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Welfare Reform on the Web (August 2000): Medical Professions - UK - Regulations

BLANK CHECK

K. McIntosh

Health Service Journals, vol. 110, June 29th 2000, p. 16-17

Article summarises concerns raised about the General Medical Council's proposals for the revalidation of doctors. These include the increase in doctors' workloads, the high costs (estimated as £2000 per doctor per year), and possible lack of impartiality in the assessment teams.

BMA ON VERGE OF GRAVEST SPLIT IN ITS HISTORY, SAY GPs

J. Laurance

Independent, June 26th 2000, p. 4

Reports that hospital doctors are strongly opposed to the General Medical Councils plans for revalidation and monitoring which are supported by GPs.

DOCTORS SPLIT OVER FIVE-YEAR CHECKS ON ABILITY

N. Timmins

Financial Times, June 7th 2000, p. 2

The General Medical Council (GMC) is seeking to introduce a procedure for five-yearly revalidation of doctors' fitness to practise. The British Medical Association Consultants' Committee has attacked the proposal as unworkable in its present form, but it has received support from GPs and the 15 medical royal colleges.

(See also Health Service Journal, vol. 110, June 8th 2000, p. 6-7)

DOCTORS TO FACE SWIFTER JUSTICE

T. Baldwin and A. Frean

Times, June 2nd 2000, p. 1

Following a series of medical malpractice scandals, government is planning to introduce a new Assessment and Support Service to investigate complaints against doctors. The service would have power to make a rapid assessment and recommendations for future action ranging from complete discharge to referral to the GMC with a view to having the doctor struck off immediately.

(See also Daily Telegraph, June 2nd 2000, p. 1 + 2; Financial Times June 2nd 2000, p. 3)

A LAST CHANCE FOR SOME SELF-DIAGNOSIS

N. Timmins

Financial Times, June 14th 2000, p. 23

Describes a range of new initiatives for rooting out incompetent doctors. These include NHS assessment and support centres to which doctors can be referred when doubts are raised about clinical performance. Annual appraisals of performance and a requirement to take part in audit are to become part of consultants' new contracts. At the same time the General Medical Council is developing proposals for a five-yearly revalidation of doctors' competence to practice. To make the new systems work, NHS management needs to be able to dismiss incompetent doctors, leaving the GMC to deal with the problem of their registration.

AN ORGANISATION WITH A MEMORY: REPORT OF AN EXPERT GROUP ON LEARNING FROM ADVERSE EVENTS IN THE NHS

Department of Health

London: TSO, 2000

Describes plans for a new central database in which all incidents of harm or potential danger to NHS patients will be recorded. It will combine complaints and litigation from patients with mandatory reports from medical staff. The aim of the new system is to identify problems as they develop and root out rogue doctors such as Harold Shipman who was convicted of killing 15 patients.

POINTING THE FINGER

S. Boseley

Guardian, June 16th 2000, p. 23

Calls for a blame-free approach to reporting, recording and learning from medical errors, instead of the scapegoating of doctors which is now being encouraged by the government.

REVALIDATING DOCTORS: ENSURING STANDARDS, SECURING THE FUTURE

General Medical Council

London: 2000

Proposes that doctors keep folders including information about complaints from patients, "critical incidents", audits of their work and how they keep their skills up to date. Every five years a team of doctors and lay assessors would check the folder and either approve the doctor or refer them to the GMC.

SUPPORTING DOCTORS, PROTECTING PATIENTS: A CONSULTATION PAPER ON PREVENTING, RECOGNISING AND DEALING WITH POOR PERFORMANCE OF DOCTORS IN THE NEW NHS IN ENGLAND

Department of Health

London: 2000

Proposes a three step process for handling doctors with performance problems. First, when a problem arose, an initial view would be taken of which of four new categories it fell into. Personal misconduct or failure to fulfil contractual obligations would be dealt with through local disciplinary procedures. Serious clinical mistakes would be referred to an Assessment and Support Centre. Second, a number of Assessment and Support Centres would be set up to impartially advise on the action to be taken to sort out problems. Recommendations might include retraining or referral for medical treatment. Finally, the Health Authority would be responsible for implementing the recommendations of the Assessment and Support Centre.

TURNED TO GOOD ACCOUNT

A. Moore

Health Service Journal, vol. 110, June 29th 2000, p. 26-29

Case study of newly introduced schemes for formal appraisal of the work of hospital consultants. Concerns emerging include availability of suitable data to assess and compare clinical work and the time required to implement the systems.

WITH DUE RESPECT

J. Goodson-Moore

Health Service Journal, vol. 110, June 29th 2000, p. 30-31

Consensus is needed on which management competencies should be included in doctors' appraisals. Article presents case study of a trust which employed consultants to find out the views of senior doctors managers, directors and patients. Common themes included concern for standards, effective use of information, openness, integrity and insight. The result will be used to guide future recruitment.

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