GMC investigations are utterly traumatic experiences for doctors regardless of the final outcome. However, there are opportunities for early resolution of GMC investigations at various stages in the process.
If you are a doctor working in the UK, you should expect to be the subject of a GMC complaint at some point in your career, however most doctors who approach us for legal advice and support have little insight into this process and are ill-prepared for this extremely stressful eventuality.
The GMC receives around 7500 complaints every year. Based on the number of doctors on the GMC register, there is an approximate 2.2% chance of being subject to a complaint. Whilst this might not sound a lot, based on a typical 35 year career, you can statistically expect to be the subject of at least one complaint to the GMC within your working lifetime.
Broadly the speaking, about 75% of all GMC complaints are closed either during the initial triage stage or during the investigation. In reality this number is higher because about 20% of cases are “in progress” and many of these will also not be referred to a full hearing.
The majority of cases are therefore dispensed with during the investigation stage. Whilst there might be a variety of reasons for this, the opportunities for doctors to influence the outcome is a contributing factor.
The GMC’s fitness to practise process provides doctors with a number of opportunities to provide evidence including, evidence of insight gained and remediation steps.
The GMC’s provisional enquiry process exists to close cases early without a full investigation, under certain circumstances. As part of this process, a GMC case officer will send a doctor an initial Rule 4 letter which outlines the complaint or allegations. Whether to respond to a Rule 4 letter is at a doctor’s discretion and, whilst under certain circumstances, a response might not be necessary, a doctor should consider this carefully and seek advice.
In any event, following the receipt of a Rule 4 letter, a doctor should reflect on the circumstances that might have led to the complaint and take remedial steps. The insight gained and remedial steps taken might form part of a Rule 4 letter’s response and doctors are advised to seek legal advice as soon as is reasonably possible.
Should the complaint progress past the provisional enquiry stage, GMC case examiners also have the discretion to close cases without the need for a full fitness to practise hearing. Case examiners will write to the doctor, outlining the evidence and allegations in a GMC Rule 7 letter. The doctor will be invited to respond within 28 days.
Whist the case examiner stage provides another opportunity for a doctor to provide evidence of insight and remediation, the timescales are short. As mentioned above, doctors are advised to seek legal advice as soon as is reasonably possible.
A 2019 study peer-reviewed study published in the journal BMC Medicine found that doctors who lacked legal representation tended to receive more serious outcomes. The study results showed clearly that both “non-attendance and lack of legal representation” were consistently related to more serious outcomes.”
A similar 2015 study revealed that – of the two outcomes, suspension or erasure – doctors with legal representation at hearings were significantly more likely to merely be suspended (72%), rather than struck off (28%). In contrast, 69% of self-represented doctors were struck off.
The benefits and necessity of legal representation for doctors facing GMC investigation is clear.
Even if you cannot stop the case completely at this early stage, it may be possible to significantly reduce the number or severity of allegations you face – therefore reducing the range of sanctions that could be imposed.
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).
At Kings View, we have experience defending every level of doctor in all tribunals for the last 10 years and our barristers have additional qualifications from the Bar Standards Board, meaning that we can carry out all of the tasks that a solicitor can – including litigation.