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Posts Tagged ‘fitness to practise’

Doctors can experience virtual GMC hearing

By Mike Broad - 15th February 2010 10:36 am

The GMC aims to provide more support to doctors attending fitness to practise hearings by encouraging greater familiarisation with the process in advance.

An online hearing room will allow doctors, patients, and witnesses to take a virtual step inside a hearing, and users can tour the room and see who attends and why.

The site includes virtual versions of all those who might attend a hearing, such as lay and medical members of the panel, and a doctor’s representative. All 12 of these characters can be clicked on for an explanation of who they are and what role they play in a hearing. The site also shows the reception area and waiting rooms for doctors and witnesses so that anyone attending a hearing can arrive feeling more comfortable with their surroundings.

In addition, the GMC will provide doctors with a booklet about what to expect at hearings.

The GMC is also launching a project to support vulnerable witnesses. This project allows witnesses to come into the GMC’s buildings in advance of the hearing and be shown round. They can also ask to be joined by an independent ‘friend,’ assigned on the day of the hearing, to provide support.

Paul Philip, the GMC’s director of standards and fitness to practise, said: “The vast majority of doctors do a good job in often difficult circumstances. We know this because of the 218,000 doctors practising in the UK, we receive around 5,000 complaints per year, and around 200 come before a public hearing.

“But attending and giving evidence in a hearing can be a daunting process for members of the public and doctors alike. We hope that this initiative will offer some peace of mind to all those who are called to give evidence at our hearings, and that the opportunity to familiarise themselves with the process and the look and feel of a hearing will help to demystify it.”

Dr Nick Clements, head of medical services (Leeds) at MPS, commented: ”We should welcome this approach - it’s very useful material to assist people unfamiliar with the GMC process - whether they are a witness, or a doctor facing charges. It helps create a feeling of familiarity with the process that should help to reduce the stress associated with attending a hearing.”

View the virtual hearing room.

Read more about the Information for doctors initiative.

Tags: fitness to practise
Posted in Hospital Dr News | No Comments »

Health worker’s two-day nitrous oxide binge at work

The Sun - 6th November 2009 6:37 pm

A hospital worker was found in a pool of his own urine after a two-day binge on laughing gas in an operating theatre, a hearing has heard.

Jason Warner sneaked into the theatre on Saturday morning and was found the following Monday with the nitrous oxide gas mask still on his face.

He admitted hallucinating and taking so much gas he was “past caring”, the Health Professions Council was told.

Sophie Kemp, for the HPC, said Warner joined Castle Hill Hospital, in Yorkshire, in February 2007 and would assist anaesthetists during the sedation of patients.

He was supposed to be on call for the weekend of 26 and 27 July last year.

Ms Kemp said Warner had a “strategy” for flushing out the effects of the gas, if there was an emergency, by inhaling pure oxygen.

But he overdosed and was only found two days later.

Following the incident Warner admitted his addiction to the anaesthetic gas and said he had used it prior to the incident, but never while on duty.

He explained that laughing gas helped him cope with problems in his private life.

In October last year Warner faced a formal disciplinary hearing and was sacked by Hull and East Yorkshire Hospitals NHS Trust a month later.

Warner admits stealing and inhaling the gas at work but denies his fitness to practise is impaired.

The hearing continues.

Appointments to fitness to practise adjudicator

By Mike Broad - 28th October 2009 8:58 am

The board steering the new adjudicator on doctors’ fitness to practise is taking shape.

Two non-executive directors have been appointed to the Office of the Health Professions Adjudicator which, from 2011, will adjudicate on the cases brought before it by the GMC.

It is hoped that the separation of investigation from adjudication through the creation of OHPA will demonstrate that fitness to practise decisions are fair and effective and separate from the profession, regulator and government.

The newly appointed non-executive directors, Andrew Colquhoun and Pamela Charlwood, will work with the chair Walter Merricks to oversee the creation of this new independent body and regulatory system.

Colquhoun is chairman of the investigation committee of the Institute of Chartered Accountants, while Charlwood is vice chair of the Hampshire Partnership NHS Foundation Trust. Merricks, who becomes chair of OHPA on 1 November, has been the chief financial ombudsman.

Ian Barker, an MDU solicitor, welcomed the progress. “It’s right that the body that prosecutes does not adjudicate as well - it’s a basic principle of fairness,” he said.

He added that the OHPA is in the interests of doctors because while the public think the GMC goes easy on doctors, in reality, the opposite is true.

This split in role was recommended by Dame Janet Smith, who presided over the Shipman Inquiry, and the GMC will in future be confined to investigating complaints, gathering evidence, and ‘prosecuting’ cases.

The General Optical Council will follow the GMC in losing its adjudication role to the new office, and all healthcare professions will eventually abide by the same system.

