Reflection is important for any healthcare professional to gain insight into the circumstances that led to things going wrong, and from this to demonstrate remediation.

In the last of three series of articles, we take an in depth look at remediation in fitness to practise.

What is remediation in fitness to practise?

Things do go wrong in medical practice and mistakes are made.  When this happens, reflection is important for any healthcare professional to gain insight into the circumstances that led to things going wrong and from this to demonstrate remediation.  It is not possible for someone to remediate if they do not have insight.

In broad terms, remediation refers to rectifying or correcting a certain behaviour that has generated fitness to practise concerns. More specifically, in the context of fitness to practise, remediation is where a health and care professional addresses concerns about their conduct, behaviour or health.

Why does remediation in fitness to practise matter?

Generally speaking, a health and care professional is fit to practise if they have the training, skills, knowledge, character and health to do their job safely and effectively. Where a regulator has concerns about a health and care professional’s fitness to practise, they can take action, including suspending or removing the health and care professional from practice.

In circumstances where a health and care professional’s fitness to practise is called into question,  they should, and be given the opportunity, to remediate.  This is important because demonstrable remediation could give regulatory bodies confidence that a health and care professional’s fitness to practise is no longer impaired, and they can continue to practise.

It is important to remember that impairment can be found in a range of circumstances, which are not limited to clinical errors or misconduct.  It can also include, amongst other things, adverse health and/or language proficiency.

Irremediable concerns

Certain fitness to practise concerns are deemed so serious that they are, either, very difficult to remediate or are irremediable.

In general, these are concerns are serious or persistent actions that, despite steps subsequently taken, action is needed to protect patients and/or maintain public confidence. This might include where a health and care professional knew, or ought to have known, they were causing harm to patients, and should have taken steps earlier to prevent this.

Irremediable concerns can also relate to specific circumstances, such as, but not limited to:

• Criminal convictions
• Cases involving dishonesty
• Sexual misconduct and/or impropriety
• Drug or alcohol use

Remediation is often a long process.  It is important that remediation is genuine and demonstrable to ensure good outcomes for doctors facing fitness to practise investigations and other issues.  In many cases, remediation steps can take many months to fully achieve.

Kings View are rated excellent and have successfully represented many doctors.  We can advise doctors on the best remediation strategy for their individual circumstances.

Examples of remediation

The correct remediation will depend on the individual circumstances of each case.  However, some common examples include:

• Training courses and learning – Probity and ethics courses in cases of dishonesty, professional boundaries courses in cases involving sexual impropriety or language proficiency training in cases involving language concerns.
• Reflective accounts – are written statements reflecting on the circumstances of each case to demonstrate that a doctor has gained sufficient insight.
• Supervision – this might be appropriate in cases involving lack of clinical competence or performance.
• Apologising – can be the simplest example of insight and remediation. (Is apologising an admission of guilt?)
• Professional help – Seeking support and help from professional services such as the AA for alcohol abuse issues and/or other professionals for behavioural issues.

Insight Works Training will help give you a clear and easy to follow understanding of the regulatory process, explanation of the central role of impairment, how to approach insight and remediation, how to evidence this at your hearing and a directed approach to presenting your learning with evidence in writing and verbally.

Remediate or contest?

In certain cases, a health and care professional might choose to contest the allegations made against them instead of seeking to remediate, which is often a long and expensive process.  In these cases, the doctor should seek legal advice.

How long does remediation take?

Remediation is often a long process, and in many cases, remediation steps can take many months to fully achieve and demonstrate.

Kings View are rated excellent and have successfully represented many doctors.  We can advise doctors on the best remediation strategy for their individual circumstances.

Insight Works Training

Developed by leading legal representatives for medical professionals facing health and social care tribunals, Insight Works Training have designed unique and practical courses with focus on impairment, reflections and remediation.

Courses are delivered by both leading healthcare experts with years of experience in mentoring and coaching who also sit on regulatory tribunal panels and, leading legal experts in the field of defence at health and social care regulatory tribunals.

Insight Works Training will help give you a clear and easy to follow understanding of the regulatory process, explanation of the central role of impairment, how to approach insight and remediation, how to evidence this at your hearing and a directed approach to presenting your learning with evidence in writing and verbally.