DECISIONS made by the General Medical Council are “appropriate” with no evidence of bias or discrimination, according to an independent report.
The research found that case examiners balanced the need to consider the emotional stakes of complainants and practitioners with the need to take an objective and reasoned approach to gathering evidence.
However, the findings also highlighted a need for greater clarity and transparency in how decisions were reached in some instances.
The regulator commissioned researchers from Peninsula Schools of Medicine and Dentistry at Plymouth University to review fitness to practise (FtP) procedures as part of an ongoing programme of work to ensure they are “fair, consistent and robust”.
The findings, based on analysis of 187 FtP case files, were overall positive, stating: “No evidence of bias or discriminatory practices was identified, either in the GMC’s guidance and criteria documentation for decision-makers, or the sampled case files.”
The report also addressed concerns that particular demographic groups of doctors – such as those trained outside the UK – are overrepresented in FtP procedures.
No evidence was found to suggest the way the GMC operates contributes to this issue.
“Our analysis has identified no causal factors for these trends, or for those which see male doctors and black/minority ethnic (BME) doctors more likely to enter the FtP procedures and to progress further,” the report stated.
It went on to state that the GMC’s approach to presenting formal charges to doctors at the rule seven stage of FtP procedures, by issuing “particulars” (the wording describing how the alleged misconduct or poor performance arose), was not found to be a source of bias or discrimination. “The particulars themselves are typically concise and very direct in style”. The report added: “There is perhaps an issue surrounding the definitions of the categories of ‘impairment by misconduct’ and ‘impairment by deficient professional performance’ but there is no known link between this issue and demographic characteristics.”
Greater clarity was recommended in the GMC’s reasoning for selecting a particular outcome. There were a number of occasions where the reasoning “was not fully explained, in reference to the relevant points in the guidance and criteria.”
Researchers also identified “informal and sometimes unrecorded aspects to decision-making which may occur in discussions between staff” which could “compromise” the defensibility of decisions, leaving them susceptible to challenge.
It was recommended the GMC justified their decisions with clear references to the relevant standards and guidance, adding: “[A]s clear and comprehensive reasoning as is possible would contribute to demonstrating that the GMC’s decision-making is careful, fair and valid.”
Read the full report here