It represents a significant step away from self-regulation, and follows an increase in lay representation within the GMC. Last year, the GMC also controversially changed the burden of proof required in making fitness to practise decisions. The civil standard of proof is now applied, so allegations no longer have to be proved beyond reasonable doubt but on the balance of probabilities.

It is hoped that OHPA’s development provides an opportunity to improve case management.

MDU’s Barker believes the length of hearings and their cost could be reduced if the OHPA used legally qualified chairs on fitness to practise panels.

He said: “As it exists, a legal assessor advises the panel. But, gone are the days when you had a panel of 12 doctors needing independent legal advice. If you had a legal chair, they could make their own legal determinations and it would cut down on the considerable amount of time spent dealing with legal aspects.”

Tags: fitness to practise, GMC, OHPA
Posted in Hospital Dr News | No Comments »

Consultant guilty of poisoning lover over abortion

BBC Health - 19th October 2009 9:39 pm

A doctor has been found guilty of poisoning his lover in a failed attempt to induce an abortion.

Dr Edward Erin, 44, a chest consultant at St Mary’s Hospital, spiked the drinks of Bella Prowse, 33, after she became pregnant but refused a termination, the Old Bailey heard.

The jury found Erin guilty of two charges of attempting to administer poison - once in a cup of coffee from Starbucks and then in a glass of orange juice.

The married father-of-two had denied administering poison to procure a miscarriage. Miss Prowse gave birth to a healthy baby in September 2008.

The court had been told tests showed traces of the drug in both Miss Prowse’s body and a cup given to her by Erin.

But Erin was found not guilty on another charge of spiking a cup of tea given to Miss Prowse as the jury could not reach a decision.

The Crown Prosecution Service will decide next week whether to seek a retrial on that charge. Judge Richard Hone told Erin: “A custodial sentence is virtually inevitable.”

Erin, originally from Caerphilly, south Wales, was banned from working with patients by the GMC pending the verdict.

The wealthy doctor, who also owns a property company, began his affair with Miss Prowse at a Christmas party in 2007.

Professor “dishonest” over medico legal report

By Mike Broad - 6th October 2009 9:01 am

A retired professor has been suspended for misleading the legal aid authorities over the amount of time he spent compiling an expert witness report for a court case.

Stewart Goodwin, a former professor of microbiology, has been found guilty of dishonesty and had his registration suspended for 12 months by the GMC.

In 2006, Goodwin provided an expert medico legal report for a firm of solicitors and invoiced them for five hours work at £350 an hour - an unacceptable rate for the Legal Services Commission (LSC), which is publicly funded.

Two months later, Goodwin re-issued the invoice with a reduced hourly rate of £200 an hour, which he knew would be more acceptable to LSC, but listing an increase in the number of hours worked (now 8.5 hours).

This followed an exchange of correspondence, in 2005, with a firm of solicitors who had requested that he act as an expert witness. Goodwin indicated an intention to mislead the LSC in order to obtain financial advantage.

He also expressed a willingness to provide a false estimate of the numbers of hours likely to be worked in the preparation of a medico legal report in order to obtain an enhanced fee.

The GMC panel concluded that the conduct was dishonest, misleading and likely to bring the profession into disrepute.

Despite Goodwin being fully retired, with no intention of performing medico legal work or practising in the future, the panel suspended his registration for 12 months.

The panel concluded that “this period would be sufficient to send out a signal to you, the public and the profession that such conduct is unacceptable, whilst upholding public confidence in the profession. It would also allow you time to reflect on your behaviour.”

In reaching its decision, the Panel said it had “borne in mind the principles contained within the GMC’s publication Good Medical Practice…in particular, paragraph 54, under the heading of Probity: You must be honest in financial and commercial dealings with employers, insurers and other organisations or individuals.”

Tags: expert witness, fitness to practise, GMC
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GP gives “lethal” overdose to two patients in an hour

The Guardian - 13th September 2009 12:33 pm

A doctor who killed a grandmother with a diamorphine overdose and gave another patient a potentially lethal injection within the space of an hour operated at “far below” the medical standard expected, a disciplinary panel ruled.

In an intermediary decision, the GMC found that the fitness to practise of Dr Michael Stevenson, 57, who worked for an out-of-hours GP service, was “impaired” by his conviction for manslaughter and his “misconduct” in dealing with the second patient.

Stevenson was spared jail when he admitted causing the death of Marjorie Wright, a 58-year-old grandmother, at her home in Workington, Cumbria, in January 2005.

The family GP, from Millom, accidentally gave Mrs Wright a 30mg dose of diamorphine instead of 5mg, failed to monitor her reaction to the drug and left to attend another house call. She was found dead when police broke into her home shortly afterwards.

