The General Medical Council works ‘to protect patient safety and support medical education and practice across the UK.’ They subdivide their purpose into five key areas, as set out by the Medical Act 1983.
Medical Registration
Firstly, they manage the UK Medical register of more than 300,000 doctors. This involves checking identities and qualifications, along with contacting employers to ensure that the doctor will practise safely.
Medical Standards
Secondly, the GMC sets standards for doctors. They set out the values, knowledge, skills and behaviours required of all doctors working in the UK. To do this, they consult with a broad range of people, including patients, employers and educators.
Medical Education
Thirdly, the GMC oversees medical education and training across the UK. That means setting standards that each university must hit, and monitoring training at universities. There is a general push towards as homogenised a course, and outcomes, as possible.
Revalidation
Fourthly, the GMC manages a process called revalidation. This is the system through which each licensed doctor in the UK keeps their knowledge and skills up to date. Each doctor has an annual appraisal, and every five years a senior doctor will correlate their junior’s appraisals and tell the GMC if the doctor is keeping up with the standards expected of them.
Medical Concerns
The last part of the GMC’s remit is to ‘investigate and act on concerns about doctors.’ If a serious concern is raised about a certain doctor, the GMC must decide whether it will investigate it. If the doctor has put patient safety at risk, or endangered the public’s confidence in doctors, then they will likely investigate. After the investigation, a range of outcomes may come into play, from a warning or advice through to retraining or restricted practice. In the most serious situations the GMC will refer the case to the Medical Practitioners Tribunal Service which may seek to remove the doctor from the register entirely.
The GMC was formed in 1858 under the Medical Act. Prior to its formation there were 19 separate bodies regulating doctors in the UK, all with different examinations and tests. At this time, a doctor in one part of the UK at this time might not have been seen as qualified elsewhere, creating an urgent need for a national body. The GMC was founded as the General Council of Medical Education and Registration of the United Kingdom, charged with registering doctors across the UK, leading medical education, and publishing a pharmacopoeia. The council would remove its first unqualified doctor in 1860, and hold its first hearing for a conviction in 1899, over a drunk doctor.
The council received its first female member in 1933, and by 2003 had radically altered the form of its council to 40% lay people, 60% doctors. It now stands at 50-50. At the turn of the millennium the GMC, criticised for not having struck off doctors like Harold Shipman, changed its focus from self-regulation to professional regulation. This would mean that the GMC would cover all stages of medical education and practice, with one central set of standards that would be the basis for a process of periodic revalidation. Revalidation began in 2012.
Now the GMC continues its work with a renewed focus on supportive frameworks for doctors rather than more punitive ‘fitness to practice’ procedures.
What is the role of the General Medical Council in the UK?
The General Medical Council works ‘to protect patient safety and support medical education and practice across the UK.’ This involves five key areas. Firstly, they manage the UK Medical register of more than 300,000 doctors. Secondly, the GMC sets standards for doctors. Thirdly, the GMC oversees medical education and training across the UK. Fourthly, the GMC manages revalidation – the system through which licensed doctors keep their skills up to date. The last part of the GMC’s remit is to ‘investigate and act on concerns about doctors.’
What do you know about the history of the GMC?
The GMC was formed in 1858 under the Medical Act, as the General Council of Medical Education and Registration of the United Kingdom. It was charged with registering doctors across the UK, publishing a precursor to the BNF, and leading medical education.
The council received its first female member in 1933, and by 2003 had radically altered the form of its council to 40% lay people, 60% doctors. It now stands at 50-50. At the turn of the millennium the GMC changed its focus from self-regulation to professional regulation. This meant that the GMC covered all stages of Medicine, with one central set of standards that would be the basis for a process of periodic revalidation. Revalidation began in 2012.
What is the name of the body in the UK responsible for setting standards for doctors?
The GMC – the General Medical Council.
Is the GMC’s primary loyalty to doctors or patients?
The GMC’s primary loyalty may be seen in its mission statement – it works ‘‘to protect patient safety and support medical education and practice across the UK.’ Protecting patient safety comes first, then its work for its doctors. If one considers much of the work they do, we may see that that work safeguards patients – for example, managing the medical register, checking identities and qualifications, ensures that only the correct doctors can be allowed onto the register. Setting standards for doctors – whilst of course of use to doctors too – also ensures patient safety through guaranteeing the competence of their doctor.
Do you think that it is a positive measure that the GMC oversees all medical education?
Overall, I fail to see how this could be a negative. Having a national body that draws on the expertise of doctors across the country – and the needs of patients and other healthcare professionals too – in control of setting standards of medical education must be a positive. Indeed, the homogenisation of medical training in the UK is set to continue to an extent with the introduction of the MLA (Medical Licensing Assessment) in 2025. GMC representatives come to universities already to ensure that their courses are teaching the correct outcomes in a safe and clear manner – helping to guarantee that foundation doctors are competent and ready to begin practising.
What do you think the disciplinary process is for a doctor that has acted unprofessionally?
If a serious concern is raised over the behaviour of a particular doctor, the GMC will decide whether it must investigate it. If the doctor has put patient safety at risk, or otherwise endangered the public’s confidence in doctors, then the GMC will likely investigate. After the investigation, there may be a range of different outcomes. This could be anything from a warning or the giving of advice, to compulsory retraining, to the scope of practice of the doctor being restricted. In serious situations the GMC will refer the case to the Medical Practitioners’ Tribunal Service which may seek to remove the doctor from the register entirely.
What is the guidance that the GMC produces for its doctors called?
The GMC’s core guidance for its doctors is entitled Good Medical Practice.
Why do you think that the GMC has made a considerable effort to change the makeup of its council from doctors to a mixture of laypeople and doctors?
I believe that the GMC is increasingly aware that patients expect to have a role to play in their own health, and that patient-centred healthcare is the future. If we extrapolate the idea of patient-centred healthcare from the consultation room to the highest levels, we see that patients should be present in the organisations that set standards and responsibilities for the Medical Profession. Especially in light of recent scandals – be it the Baby Deaths Scandal, the Mid Staffordshire Scandal or even Harold Shipman – the GMC will be increasingly concerned with correctly regulating its doctors and ensuring that patients feel both safe and comfortable in dealing with the NHS – which is far easier if they are involved in the GMC.
What major incidents can you think of in the UK that would have caused the GMC to tighten their regulations and oversight?
There are a few major incidents that I can think of that would have led to the GMC tightening regulations and oversight. Perhaps the most important though is Harold Shipman. Failures to act in his case, and that he was able to continue ‘practicing’ for such a long period of time, led to a huge public outcry against the GMC. It therefore changed its focus from self-regulation of doctors to professional regulation, covering all stages of medical education and practice, with one central set of standards that would be the basis for a process of periodic revalidation. Revalidation itself began in 2012.
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