GMC PERFORMANCE PROCEDURES

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GMC PERFORMANCE PROCEDURES

• G.W.McGARRY

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Conditions !

• No names/real cases
• Anyone in audience in process?
• Actual instruments, details witheld

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Functions of GMC

• Keep register
• Oversee standards of medical education
• Guide doctors
• Deal firmly and fairly with doctors whose FTP is
  in doubt

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• FTP
• Conduct Health Performance

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Performance Procedures Law

• Medical (professional performance) Act 1995
• Assessment referral committee, Committee on
  Professional Performance CPP
• GMC given power to require assessment
• Gives Assessors access to medical records
• Enabled CPP to impose sanctions

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Seriously Deficient Performance

• SDP is a departure from good professional
  practice (whether covered or not by specific GMC
  guidance) sufficiently serious to call into
  question the doctors registration that is
  repeated or persistent failure to comply with
  professional standards appropriate to the work
  being done or with GMP, particularly where this
  places patients or members of the public in
  jeopardy

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• Performance
• Performance (does) Competence (can do)
• Phase 1 Phase 2
• Peer review TOC
• report and opinion

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The instruments

• Developed from scratch
• Cover all aspects of performance and GMP
• Generic and all specialities
• Robust and validated (validation groups)
• Accurate recording of evidence

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Complaints

• Screened
• Decision to assess
• Team leader invited
• Team configured
• Assessment in 2 phases
• Decision and outcome

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Team

• Lead
• Medical Assessor
• Lay
• Additional Assessor
• GMC admin staff
• Stenographer

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Phase 1

• Portfolio
• Initial interview
• Site tour
• Observation of practice
• Records review
• TPI
• CBD
• Summary interview

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Phase 2

• Initial interview
• Knowledge test
• Structured oral
• Communication skills
• 10 station OSCE
• Final interview

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Report

• Background /Narrative/ Complaints/Setting
• Legal framework (1997/Krippendorf/etc)
• Phase 1 headings of GMP ACU
• Phase 2 objective/subjective scoring/ACU
• Triangulation
• Summary
• Panel opinion

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Example of report paragraph

• Treatment U
• The panel heard how DrX seemed unable to perform
  tonsillectomy without removing the uvula and
  causing bleeding. On at least two occasions he
  was observed to use monopolar diathermy to
  remove the tonsils. He was unable to list the
  common complications of tonsillectomy and did not
  understand the basics of treatment of otitis
  media. He told the panel that oral gentamicin was
  treatment of choice in sinusitis. He precribed
  125mg of amoxil bd for a 80 Kg male patient with
  pneumonia.
• TPI.CBD.REC.
• 125,567,926,1078,1145

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Computer database

• 926 CBD McGarry
• Q. List the common complications of Tonsillectomy
• You can get septic shock and heart failure, oh
  and it hurts.
• U Treatment

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Possible outcomes

• No case to answer
• Voluntary remedial action then reassessment
• Refer to CPP
• Conditions
• Suspension
• Erasure

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CPP hearing

• Court
• Adversarial
• Standard of proof criminal (change?)
• Report forms part of GMC case
• Judgement and sanctions
• Appeals to Privy Council

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CPP outcomes

• Admonish
• Conditions
• Suspension
• Erasure

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