The General Medical Council has stressed that patient safety must always take priority over the freedom of movement of doctors in Europe. Responding to proposed changes to EU law governing the movement of doctors and other professionals around Europe, the GMC has stated whilst free movement is to be encouraged nevertheless there must be reassurance for patients that the doctors treating them are qualified and fit to practise.

For decades, patients in the UK have benefited from EU and overseas qualified doctors practising here and the GMC says many of the proposals in the updated draft directive are welcome. But it stressed that any changes must put patients first.

Niall Dickson, the Chief Executive of the GMC, said:

‘Patient safety is paramount. Although we support the freedom of movement of doctors, patient safety must always come first when making laws in Europe.

‘We welcome many of the proposed changes including the introduction of a duty on regulators to share information and the recognition of the importance of language skills for doctors to practise safely.

‘But there are some areas where we still need further clarity, including with the professional card where we are seeking further assurances on how it will work.’

‘We are now entering a critical stage in the process of confirming how the new rules will work in practise. During this time, we will continue to work with the UK Government, the EU institutions, and other regulators to do everything we can to make sure that the final directive provides the right safeguards for patients while allowing the UK to continue to benefit from the skills of doctors from across Europe.’

Other key elements in the updated draft directive are covered in the GMC’s position in response to the Commission proposal which is available on their website at www.gmc-uk.org

Earlier this month, the Nursing and Midwifery Council introduced new rules governing fitness to practise allowing them to take action more promptly to protect patients and the public by improving the efficiency, timeliness and effectiveness of our procedures.

Following a consultation last year, the NMC have amended rules relating to:

• The investigation of fitness to practise allegations referred to the NMC, and
• Procedures for seeking and making interim orders.

NMC Acting Chief Executive and Registrar Jackie Smith said:

“We have seen a steady rise in the number of referrals in recent years. The rules governing our fitness to practise procedures date back to 2004 and these amendments will not only help us deal with the growing number of referrals more efficiently, but help address concerns raised about our processes.

“The most significant changes relate to interim orders and investigations, which should mean interim orders can be imposed more quickly when needed. We can now refer appropriate cases directly to an interim order hearing, which will significantly reduce the time it takes to make an order when required and ultimately to protect the public.

“We expect to reduce the overall time it takes to progress a case, especially where there is no case to answer. We believe the public and our stakeholders can have greater confidence in our processes and our ability to deal with nurses and midwives whose conduct or competence puts patients at risk.”

Further details of the chnages can be found in the consolidated version of the Nursing and Midwifery Council (Fitness to Practise) Rules 2011.

The GOC has announced plans to carry out further consultation with stakeholders on an amendment to its Fitness to Practise Rules.

The GOC will consult on one proposed change, which will result in case examiners, rather than the GOC’s Registrar, reviewing decisions not to refer registrants to the fitness to practise committee. This follows the Council’s decision in September 2011 that the rules should be amended in this way in response to stakeholder feedback.

It is anticipated that the new fitness to practise rules will be fully implemented in 2013. The Council aims to agree plans for the transitional period in April 2012. As part of the new rules, the GOC will be recruiting up to 12 case examiners to include optometrists, dispensing opticians and lay people. Further details of the recruitment timetable will be announced in the coming months.

Further details can be found at www.optical.org/en/news_publications/consultations/index.cfm

The general Dental Council (GDC) have issued new guidance aimed at ensuring that advertising by dental professionals is clear and never misleads the public.

The guidance, which covers all forms of promotion of services by dental professionals – both in print and on the internet – guides dental professionals on appropriate use of specialist titles. Specifically, dental care professionals (DCPs) must not imply they have specialist status by giving themselves a title with ‘specialist’ in it since only those dentists who are on one of the 13 specialist lists held by the GDC may describe themselves as being a specialist, e.g. orthodontists.

Under the guidance, dental professionals will be required to feature their GDC registration number in advertising their services. Websites must contain details of a dental practice’s complaints procedure and information of who patients may contact if they are not satisfied with the response, e.g. the relevant NHS body for NHS treatment and the Dental Complaints Service for private treatment.

The guidance also makes clear that every dental professional has a responsibility to ensure that any promotional information containing their name, in print or online, is current and accurate.

