a death will have a bearing on the consideration of the case....
(but)…. needs to be considered along with all the other factors.
….ensure that any local inquiry has been sufficiently rigorous
before relying on this when concluding a GMC investigation.
….some cases which do not result in the death of a patient, but
which, nonetheless, raise questions about the standard of the
doctor’s practice.
….a serious failure to meet the standards in Good Medical
Practice.
Outcome of referrals / complaints (2011 data)
Further information
Dr Colin Pollock
GMC Employer Liaison Advisor
(Yorks & Humber)
cpollock@gmc-uk.org
Any Questions?