Ethics and GMP - PowerPoint PPT Presentation


Title: Ethics and GMP


1

Standards and ethics in the UG curriculum
  • ImE

Jim McKillop Chair, GMC UG Board,
IME, Glasgow 24th June 2011
2
What we do
Education
Register
Fitness to Practise
Standards
3
GMC role in medical education
  • GMC sets outcomes and standards
  • Ensures outcomes and standards are met.

4
Key developments in GMC educational role
  • Regulation across the continuum from April 2010
  • GMC Education Strategy 2011-2013
  • Quality Improvement Framework (QIF) superseding
    QABME, QAFP and QF
  • Tomorrows Doctors (2009) to apply from 2011/12

5
Professionalism
  • Ethics are integral to the expectations around
    professionalism as part of
  • Good Medical Practice
  • Tomorrows Doctors
  • Our guidance (eg on consent, confidentiality,
    end of life care...)

6
Standards Ethics in the UG Curriculum
2003
1993
2009
7
Tomorrow's Doctors Outcomes 2 - The doctor as a
practitioner
  • Confidentiality
  • Use information effectively in a medical
    context......
  • (c) Keep to the requirements of confidentiality
    and data protection legislation and codes of
    practice in all dealings with information.

8
Tomorrow's Doctors Outcomes 3 - The doctor as a
professional
  • Know about and keep to the GMC's ethical guidance
    and standards.
  • Demonstrate awareness of the clinical
    responsibilities and role of the doctor, making
    the care of the patient the first concern.
  • Be polite, considerate, trustworthy and honest,
    act with integrity, maintain confidentiality,
    respect patients' dignity and privacy, and
    understand the importance of appropriate consent.

9
Tomorrow's Doctors Outcomes 3 - The doctor as a
professional
  • Respect all patients, colleagues and others
    regardless of their age, colour, culture,
    disability, ethnic or national origin, gender,
    lifestyle, marital or parental status, race,
    religion or beliefs, sex, sexual orientation, or
    social or economic status..
  • Recognise the rights and the equal value of all
    people and how opportunities for some people may
    be restricted by others' perceptions.

10
Tomorrow's Doctors Outcomes 3 - The doctor as a
professional
  • Understand and accept the legal, moral and
    ethical responsibilities involved in protecting
    and promoting the health of individual patients,
    their dependants and the public including
    vulnerable groups such as children, older people,
    people with learning disabilities and people with
    mental illnesses.
  • Demonstrate knowledge of laws, and systems of
    professional regulation through the GMC and
    others, relevant to medical practice.

11
IME Core Curriculum
  • Available as link on GMC TD2009 website
  • http//www.gmc-uk.org/MEL_for_Doctors_of_Tomorrow_
    __JME_Jan_2010_29451024.pdf

12
Student professionalism fitness to practise
  • GMC and the Medical Schools Council joint
    publication (2009)
  • Aimed at medical schools and students
  • Advice on the kinds of professional behaviour
    expected of students
  • Advises schools on FtP procedures

13
Student FtP
14
Student fitness to practise
  • ..deliberate or reckless disregard of
    professional and clinical responsibilities....
  • ...isolated lapse.....would not in itself suggest
    that the students fitness to practise is in
    question.
  • ....persistent misconduct, whether criminal or
    not... indicates a lack of integrity....unwillingn
    ess to behave ethically or responsibly.....serious
    lack of insight into obvious professional
    concerns.....

15
EAR - SFTP Cases AY 2009/10
  • Total number of cases 572
  • Average - 18.5 cases per school

Number of cases Number of Schools
0 1
1-10 17
11-20 4
21-30 6
30 3
16
AY 2009/10 - Cases by FTP Concern
Conduct 391
Health 64
Conviction/Caution 43
Health Conviction 74

17
AY 2009/10 - Cases by year of course
Yr 1 69


Yr 2 138
Yr 3 129
Yr 4 122
Yr 5 106
Yr 6 3
18
AY 2009/10 - Cases by outcome
Incomplete 26
No action 59
Support 300
Warning 13
Conditions/undertakings 42
Withdrawal 28
Suspension
Expulsion 11
19
Student registration
  • GMC re-examining case for student registration
  • Effectiveness of our student engagement
    programme.
  • Whether benefits outweigh disadvantages.
  • Background context - Coalition Government less
    inclined toward statutory regulation.

