United Kingdom - General medical council chief calls for greater focus on delivery of care

United Kingdom - General medical council chief calls for greater focus on delivery of care

Article Type: News and views From: International Journal of Health Care Quality Assurance, Volume 25, Issue 1

Keywords: Patient safety and quality outcomes, Clinical audit systems, Performance management measures

The NHS has “taken for granted” that care is good and that professionals are by and large competent other than “a few bad apples”, Niall Dickson, chief executive and registrar of the General Medical Council (GMC) has said.

“In spite of the patient safety and quality movement of the last 20 years, which have been driven both here and in the states, healthcare I would argue has still not fully embraced the safety culture that you find in other safety critical industries such as aviation, nuclear plant power or fossil fuel extraction,” he told an audience at the Westminster Health Forum keynote seminar in London.

“All of those [industries] have their disasters let’s be clear about that, but in each case I think if you went into those industries you would find safety lay at the absolute heart of everything they do. I don’t think we have quite reached that in the healthcare world.”

He went onto say that the NHS has the capacity to tackle the problem.

“There is a danger that we say the system is broken, it’s all terrible and look at what’s happening, but I think you have to remember and look back over time,” Dickson said. “Clinical audit is much more established than it was 10 to 15 years ago, safety reporting is much more embedded in our system than it was. The willingness of professionals to report problems in their own practice and others I think has increased.”

Dickson also disclosed that he believed whistle blowing to be a sign of failure, adding that by the time a situation reaches that stage it is a sign of an unsuccessful system. He explained that the GMC was looking at ways to help encourage a culture that was about learning rather than blame.

The council, which regulates doctors in the UK, is currently undergoing some major changes, which aim to change the relationship between the registrant and the regulator. Dickson said that it was important to switch from what he believes is an “intermittent and traumatic intervention when things have gone badly wrong” to “ongoing engagement with every doctor in the country”.

As part of these changes the GMC will roll out a programme of revalidation next year, which Dickson told the audience had been a long time coming. This will mean that every practising doctor will have to demonstrate that they are up to date and fit to practice.

“As the secretary of state has pointed out this is what the public expect, it’s also what the public thinks already happens. I think they would be quite shocked to know that the person operating on them, in theory, could be operating on them based on an exam they passed 25 years ago,” said Dickson.

A report by the House of Commons health select committee concluded that the GMC was putting the public at risk by being too lenient on doctors who were clearly under performing.

For more information: www.guardian.co.uk