The GMC has issued revised triaging guidance where doctors are accused of low-level violence or dishonesty outside their professional practice.

Rationale

The GMC said

“Given the wide range of behaviour that can be defined as violent or dishonest, this has resulted in a number of cases being concluded with no action or a warning at tribunal as the doctor’s fitness to practise was not found to be impaired.

“We have also reflected on research into promoting and maintaining public confidence in the medical profession. Participants were asked to consider a range of scenarios including where a doctor had punched someone in a nightclub fight and one where a doctor had stolen a low value item from a shop. The detailed findings showed that the vast majority of respondents felt that the GMC should take no action or give doctors a warning for lower-level violence and dishonesty issues that occurred outside the workplace.”

Previous Guidance

The previous guidance presumed that all allegations of violence or dishonesty would be referred to a tribunal unless there were exceptional reasons not to refer.

GMC data showed that between September 2018 and June 2020, 33 tribunal hearings involving allegations of violence/dishonesty concluded with a finding of no impairment and either no action or a warning.

Guidance for decision makers on allegations of low-level violence and dishonesty

The guidance now states the following:

Factors to consider

Doctors are among the most trusted professionals and trust is critical to the doctor/patient relationship. In view of this, violence and dishonesty allegations carry a presumption of impaired fitness to practise and therefore should normally be promoted for a full investigation so that the case examiners can consider whether the nature of the allegations are such that the presumption of impairment is rebutted or, if not, require referral for a hearing.

However, the range of behaviours which fall into these two broad categories will vary considerably and the nature of some violence and dishonesty allegations are such that they are unlikely to raise a question of impaired fitness to practise and therefore require a full investigation. The conduct that gives rise to such allegations:

1. will be minor in nature and less likely to pose a risk to patients, public confidence or proper professional standards and conduct; and
2. will have occurred outside the doctor’s professional practice; and
3. will have been investigated by the police or another relevant body, such as the doctor’s employer.

If all these factors are met, the allegations are unlikely to raise a question of impaired fitness to practise and to meet our threshold for investigation.

Case examiner guidance

In addition to the triaging guidance, the GMC has also updated its “Making decisions at the end of the investigation stage” guidance “to provide case examiners with discretion to conclude some allegations of violence and dishonesty with a warning or, more rarely, advice or no action.”

The GMC said “Although violence and dishonesty will continue to carry a presumption of impaired fitness to practise, this presumption will be rebutted where the nature of the conduct is such that the doctor would not pose a risk to public protection.”

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