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April’s medical law news

Dr Bawa-Garba able to return to work & communication improvements needed from the NMC

Each month, the team at Medic Assistance Scheme finds articles and stories from the past few weeks that will help medical practitioners to stay on top of fitness to practise trends in their profession. If you have concerns relating to anything you’ve read on our website, contact us today.

Dr Bawa-Garba restored to the GMC register

Source: BBC News (9/4/2019); Pulse (8/4/2019)

One of the highest profile fitness to practise cases in recent years looks to be drawing to a close. The MPTS tribunal has ruled that Dr Hadiza Bawa-Gaba can return to the medical register and continue to practise under supervision. Dr Bawa-Garba was found guilty of gross negligence manslaughter in 2015, following the death of Jack Adcock. Since then, her sentencing, appeal and support from the medical community have garnered significant media attention.

In a hearing at the start of the month, both Dr Bawa-Gaza’s defence and the GMC submitted to the MPTS that her fitness to practise was still impaired due to her lack of practice since 2015. The tribunal agreed, but due to her remediation efforts they ruled that she will be able to return to work under strict supervision once her maternity leave finishes in February 2020. This course of action makes it possible that Dr Bawa-Gaza could return to full, unrestricted practice in the future.

Our take

There are too many different elements of Dr Bawa-Garba’s case to discuss here. In these most recent (and possibly final) developments, the two most interesting aspects are the fitness to practise submission of Dr Bawa-Garba’s defence and the mention of her remediation efforts by the MPTS tribunal.

From the information we have, it sounds like the defence was honest in their assessment of the situation and did not attempt to argue that Dr Bawa-Garba is currently fit to practise without some form of supervision. In a case such as this, honesty is often the most productive strategy for securing a positive outcome. Such a submission shows the MPTS that Dr Bawa-Garba has thought seriously about her situation and is willing to do whatever necessary to ensure that she does not put patients at risk in the future.

In addition, Dr Bawa-Garba’s remediation efforts were vital to the outcome of her case, despite their comparative lack of coverage in the media. Dr Bawa-Garba has shown the MPTS that she is aware of any failings on her part in the death of Jack Adcock and that she has taken steps to ensure that she will not be involved in such a tragedy again. Where some kind of misconduct is undeniable, remediation is often essential if a doctor wishes to be allowed to practise in any capacity at some point in the future.

NMC found wanting in two core areas by PSA

Source: Nursing Notes (24/4/2019)

The Professional Standards Authority (PSA) found that the NMC was failing to meet two of its 24 core standards in a recent review. While the NMC was found to have improved overall, the regulator’s most recent review stated that the body fell short in the transparency and fairness of fitness to practise cases and keeping the involved parties involved in fitness to practise cases updated. The PSA raised particular concerns over the way the NMC deals with cases involving registrants who have completed Personal Independent Payment (PIP) assessments.

The NMC has pledged to improve in the areas identified by the PSA as deficient. The NMC’s Chief Executive and Registrar, Andrea Sutcliffe, said that she was encouraged by the progress indicated in the review. She also apologised for the NMC’s shortcomings in PIP cases and made assurances that training measures have been put in place to prevent such failings from reoccurring in the future.

Our take

It is always good to see a regulator making progress in the areas highlighted by the PSA’s report. The NMC’s improvements in communication with families and patients were noted and these are an important part of the regulator’s responsibilities. However, the deficiencies in transparency and communication with registrants during investigations remain a cause for concern. A lack of communication can increase the stress that a registrant feels unnecessarily.

It does appear that the NMC is willing to work on these areas in light of the review. Improvements in the way that the body communicates during an investigation will undoubtedly be beneficial for the nurses and midwives that they are dealing with. A lack of transparency and communication is one of the primary causes of additional stress for those undergoing an investigation; a clearer idea of what is happening and when can only be beneficial.

GMC trials a softer response to one-off incidents

Source: GP Online (24/4/2019)

Over the last two years, the GMC has trialled a new method of dealing with one-off fitness to practise clinical incidents with the goal of reducing the number of investigations needed. Instead of referring every concern to an investigation, the regulator has instead experimented with a method of information gathering to ascertain whether or not a complaint warrants the full investigative process. This information gathering involves speaking to independent specialists, to the doctor’s responsible officer and to the doctor themselves, to determine whether or not a one-off incident is likely to be indicative of a deeper issue that could place patients at risk in the future.

The results of the trial appear to be positive. The new method was tested in 309 cases over the course of two years, of which 202 (65%) were successfully resolved without the need for an investigation. The GMC’s Chief Executive, Charlie Massey, was positive about the trial, showing confidence that it would speed up the fitness to practise process without increasing the risk of patients. However, for the GMC to be able to continue using this method in the future they will need to convince the government to relax the current legal requirement that the GMC investigate any alleged fitness to practise breach.

Our take

If the GMC is able to formalise this new information gathering process it will be a positive step for doctors. Full fitness to practise investigations are a significant source of stress for doctors forced to undergo them. Such stress is needless in instances wherein the incident under investigation was a one-off and there is no further risk to the public. Furthermore, there is a stigma attached to fitness to practise investigations that doctors will be able to avoid if their case is stopped from progressing that far.

Another benefit of this method is that the GMC will have more resources to put into full, necessary fitness to practise investigations. Appropriate cases involving isolated clinical incidents will no longer need to draw time and money away from more serious cases, allowing the GMC to be more thorough in their approach. This may also reduce the time that it takes to close larger cases, helping to reduce stress even for doctors whose cases have not been resolved at the information gathering stage.

Related services

The Medic Assistance Scheme’s lawyers can help medical professionals in many of the areas referred to in these news topics. See below for the services that relate to March’s stories:

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