"Terms of reference" set in gross negligence manslaughter review

THE GMC has announced the terms of reference for its independent review into how gross negligence manslaughter is applied to medical practice.

The review being led by Dame Clare Marx will cover the whole of the UK and will examine what needs to be done to improve how existing law, procedures and processes are applied, whilst still protecting the public and maintaining confidence in the medical profession. It will also look at how the GMC should handle cases involving gross negligence manslaughter and the equivalent offence of culpable homicide in Scotland.

Among other issues outlined in the terms of reference are:

• The quality of local investigations and the distinction between errors and failings which amount to gross negligence manslaughter.
• Equality, diversity and inclusion issues, including whether there is fair and consistent representation of particular groups of doctors with protected characteristics in allegations of gross negligence manslaughter.
• The lack of corporate manslaughter prosecutions against healthcare organisations as compared to individual healthcare professionals within organisations facing gross negligence manslaughter prosecution, and any differences in approach between the UK countries and the possible reasons for this.
• The role of medical expert evidence and its appropriateness in relation to the practitioners being investigated.
• Whether sufficient regard is taken into all the circumstances in which the medical practitioner found themselves at the time of the fatality, such as system pressures, errors or failures.
• Whether there could be more clarity in GMC guidance and communication around the role of reflective practice.
• The extent of emotional, pastoral and other support available for medical practitioners who are the subject of an allegation or charge of gross negligence manslaughter.

Dame Clare said: "Doctors are often working in an immensely pressurised system where mistakes can happen. This review aims to encourage a renewed focus on a just culture, reflective practice and individual and systemic learning. It’s vital that accountability is appropriately apportioned between healthcare systems and individual doctors and that doctors are supported to act on concerns."

The working group undertaking the review will aim to report its findings to the GMC by the start of 2019.