GMC uncovers factors in high BAME referrals

INADEQUATE job induction and support along with isolating work patterns and poor feedback are all factors in higher GMC referrals for black, Asian and minority ethnic (BAME) doctors, new research suggests.

The GMC commissioned the research in response to data showing that employers and healthcare providers refer BAME doctors to the GMC at more than double the rate of their white counterparts. This means they have more chance of being investigated and, in turn, receiving a warning or sanction.

Previous audits of GMC processes have found no evidence of bias, so to help address the disparity in referral rates, the GMC commissioned Dr Doyin Atewologun and Roger Kline to conduct UK-wide research and offer recommendations.

The report Fair to Refer? concluded that some BAME doctors do not receive adequate induction or support in transitioning to new social, cultural and professional environments. It also found that doctors from diverse groups do not always receive effective, honest or timely feedback which could prevent problems later. This is attributed to some clinical and non-clinical managers avoiding "difficult conversations", particularly when they are with individuals from a different ethnic group.

Working patterns also mean that some BAME doctors in isolated roles lack exposure to learning experiences, mentors and resources. The report found that BAME doctors may be treated as "outsiders", creating barriers to opportunities and making them less favoured than "insiders" who experience greater workplace privileges and support.

The report also cites organisational leadership cultures with a "knock-on effect" where leadership teams are remote and inaccessible, and doctors struggle to approach them for advice and support and may not be listened to.

The report recommends:

• improving support for doctors new to the UK or the NHS or whose role is likely to isolate them (such as SAS doctors and locums)
• addressing the systemic issues that prevent a focus on learning, rather than blame, when something goes wrong
• ensuring engaged, positive and inclusive leadership is more consistent across the NHS
• developing UK-wide mechanisms to ensure delivery of the recommendations.

MDDUS welcomes GMC report. Medical adviser Dr Susan Gibson-Smith commented: "BAME doctors are entitled to the same levels of support in their medical roles as other groups of doctors. All doctors should be treated fairly and consistently regardless of their background or characteristics.

"Facing a fitness to practise hearing is extremely stressful for doctors. We welcome the measures contained within this report and fully support the research recommendations that focus on the four key areas of support, working environments, inclusive leadership and delivery of these recommendations."