Doctors facing allegations of violence & dishonesty

The GMC has changed its guidance for circumstances where allegations of dishonesty and violence might not impact on public safety.  I look at the guidance and the implications for doctors.

Guidance when violence and dishonesty may represent a lower risk to public protection

GMC decision makers will now be able to weigh the full circumstances of a concern earlier in the fitness to practise process to assess the overall risk to public protection including to public confidence in the profession– meaning some concerns may not need to be investigated or referred to a tribunal. 

Concerns that fall under the guidance are those that are minor in nature and did not impact patient care. Allegations of violence and dishonesty which raise a risk to public protection, including where there is a history of repeated behaviour, will continue to be investigated.

GMC provisional enquiries & Triage

As outlined above, the decision-making process happens at an early stage in the GMC’s fitness to practise process, also referred to as provisional enquiries and triaging.

Simply put, when the GMC receives an initial complaint or allegation, it will look at the information and evidence against a set of criteria to determine whether the concern appears to raise a question whether the doctor’s fitness to practise is impaired. This is known as the triage test.

Where the information and evidence meets the criteria, the GMC will move to provisional enquiries. 

During the provisional enquiries stage, the GMC will identify and assess the information and evidence.  The GMC will write to the doctor to inform them of the complaint or allegation and giving them a right to reply if they so wish.  At the provisional enquiry stage, the GMC may also seek information and evidence elsewhere.

During provisional enquiries, the GMC will consider the nature and seriousness of the allegations, the evidence obtained through our provisional enquiries and the risk of the conduct being repeated and placing patients at risk and decide to either:

• close the enquiry with no further action
• close the enquiry but, in addition, notify the Responsible Officer (RO) or notify Employers process
• promote the enquiry to a full investigation.

Provisional enquiries are normally concluded within 2–3 months.

Triage threshold test

The GMC will determine whether the concern appears to raise a question whether the doctor’s fitness to practise is impaired, also known as the triage test.

The test applied to determine whether the triage test has been met involved the GMC asking itself, during the provisional enquiries stage:

“Whether the allegation appears to raise a question as to whether the doctor’s fitness to practise is impaired.”

In other words, the triage test focuses on whether the issues are such that they require investigation by the GMC. Although this test applies universally, the factors to be considered by decision makers will vary depending on the nature of the concerns and the information we have gathered through different provisional enquiry streams.

Violence and Dishonesty

There are certain categories of cases where the allegations, if proven, would normally lead to a presumption of impaired fitness to practise.  This includes allegations of violence and dishonesty.  However, in the case of violence or dishonesty allegations, this presumption may be rebutted if the nature of the conduct does not indicate that the doctor poses a risk to public protection.

Whether the doctor poses a risk to public protection and the extent of that risk will be determined on a case-by-case basis.  Conduct that is unlikely to raise a question of impaired fitness to practise, and therefore a full investigation:

• will be minor in nature and less likely to pose a risk to patients, public confidence or proper professional standards and conduct
• will usually have occurred outside the doctor’s professional practice
• will often have been investigated by the police or another relevant body, such as the doctor’s employer.

Violence

The guidance states that allegations of violence are less likely to pose a risk to patients, public confidence or proper professional where:

1. the alleged violence was outside a professional context
2. the alleged violence was limited in nature rather than sustained or repeated
3. no weapons were involved
4. no physical, emotional or psychological harm was caused
5. the alleged violence was not directed towards a vulnerable person*
6. the doctor has no history of violent behaviour†
7. there is no evidence on the face of it indicating that the doctor may repeat the alleged violence in the future
8. there is no evidence on the face of it that the alleged violence was motivated by hostility towards someone’s race, sexual orientation (or perceived sexual orientation), disability, sex, gender (or presumed gender identity), religion or age
9. any investigation conducted by the police or another relevant body, such as the doctor’s employer, resulted in no formal action or a single warning by the employer.

Dishonesty

Similarly, allegations of dishonesty are less likely to pose a risk where:

1. the alleged dishonesty was outside a professional context
2. the alleged dishonesty was a one-off, isolated incident and not persistent or repeated over a period of time
3. the value of the financial or other material benefit derived by the doctor from the alleged dishonesty was low
4. the doctor has no history of dishonesty*
5. there is no evidence on the face of it indicating that the doctor may repeat the alleged dishonesty in the future
6. the alleged dishonesty was not directed towards a vulnerable person†
7. any investigation conducted by the police or another relevant body, such as the doctor’s employer, resulted in no formal action or a single warning by the employer.

Things will go wrong, and we are here when you need us

Kings View has been advising and representing health care professionals for many years, and we know that despite their best efforts, some things do go wrong.  Through our experience, we know that the circumstances that lead to things going wrong are never straightforward.

It is a well-established fact that healthcare professionals 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).

You can speak to me today for a free, no obligation assessment of your case.