Chair of the GDC, Kevin O’Brien said:

“The duty of all dental professionals is to put their patients’ interests first. Related to advertising, this means never making claims which could mislead patients. This new guidance will help to ensure that patients’ basic right to clear, accurate information is protected and that dental professionals have helpful guidance to assist them with ethical advertising.”

The new guidance will take effect from 1 March 2012. Full details can be found on the GDC’s website at www.gdc-uk.org/Dentalprofessionals/Standards/Pages/Ethical-advertising.aspx

The General Medical Council (GMC) is seeking views on guidance about the factors its decision makers should consider when dealing with an allegation that a doctor has assisted a person to commit suicide.

Niall Dickson, the Chief Executive of the General Medical Council said:

‘This is a complex and sensitive issue. Nothing in the draft guidance changes the law on assisting suicide; neither should it be taken to imply that the GMC supports or opposes a change in that law. Encouraging or assisting suicide remains a criminal offence and the guidance reflects the law on the subject.

‘We recognise that there are a range of actions which would contravene the Suicide Act – from providing information to a patient to helping someone to travel to Dignitas. Some of these actions may not lead to criminal charges, but may still lead to complaints about a doctor’s fitness to practise.

‘We do think our decision makers will find it useful to have guidance about the factors they should consider when dealing with an allegation that a doctor has assisted a person to commit suicide. Doctors, patients and others may also find it helpful if we set out clearly how we will consider complaints in this area.

‘The consultation is open to anyone who wishes to respond and we are particularly keen to hear from those who are, or have been, affected by these issues.’

When the Investigation Committee or Case Examiners consider an allegation they must decide whether there is a realistic prospect of establishing that a doctor’s fitness to practise is impaired to a degree that justifies action against their registration. The draft guidance sets out some of the things doctors might be alleged to have done in order to encourage or assist a suicide and the factors that should be considered in deciding whether the allegations should be referred to a fitness to practise panel.

The guidance is being produced to ensure that people considering seeking assistance from doctors and doctors themselves understand the likely impact of such assistance on the doctor concerned. A working group of GMC Council members also considered the issues and agreed that it was practical and desirable to have guidance for internal decision makers.

The guidance sets out the:

• law on assisting suicide;
• ethical principles which underpin all our guidance to doctors;
• test that our decision-makers must apply when they consider such allegations;
• types of cases and the factors that may be relevant to their consideration.

The consultation is open to anyone who wishes to respond and the GMC is particularly keen to hear from people who are affected by the issues it raises.

Those who wish to take part can complete an online questionnaire and further details can be found at www.gmc-uk.org/guidance/news_consultation/11953.asp.

Those wishing to respond are asked to do so by 4 May 2012.

Changes introduced by the General Dental Council (GDC) to improve the handling of complaints against dental professionals is beginning to have a positive impact.

The GDC have revealed that progress has been made between 2010 and 2011 in that:

• More cases overall, are being concluded – 18% increase (1,415 vs 1,199);
• Cases are being investigated more quickly – 11% decrease in the time taken to get a case to Investigating Committee;
• The number of cases awaiting a hearing is decreasing – 13.5% decrease in 2011 (164 to 142);and
• The number of cases awaiting a hearing which have been waiting for longer than 9 months is decreasing – 29% decrease (from 72 to 51);

The changes which were brought in last year to improve the quality and speed of complaints handling and to ensure patients are protected effectively, include:

• Increasing the number of decision meetings and hearings aimed at clearing a backlog of cases and reducing delays;
• Fast tracking the most serious cases and dealing proportionately with all other cases; and
• Seeking clinical advice at the outset of particular cases in order to ensure proportionate handling.

Chief Executive and Registrar of the GDC, Evlynne Gilvarry said:

“The measures we have introduced to improve our Fitness to Practise processes are specifically aimed at enhancing patient protection. We have made significant progress in the last 12 months and further reforms planned will see a continued improvement in 2012.”

The General Medical Council has set out its priorities for 2012 and has placed the introduction of revalidation at the top of the list.

