The GMC received the highest ever number of complaints against doctors and held a record number of investigations and fitness to practise hearings in 2010.

The annual report of fitness to practise statistics shows the GMC received 7,153 complaints in 2010, compared with 5,773 in 2009. The GMC launched more than 2,000 investigations in 2010, an 18% increase from 2009. The number of fitness to practise hearings also increased from 270 in 2009 to 326 in 2010.

A total of 92 doctors were erased from the medical register for disciplinary reasons in 2010, the largest ever annual total. A further 106 doctors were suspended from the register by fitness to practise panels.

Niall Dickson, chief executive of the GMC, said: “Our job is to protect patients. Taking firm action with doctors who are failing to meet our standards is an important part of doing that job and addressing the unacceptable variation in medical practice identified in our recent State of Medicine report.

“But the rise in complaints and investigations does not mean that standards of medical practice are falling. Our research shows that doctors and their employers are now much more likely to raise concerns about their medical colleagues - this is a welcome development.”

A GMC report, released last month, analysed the regulator’s data to better understand the nature of medical practice today.

The report examined trends in the GMC’s fitness to practise statistics and concluded there was a significant variation in the quality of medical practice in the UK. A number of priorities were identified by the GMC to improve medical practice, including the introduction of revalidation and making sure doctors apply our standards in their day-to-day practice.

The detailed data for 2010 published today outlines the number of complaints received about doctors and how those complaints are dealt with at each stage of the fitness to practise procedures. It also breaks down the results by ethnicity, gender, place of primary medical qualification, time since the primary medical qualification and area of practice.

The data suggests that the GMC needs to follow up on more complaints about male doctors. Male doctors represented just over 58% of registered doctors, but accounted for 75% of complaints in 2010.

Furthermore, at panel hearings in 2010, the older the doctor the more likely on average they were to be erased from the register.

There are differences in the numbers of complaints between specialties. A quarter of all registered doctors are GPs, but nearly half of the complaints received in 2010 were about GPs.

Dickson added: “We are delivering a series of far-reaching reforms to our fitness to practise procedures. We are transferring responsibility for running doctors’ hearings to a new tribunal service headed by an independent figure with judicial experience who will report to Parliament. We are also seeking the right to appeal decisions we think do not go far enough to protect the public from doctors who should not be practising. We will make further changes so that cases can be dealt with more quickly, providing faster public protection and a quicker process for complainants and doctors.”

Read the statistics.

There has been a doubling in the number of doctors referred to the GMC by medical directors and other public bodies, new figures reveal.

In 2010, medical directors made 1,395 referrals representing one in five of all complaints to the GMC.

The GMC research sought the views of 100 medical directors asking them to explain why more doctors are being referred to the GMC than ever before.

It suggests the NHS has better systems for monitoring doctors’ performance and that there is greater awareness of and commitment to high professional standards, the regulator claims.

Over 85% of the medical directors surveyed had made a referral to the GMC in the last five years. The medical directors also reported that there was an increased commitment among doctors themselves to reporting concerns, as well as patients feeling more empowered to complain.

Niall Dickson, GMC chief executive, said: “More complaints about doctors does not necessarily mean standards are slipping; it could be a sign that the systems to identify problems are improving. Our research certainly suggests that employers are giving priority to detecting and dealing with concerns and that has to be welcome.

“In addition, rather than keeping quiet about problems, doctors are more likely to speak up when they see anything that could pose a risk to patient safety. And that is exactly as it should be. There is no cause for complacency and we know there is more to do in this area, but the system is becoming more open and we have come a long way from the idea of medicine as an ‘old boys’ club’.”

Of medical directors who said the number of referrals they made in 2010 was higher than previous years, the main reason cited for the increase was colleagues being more likely to raise a fitness to practise issue.

95% of those who made referrals contacted the National Clinical Assessment Service for advice.

The GMC is launching a new liaison service to support medical directors in dealing with concerns they may have about the doctors for whom they are responsible.

Dickson said: “A referral to the GMC can be the start of an anxious time for everyone involved, and we recognise that. The piloting we have already done shows that employer liaison advisers can bring real benefits to medical directors and we will soon have someone in each area of the UK to support them.”

Dean Royles, director of representative body NHS Employers, commented: “It is encouraging that the GMC recognises that employers are giving priority to reporting concerns and that this is having a positive impact on patient safety. Protecting patients is of paramount importance to employers, who have worked hard to improve procedures and policies for reporting concerns, making it easier for staff to raise concerns with confidence.

“Employers will act when concerns are raised and will involve the regulators where appropriate, therefore we welcome the GMC liaison service which will help them navigate the appropriate referral route.”

The GMC needs to do more to reassure doctors that its new tribunal service will be independent, defence bodies have warned.

The MDU says the Medical Practitioners Tribunal Service, being set up by the GMC to adjudicate on fitness-to-practise cases, should not be overly influenced by the regulator.