On his next visit for the CueDoc out-hours GP service, Stevenson administered an identical overdose to a 59-year-old builder, who suffered an immediate respiratory arrest. The patient survived after paramedics were called and gave him an emergency antidote.

The GMC panel’s chairman, Professor Ken Hobbs, said: “In respect of both Mrs Wright and Mr E, the panel finds Dr Stevenson’s conduct to have fallen far below the standard expected of a competent registered medical practitioner.”

His 15-month jail term, suspended for two years, over the death of Mrs Wright was considered by the panel after they determined the facts of the other cases.

The GMC disciplinary hearing will now consider further evidence and submissions to decide whether Stevenson should be struck off the medical register or be subjected to any professional sanctions. He has previously vowed never to practise again.

Try to avoid rugby clubs and shagging patients

By Mike Broad - 29th August 2009 1:11 am

Two doctors copped a lot of flak in the media this week.

The first was Wendy Chapman, an A&E consultant at Maidstone Hospital, in Kent, who became embroiled in Harlequins Rugby Club’s Bloodgate saga.

To cut a long (and slightly tedious) story short, a player pretended to have a mouth injury towards the end of an important rugby match in order to allow a good kicker to come on to the pitch as his replacement in attempt to slot a winning penalty.

The Harlequins winger, Tom Williams, burst a capsule of fake blood in his mouth and was ‘helped’ from the pitch. But, when it looked like he was going to be rumbled by the match officials he claims to have asked Chapman, the club doctor, to cut his mouth to make it appear convincing.

The officials weren’t fooled and Williams received a lengthy ban. He promptly whistleblew on the club’s director of rugby, which created a whole new round of public bloodletting at the club.

Chapman now potentially faces an investigation by the GMC, despite the player saying he didn’t believe she was involved in the fake blood scandal.

Her case is now being handled by the MDU, inferring that the GMC are indeed considering proceedings. Neither organisation, understandably, is discussing the case.

It sends a clear message - the principles of the GMC’s Good Medical Practice apply whether you’re in A&E or the changing room of a rugby club.

The second case, if true, is a little more ethically clear cut. It involves a GP being accused of shagging a patient in his clinic while the patient’s husband sat outside.

Some dilemmas for doctors are easy to avoid, others less so - but it’s worth remembering, in the eyes of the GMC, it all has a bearing on your fitness to practise.

Tags: fitness to practise, GMC
Posted in Dr Blogs | 7 Comments »

Laughing all the way to the fitness-to-practise panel

By Mike Broad - 16th July 2009 10:58 am

We’re about to have our third child. And like all anxious expecting couples, we’re considering our options for the birth. Home or hospital? Anaesthetic or natural? Daily Telegraph or Guardian (for me)?

My wife had epidurals with our previous two children but we’re flirting with having just gas and air this time (easy for me to say).

Gas and air - as you know, an equal mix of nitrous oxide and oxygen - has a long and interesting history.

Nitrous oxide, or laughing gas, was first used as a medical analgesic in 1844 by American dentist Horace Wells. It grew in popularity in the late 1800s.

But the hypoxia caused by a lack of oxygen was a real problem until it was discovered that an oxygen content of at least 21% (the same percentage as in air) reduced its occurrence significantly.

The anaesthetist Arthur Ernest Guedel first described the use of self-administration of a nitrous oxide and oxygen mix in 1911. But, it was not until 1961 that the first paper was published by Michael Tunstall et al describing the administration of a pre-mixed 50:50 nitrous oxide and oxygen mix, which led to the commercialisation of the product.

Its analgesic effect is strong - said to be equivalent to 15 mg of subcutaneous route morphine - and is characterised by rapid onset and offset.

This is great if you’re having contractions in labour.

But it’s not great for patients with a bowel obstruction, pneumothorax, middle ear or sinus disease or who’ve recently been scuba diving.

Or, rather importantly, if you’re an SHO who is on duty in a children’s ward.

Dr Chahal, as you now realise, there are better ways of impressing a nurse than holding an “Entonox” party…

Tags: fitness to practise, Humour
Posted in Messy Business | No Comments »

Jump in number of GMC fitness-to-practise hearings

Pulse - 10th June 2009 11:11 pm

The number of doctors referred by GMC case examiners to fitness-to-practise hearings increased dramatically last year - prompting warnings that the switch to the civil standard of proof may be putting GPs at greater risk of sanction.

New fitness-to-practise statistics published by the GMC reveal 359 doctors were referred to hearings by case examiners in 2008, compared with 196 in 2007 - an 83% rise.

The total number of cases dealt with by the GMC rose only slightly, but the proportion referred to hearings jumped by almost two-thirds from 17% to 28%.