General Medical Council (GMC) Performance Assessments are carried out to assess a doctor’s professional performance to obtain an independent opinion on their fitness to practise. Are Performance Assessments a fair system, and what are appeal options available to doctors?
First thing to say is that GMC complaints are unfortunately an ‘occupational hazard’ for doctors. Doctors should expect to be referred to the GMC at least once in their medical career. However, most doctors have little insight into this process and are ill-prepared.
Issues associated with skills, knowledge and performance consistently rank at the top of the list of most common GMC complaints. Complaints relating to deficiencies in a doctor's clinical skills, knowledge and performance are likely to result in the GMC requesting a Performance Assessment.
GMC Performance Assessments are normally carried out by two doctors and a lay person. The team of assessors will provide a report which will describe a doctor’s professional performance and give an opinion on the doctor’s fitness to practise. The team may also make recommendations on the management of a case.
GMC Performance Assessments can last for several days and the content and format depend on the circumstances of each case such as a doctor’s speciality, the nature of their work etc. The team of assessors will be provided with certain information, including a summary of the performance-related allegations, which might include extracts from other reports.
Performance Assessments are assessed against the standards described in the Good Medical Practice (when was the last time you actually read it?) and other GMC explanatory guidance. Assessments are undertaken in two phases: a peer review (some of it undertaken at a doctor’s place of work); and a test of competence held at a GMC assessment centre.
Finally, a Performance Assessment will be broad. This means that the assessment might not focus exclusively on the alleged areas of concern. In addition, the assessment might also call on third parties (such as employers, colleagues etc.) to comment on a doctor’s practice and the outcomes of these will form part of the final report.
According to GMC statistics, 60% of doctors subject to a GMC Performance Assessment are judged to not be fit to practise. A further 17% are judged to have limited fitness to practise, leaving only 23% of doctors who are deemed fit to practise following a Performance Assessment.
GMC Performance Assessments have been described as “designed to fail doctors.” The statistics quoted above certainly appear to indicate that there is some truth in this. From years of experience in defending doctors facing GMC fitness to practise investigations and hearings, we know that doctors often feel that their Performance Assessments were unfairly conducted, based on wrong/inadequate assessment criteria, not based on “real life” and/or have inadequate focus.
Doctors have called on the GMC to stop the “unethical and questionable” Performance Assessments.
If you have been asked to undertake a GMC Performance Assessment or, been subject to such an assessment, what are your representation and appeal options?
There are two matters for doctors to bear in mind. A doctor can:
Expert legal advice and representation are key to both these. Kings View have experience defending every level of doctor in all tribunals for the last 10 years. We are very experienced in defending doctors who have been subject to GMC Performance Assessments.
GMC Performance Assessments can be complex and multifaceted. Doctors face the prospect of suspensions or, in extreme cases, erasure, for persistently refusing to undergo a Performance Assessment or actively hindering the assessment process.
It is a well-established fact that doctors who seek legal advice and representation at an early stage in any fitness to practise process, generally, receive better outcomes and lesser sanctions, if any. We can advise on the right strategy to take and represent you before a fitness to practise hearing.
Kings View are public access barristers, meaning that you can instruct us directly without having the additional expense of hiring a solicitor first (so we are generally at least one third cheaper).
Doctors might also find the GMC guidance useful to refer to.