Review of doctors recommends clear standards and revalidation

Chief medical officer Professor Sir Liam Donaldson has published the results of the first review of the regulation of the medical profession conducted in more than 30 years.

Good Doctors, Safer Patients was commissioned following the publication of the The Shipman Inquiry: fifth report, which was highly critical of the General Medical Council (GMC) and the broader arrangements for medical regulation.

The recommendations of Donaldson’s report include:

  • The creation of unambiguous standards for generic and specialist practice to give a clear, universal definition of a ‘good doctor’ and to allow patients, employers and doctors themselves to have a shared understanding of what is expected of doctors. These standards would be incorporated into the contracts of doctors
  • Devolution of some of the powers of the GMC, as statutory regulator, to the local level
  • The creation of an independent tribunal to adjudicate on fitness to practise
  • A renewed focus on the assessment, rehabilitation and supervision of doctors with performance problems where these problems are not borne of malice
  • Greater public and patient involvement – to ensure public and patients work with GMC affiliates in making decisions abuot fitness to practice.

Donaldson said: “The proposals that I have made are designed to help doctors maintain their standards and to achieve excellence, as much as they are designed to identify poor practice.

“Patient safety has been my primary concern. There must be a robust revalidation process. At present, a senior doctor can go through a 30-year career without undergoing a single assessment of their fitness to practise, whereas an airline pilot, meanwhile, would face over 100 checks over a similar timescale.

“I have made many recommendations to allow doctors to improve their practice and also increase public confidence in the regulation system,” he said.

Health secretary Patricia Hewitt said the report was extremely important and would be considered carefully by the government.

A Department of Health review of the regulation of non-medical professionals, undertaken concurrently with Donaldson’s review, was also published today.

It recommended increased responsibility for employers in regulation, including improved workplace appraisals and a system to check that employers fulfil their revalidation duty.

NHS Employers deputy director Alastair Henderson said: “NHS Employers thinks it is absolutely right that employers” responsibility for ensuring the continuing competency of their staff is clearly recognised.

“NHS Employers will now be carefully considering the implications of these proposals for employers, staff and patients, and we will be holding discussions with employers to ensure their views are fed into the consultation.”


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