20
Student Registration - Next steps
  • Not just about solving student FtP concerns
  • Key test - whether registration would contribute
    positively to
  • - promotion of professional values and
  • - to supporting a smoother transition to
    practice.
  • ( November 2011 update Decision has now been
    made not to introduce student registration in the
    foreseeable future.)

21
Provisional Registration
  • FtP declaration introduced 4 years ago.
  • 20,000 applications from UK graduates since
  • 10 declare something mostly trivial
  • 3 refused registration complex or multiple
    problems or failure to declare

22
Review of Good Medical Practice
  • Last published 2006
  • Updating rather than extensive fundamental
    changes
  • Scoping consultation complete 2,000 responses

23
GMP Review some of the issues raised (1)
  • Is alignment with the 4 domains of revalidation
    possible/desirable?
  • (1 Knowledge, skills performance 2
    Safety quality
  • 3 Communication, partnership teamwork
    4 Maintaining trust)
  • Conflicts of interest
  • Delegation and referral
  • Interactions between NHS and private healthcare
  • Best use of resources/individual patient need

24
GMP Review some of the issues raised (2)
  • Best use of resources/individual patient need
  • Doctors responsibility for environmental
    concerns
  • Doctors responsibility to promote return to work
  • Relevance of doctors private/non-professional
    activities
  • Social networks

25
GMP Review Next Steps
  • Ongoing questions on consultation website
  • Draft text for public consultation Oct 2011 Jan
    2012
  • Revision of supplementary guidance where
    necessary
  • New GMP issued Autumn 2012
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Ethics and GMP

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Transcript and Presenter's Notes

Title: Ethics and GMP


1

Standards and ethics in the UG curriculum
  • ImE

Jim McKillop Chair, GMC UG Board,
IME, Glasgow 24th June 2011
2
What we do
Education
Register
Fitness to Practise
Standards
3
GMC role in medical education
  • GMC sets outcomes and standards
  • Ensures outcomes and standards are met.

4
Key developments in GMC educational role
  • Regulation across the continuum from April 2010
  • GMC Education Strategy 2011-2013
  • Quality Improvement Framework (QIF) superseding
    QABME, QAFP and QF
  • Tomorrows Doctors (2009) to apply from 2011/12

5
Professionalism
  • Ethics are integral to the expectations around
    professionalism as part of
  • Good Medical Practice
  • Tomorrows Doctors
  • Our guidance (eg on consent, confidentiality,
    end of life care...)

6
Standards Ethics in the UG Curriculum
2003
1993
2009
7
Tomorrow's Doctors Outcomes 2 - The doctor as a
practitioner
  • Confidentiality
  • Use information effectively in a medical
    context......
  • (c) Keep to the requirements of confidentiality
    and data protection legislation and codes of
    practice in all dealings with information.

8
Tomorrow's Doctors Outcomes 3 - The doctor as a
professional
  • Know about and keep to the GMC's ethical guidance
    and standards.
  • Demonstrate awareness of the clinical
    responsibilities and role of the doctor, making
    the care of the patient the first concern.
  • Be polite, considerate, trustworthy and honest,
    act with integrity, maintain confidentiality,
    respect patients' dignity and privacy, and
    understand the importance of appropriate consent.

9
Tomorrow's Doctors Outcomes 3 - The doctor as a
professional
  • Respect all patients, colleagues and others
    regardless of their age, colour, culture,
    disability, ethnic or national origin, gender,
    lifestyle, marital or parental status, race,
    religion or beliefs, sex, sexual orientation, or
    social or economic status..
  • Recognise the rights and the equal value of all
    people and how opportunities for some people may
    be restricted by others' perceptions.