A new version of Good Medical Practice, the launch of the new Medical Practitioners Tribunal Service, and the piloting of an induction programme for doctors new to UK practice are among the regulator’s other priorities for the year.

The plans, published today, are set out in the GMC’s 2012 Business Plan.

Niall Dickson, the Chief Executive of the General Medical Council, said:

“The GMC has invested considerable effort in ensuring that revalidation is as simple and straightforward as possible for doctors, while providing assurance to patients that their doctor’s skills and knowledge are up-to-date. There is still much work to do and we are sparing no effort to ensure a smooth start to revalidation at the end of this year.

“The recent appointment of His Honour Judge David Pearl as the first chair of the new Medical Practitioners Tribunal Service is an important step. Establishing the MPTS is a key part of the GMC’s plan to reform its adjudication work, introducing an even greater separation between the GMC’s investigations and its fitness to practise hearings.

“In 2012, we will have a much stronger local presence. The new regional and employer liaison teams we established in 2011 are now supporting medical directors and others throughout the UK and will be in place in all areas in the first few months of this year.”

“Our new induction programme will be an important way to reinforce the standards expected of doctors in this country and to help prepare those who are new to practice here.

“We will do all this while seeking further efficiency savings on top of those we have already made and which allowed us to cut fees for doctors for the first time last month.”

For more information about the business plan, and to download a copy, go to www.gmc-uk.org/publications/corporate_publications.asp

Yesterday, the online edition of Pulse Magazine revealed that the GMC have been left needing to apologise to more than 200 GPs and other doctors who were mistakenly sent letters informing them that they had been subject to disciplinary investigation in 2010.

Pulse state that the blunder occurred when the GMC wrote to 2,500 doctors investigated by the GMC last year requesting feedback. Unfortunately due to a ‘clerical error’, 209 who had not been investigated were included in the mailing.

The letter said: ‘The GMC wants to explore the experience of doctors who have been through a fitness-to-practise procedure in 2010.’

The GMC confirmed to Pulse that a number of doctors had contacted them to complain and that the GMC would be writing to all the doctors involved to apologise.

The Health Select Committee has stated that doctors and nurses should be required by their regulatory bodies to report malpractice on the part of colleagues.

Committee Chairman, Stephen Dorrell, stated that failure to do so should be regarded as a “serious breach of professional obligation” and that more should be done by the General Medical Council and the Nursing and Midwifery Council to ensure that reports were made and that whistle-blowers were protected from disciplinary action from their employers.

The committee took the view that the GMC and NMC should send a clear signal to staff that failure to report concerns might put them as much at risk of investigation as poor practice on their own part.

The BBC reported on their News Health web site (http://www.bbc.co.uk/news/health-14281197) that Mr Dorrell had stated that “we regard the principle behind this wider obligation as an important safeguard for patients.”

He went on to say that “There have been examples of people raising concerns, and then facing inappropriate or heavy-handed action from their employer. We intend to follow up and to examine what is appropriate and what isn’t, in terms of how employers respond.”

More information regarding this story can be found on the BBC web site.

The successful prosecution of a non-dental professional who has been providing tooth whitening treatments is good news for patients, according to the British Dental Association (BDA). The defendant in the case, a non-dental professional, pleaded guilty to providing teeth whitening services in breach of the Dentists Act.

The BDA agrees with the General Dental Council that tooth whitening constitutes the practice of dentistry and should therefore only be carried out by dentists or other dental care professionals who are registered to provide dental care. It also shares the concerns of the European Union’s Scientific Committee on Consumer Products which has highlighted the potential dangers of non-dentists providing whitening.

Stuart Johnston of the British Dental Association said:

“This is a victory for patient safety. Patients having their teeth whitened need to know that they are completely safe and are being treated by fully-trained dental professionals. Non-dental professionals are not trained to consider a patient’s wider health and detect problems, such as gum disease for example, that impact on the suitability of an individual to have their teeth whitened. We’re also concerned that some non-dental professionals carry out whitening treatments using inappropriate and potentially dangerous chemicals.

“The success of the GDC’s criminal proceedings sends a clear message that patient safety is of paramount importance and reminds members of the public considering whitening to check that they are dealing with qualified professionals before going ahead with the treatment.”