{"id":44814,"date":"2019-06-12T17:45:18","date_gmt":"2019-06-12T16:45:18","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=44814"},"modified":"2019-06-20T12:09:19","modified_gmt":"2019-06-20T11:09:19","slug":"a-change-of-tone-from-the-gmc-but-can-they-win-back-doctors-trust","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/06\/12\/a-change-of-tone-from-the-gmc-but-can-they-win-back-doctors-trust\/","title":{"rendered":"A change of tone from the GMC\u2014but can they win back doctors\u2019 trust?"},"content":{"rendered":"<p><strong>Samantha Batt-Rawden<\/strong><\/p>\n<p><span style=\"font-weight: 400\">This week I had the opportunity to interview Charlie Massey, the chief executive of the General Medical Council (GMC), for a <a href=\"https:\/\/www.bbc.co.uk\/programmes\/m0005t3h\">BBC Radio 4 documentary<\/a> on why doctors are leaving the NHS. It didn\u2019t start well. I found myself on a train to Portsmouth instead of London having been up most of the night; proof that tired doctors do indeed make mistakes.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Generously Charlie did meet with me, some hour and a half late. I felt it was crucial that we acknowledge the impact that the blame culture has had on recruitment and retention.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I was surprised and encouraged, when Massey admitted publicly that the decision to take Hadiza Bawa-Garba to the High Court to have her erased from the medical register was wrong.<\/span><\/p>\n<p><span style=\"font-weight: 400\">To me, this was an incredible acknowledgement from the GMC. But I have no doubt that doctors will be asking: why did it take so long? The Doctors\u2019 Association UK (DAUK) was established in response to the GMC\u2019s actions in the Bawa-Garba case. The very first action by the DAUK was to co-ordinate a letter signed by over 4500 doctors outlining why they believed the GMC\u2019s decision to appeal the Medical Practitioners\u2019 Tribunal Service (MPTS) verdict in Bawa-Garba\u2019s case was wrong. This was all the way back in February 2018.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Since then DAUK, in conjunction with a number of organisations, have been campaigning to see this decision overturned. There was widespread relief when Bawa-Garba was returned to the medical register in <\/span><a href=\"https:\/\/www.bmj.com\/content\/362\/bmj.k3510\"><span style=\"font-weight: 400\">August 2018<\/span><\/a><span style=\"font-weight: 400\">. The Court of Appeal\u2019s judgment was unequivocal, and doctors hoped this would be the start of a move towards a learn not blame culture across healthcare, and especially within the GMC, an organisation that promotes acknowledging and reflecting on one\u2019s mistakes.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Unfortunately, <a href=\"https:\/\/www.bmj.com\/content\/362\/bmj.k3673\">it appeared to many<\/a> that the GMC continued to try to justify an inexplicable decision that was responsible for an unprecedented breakdown in trust between doctors and their regulator. This was against a backdrop of doctors saying that as a direct consequence of the blame culture, they were practising more defensively, and were increasingly fearful of speaking up and of reflecting when things go wrong. Ultimately many doctors are considering leaving medicine as they feel that practising medicine in the UK has become too \u201chigh risk.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">But change takes time, and perhaps especially a change in culture. Still, the interview with Massey caught me off gua<\/span><span style=\"font-weight: 400\">rd. Quickly it became clear that the tone had changed. There appeared to be genuine reflection on the part of the GMC, and it seemed that some real learning had taken place. In<\/span><span style=\"font-weight: 400\"> acknowledging the error of appealing the MPTS verdict in Bawa-Garba\u2019s case, Massey also stated he had not appealed a single case since. This decision no longer resides with Massey as the registrar alone, and the GMC&#8217;s own regulator the PSA must be consulted (although the GMC will lose its right to appeal after the recommendations of the Williams Review were accepted by the Department of Health.)<\/span><\/p>\n<p><span style=\"font-weight: 400\">The interview revealed some other key indicators of change, such as how the GMC are ensuring that they take into account systemic issues when determining a doctor\u2019s fitness to practise, demonstrating a greater understanding of human factors. Indeed the GMC recognise that they have a much larger role to play in identifying unsafe working environments and ensuring safe staffing levels.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Clearly, there is more to do. The GMC will have to show that they are capable of real change to regain doctors\u2019 trust. Thes<\/span><span style=\"font-weight: 400\">e words, although reassuring, must be translated into affirmative action. \u00a0For many, however, this will represent a crucial and long-awaiting first step in healing the damage done to the medical profession.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b><i><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/sammy.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-44815\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/sammy.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/sammy.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2019\/06\/sammy-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a>Samantha Batt-Rawden<\/i><\/b><i><span style=\"font-weight: 400\"> is a registrar in emergency and intensive care medicine and the Chair of The Doctors\u2019 Association UK (DAUK).<\/span><\/i><\/p>\n<p><b><i>Competing interests<\/i><\/b><i><span style=\"font-weight: 400\">: Samantha Batt-Rawden founded DAUK and has continued to lobby for a just culture in healthcare through DAUK\u2019s Learn Not Blame campaign. She is the Chair of The Doctors\u2019 Association UK, an independent lobbying group who supported Dr Hadiza Bawa-Garba\u2019s appeal against the GMC.<\/span><\/i><\/p>\n<p>&nbsp;<\/p>\n<p><b>Twitter<\/b><span style=\"font-weight: 400\">: <a href=\"https:\/\/twitter.com\/sbattrawden\">@sbattrawden <\/a><\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Samantha Batt-Rawden This week I had the opportunity to interview Charlie Massey, the chief executive of the General Medical Council (GMC), for a BBC Radio 4 documentary on why doctors [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/06\/12\/a-change-of-tone-from-the-gmc-but-can-they-win-back-doctors-trust\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":41256,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-44814","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>A change of tone from the GMC\u2014but can they win back doctors\u2019 trust? 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