10
Tomorrow's Doctors Outcomes 3 - The doctor as a
professional
  • Understand and accept the legal, moral and
    ethical responsibilities involved in protecting
    and promoting the health of individual patients,
    their dependants and the public including
    vulnerable groups such as children, older people,
    people with learning disabilities and people with
    mental illnesses.
  • Demonstrate knowledge of laws, and systems of
    professional regulation through the GMC and
    others, relevant to medical practice.

11
IME Core Curriculum
  • Available as link on GMC TD2009 website
  • http//www.gmc-uk.org/MEL_for_Doctors_of_Tomorrow_
    __JME_Jan_2010_29451024.pdf

12
Student professionalism fitness to practise
  • GMC and the Medical Schools Council joint
    publication (2009)
  • Aimed at medical schools and students
  • Advice on the kinds of professional behaviour
    expected of students
  • Advises schools on FtP procedures

13
Student FtP
14
Student fitness to practise
  • ..deliberate or reckless disregard of
    professional and clinical responsibilities....
  • ...isolated lapse.....would not in itself suggest
    that the students fitness to practise is in
    question.
  • ....persistent misconduct, whether criminal or
    not... indicates a lack of integrity....unwillingn
    ess to behave ethically or responsibly.....serious
    lack of insight into obvious professional
    concerns.....

15
EAR - SFTP Cases AY 2009/10
  • Total number of cases 572
  • Average - 18.5 cases per school

Number of cases Number of Schools
0 1
1-10 17
11-20 4
21-30 6
30 3
16
AY 2009/10 - Cases by FTP Concern
Conduct 391
Health 64
Conviction/Caution 43
Health Conviction 74

17
AY 2009/10 - Cases by year of course
Yr 1 69


Yr 2 138
Yr 3 129
Yr 4 122
Yr 5 106
Yr 6 3
18
AY 2009/10 - Cases by outcome
Incomplete 26
No action 59
Support 300
Warning 13
Conditions/undertakings 42
Withdrawal 28
Suspension
Expulsion 11
19
Student registration
  • GMC re-examining case for student registration
  • Effectiveness of our student engagement
    programme.
  • Whether benefits outweigh disadvantages.
  • Background context - Coalition Government less
    inclined toward statutory regulation.

20
Student Registration - Next steps
  • Not just about solving student FtP concerns
  • Key test - whether registration would contribute
    positively to
  • - promotion of professional values and
  • - to supporting a smoother transition to
    practice.
  • ( November 2011 update Decision has now been
    made not to introduce student registration in the
    foreseeable future.)

21
Provisional Registration
  • FtP declaration introduced 4 years ago.
  • 20,000 applications from UK graduates since
  • 10 declare something mostly trivial
  • 3 refused registration complex or multiple
    problems or failure to declare

22
Review of Good Medical Practice
  • Last published 2006
  • Updating rather than extensive fundamental
    changes
  • Scoping consultation complete 2,000 responses

23
GMP Review some of the issues raised (1)
  • Is alignment with the 4 domains of revalidation
    possible/desirable?
  • (1 Knowledge, skills performance 2
    Safety quality
  • 3 Communication, partnership teamwork
    4 Maintaining trust)
  • Conflicts of interest
  • Delegation and referral
  • Interactions between NHS and private healthcare
  • Best use of resources/individual patient need

24
GMP Review some of the issues raised (2)
  • Best use of resources/individual patient need
  • Doctors responsibility for environmental
    concerns
  • Doctors responsibility to promote return to work
  • Relevance of doctors private/non-professional
    activities
  • Social networks

25
GMP Review Next Steps
  • Ongoing questions on consultation website
  • Draft text for public consultation Oct 2011 Jan
    2012
  • Revision of supplementary guidance where
    necessary
  • New GMP issued Autumn 2012
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