On 16 December 2022 the GMC announced changes to how it makes initial contact with a doctor if the GMC needs to investigate a concern (https://www.gmc-uk.org/news/news-archive/gmc-to-roll-out-personalised-contact-when-starting-investigations). The changes aim to reduce anxiety for doctors, to take a more compassionate approach and reduce the impact of investigations on doctors. May is Mental Health Awareness month, so we take this opportunity to look at how doctors can protect their mental health – and their professional position – when they first learn about a GMC investigation.

It is important to acknowledge that most doctors, understandably, find it stressful and alarming if they learn of a GMC investigation relating to them. Some doctors experience a greater impact on their mental health and find a complaint extremely distressing. Very sadly, some doctors have died by suicide while under investigation by the GMC, or during a period of monitoring. The GMC has now committed to reporting on these awful cases every three years, as part of its work to monitor the effectiveness of these reforms. Clearly, reforms to reduce the impact of GMC investigations on the mental health of doctors are to be welcomed. A pilot scheme in 2022 received positive feedback.

Nevertheless, it is important for all doctors to understand the changes – if they don’t, they could inadvertently cause themselves difficulties. The process for the GMC to inform doctors of investigations is now:

• A ‘pathfinder’ email is sent to the doctor, asking to arrange a phone call between the doctor and the GMC contact.
• A call takes place at a time convenient for the doctor, so that the GMC contact can introduce themselves, explain the immediate next steps and signpost the doctor to any relevant support services. During that call the GMC contact will also create a bespoke communication plan, factoring in the doctor’s communication preferences and assessing whether the doctor may be vulnerable.
• The GMC immediately follows up with written correspondence.

It is helpful that doctors will receive an initial email, as it gives an opportunity to seek preliminary guidance and reassurance from a medico-legal service – such as the excellent Incision medico-legal helpline.

However, there could also be risks for the doctor in having direct telephone contact with the GMC so early in the process. Some doctors could be tempted to try to explain their side of the story right away – perhaps because of the stress of the situation or in a misguided attempt to bring the investigation to an early close. The GMC contact will explain matters in a compassionate way, but some doctors might therefore forget that the telephone discussions are not confidential, and that it is not the GMC’s role to protect the doctor’s professional position. In a worst-case scenario, the doctor might say something unguarded to the GMC contact that is relevant to the investigation and is used against them later on.

As a result, our guidance to Incision members is:

• As soon as you receive a ‘pathfinder’ email from the GMC about a new investigation, contact the Incision medico-legal helpline. The medico-legal team can provide sympathetic support that is confidential. The team can also provide guidance on next steps that is fully tailored to your situation. Contacting Incision right away will also help ensure that insurance notifications are made at the right time, as Incision members have cover for the cost of legal representation in GMC investigations.
• When you have your call with the GMC, treat it as an opportunity to gather information only. This is not the time to try to give the GMC your views, opinion or evidence, or to make comments to relieve any sense of stress or frustration. Make a note of the call, and make sure the GMC understands your wishes in terms of how they should contact you about the matter going forward.
• As soon as you receive the follow up email, contact the Incision medico-legal helpline again with an update so that you can continue to receive the proper support throughout the process.

It may also help to know that the vast majority of GMC investigations end without any action being taken. The GMC’s published statistics show that in 2021 there were 9,074 enquiries in total. Out of these 7,401 were closed with no action at all. Only 490 enquiries progressed to the Provisional Enquiry stage, and of these 400 were closed. This leaves only 1,273 matters which progressed to the investigation stage. Therefore, of the 9,074 enquiries, nearly 86% closed at a very early stage without any substantive input being needed from the doctor. We know that hearing that a GMC investigation is starting will always be upsetting, and that waiting for news about it can be worrying. However, doctors should keep in mind that most GMC investigations close soon after with no action against the doctor. Incision members should also keep in mind that if they are ever unlucky enough to be contacted by the GMC, they have the benefit of excellent, expert, holistic medico-legal support to help them through the process.

Incision

May 2023