Dr Catherine Wills deputy head of the MDU’s advisory department, said: “We don’t think the GMC’s proposals go far enough and we think there needs to be greater safeguards to ensure tribunals that decide on a doctor’s fitness to practise are completely independent of the GMC.

“For example, there is no mention of whether the MPTS will need to take account of GMC indicative sanctions guidance when deciding what action to take against a doctor whose fitness to practise is found impaired. In the same way that it would be inappropriate for the Crown Prosecution Service to impose sentencing guidelines on judges in criminal proceedings, it must be clear that the ultimate decision on sanctions should be for the tribunals themselves.”

The MDU was responding to the GMC’s consultation The future of adjudication and the establishment of the Medical Practitioners Tribunal Service.

Wills also criticises the GMC’s right to appeal against MPTS decisions which it considers unduly lenient, alongside the Council for Healthcare Regulatory Excellence which already has this power.

She said: “We believe this would create a cruel element of double jeopardy in which doctors who have been exonerated by a tribunal then have to wait to find out if either the GMC or CHRE wanted to appeal the decision. Not only that but doctors concerned could effectively find themselves paying the GMC’s legal costs through their annual registration fee, as well as two sets of defence costs.”

Wills added that it may be in the public interest for one body to be able to appeal fitness to practise decisions but not for two separate bodies to have the same powers.

The MPS raised concerns over the GMC wanting to move to a single hearing centre in Manchester.

Dr Stephanie Brown, director of policy and communications, said: “Cost should be an important factor, particularly in the current financial climate, however it should not be the overriding factor that dictates the venue of all hearings. In criminal and civil court settings, it is the balance of convenience which is the primary factor; this is the right approach to take.”

She said there was ample scope for efficiency savings in the overall management of FTP

Meanwhile, the GMC has claimed that doctors and patients have voiced support for many of the fitness to practise reform proposals. The proposals include plans that would see doctors able to accept a sanction without going to a hearing, delivering a quicker way to protect patients.

Cases where there is a significant dispute about the evidence, or where the doctor did not accept the sanction the GMC believed necessary to protect patients, would continue to go to a hearing.

Doctors could be able to avoid GMC fitness to practise hearings in future if they are prepared to accept pre-determined sanctions such as suspension and erasure, under new proposals.

A GMC consultation document recommends that doctors and patients should be allowed to avoid long and stressful public hearings. The GMC claims patient protection is the driving force behind the reform, which would still be a transparent process because even without a hearing, concerns and any sanctions would still be published on the regulator’s website.

For those doctors who do not accept the sanction proposed, or where there is a significant dispute about the facts, cases would still be referred for a hearing.

The consultation was welcomed by the medical defence bodies, but they warned a culture shift was needed at the GMC for them to work.

MPS’s director of policy and communications, Dr Stephanie Bown, said the organisation had long held concerns about the fairness, efficiency and proportionality of the GMC’s fitness to practise procedures, and the consultation offered an opportunity to shape better procedures with the right balance for doctors, patients and the public.

She said: “We are extremely receptive of the idea of greater discussion with the GMC and the opportunity for fair and sensible decision making at an earlier stage - it is pragmatic and makes sense, as hearings are stressful, and can be drawn out and costly.

“This is, however, a fundamental change to how the GMC currently operates and the success of this scheme will depend on a robust strategy for communicating and engaging public confidence, and a change in culture for case examiners, moving away from the current adversarial approach.”

The consultation document also proposes a more speedy process for dealing with doctors convicted of serious crimes, such as murder and rape, with the GMC arguing that those who have committed such crimes are not fit to be doctors.

Niall Dickson, GMC chief executive, said: “We are here to protect patients and that means making sure that only doctors who are fit to practise are allowed to do so. However, it is not our role to punish doctors or even to provide redress to patients - there are other ways to achieve that.

“Our view is that attending a hearing can be a stressful experience for everyone involved and there is no need to do this if the doctor is willing to accept sanctions that protect patients.”

The recommendations are in part a response to the GMC’s burgeoning case load. In 2000, the regulator received 4141 complaints about doctors compared with 7,022 projected for 2010.

MPS’s Brown said the GMC and doctors will have to cooperate for the proposals to work. “We believe the proposals will bring a level of consistency in approach, which we welcome. But we maintain that nothing must usurp a doctor’s entitlement to a hearing, where agreement cannot be reached,” she said.

Doctors can already seek to voluntarily erase their name from the medical register ahead of a fitness to practise hearing, although this has proved controversial and allegations of inconsistency have dogged the process.

Recently the government has confirmed the scrapping of a fledgling regulator that was being set up to preside over the adjudication of doctors’ fitness to practise, allowing the GMC to retain control of the process.

Dr Catherine Wills, deputy head of advisory services at the MDU, said: “We welcome the opportunity to enter into discussions with the GMC with a view to identifying ways of disposing of cases without panel hearings and we will be responding to the consultation on our members’ behalf.”

The GMC is seeking views - which can be emailed to ftpconsultation@gmc-uk.org - until 11 April.

Read the full document.