We asked employers' for their views on key areas of the future of non-medical and medical regulation, in order to respond to the current consultation on the reviews carried out by Sir Liam Donaldson and former DH director of workforce Andrew Foster . This is a summary of the responses we received*.
Overall
We received 28 responses to the consultation through our on-line survey, feedback from our medical workforce forum and the forum's reference group. The majority of employers were in support of the main principles and recommendations of the two consultation reports.
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GMC affiliates
- 23 respondents agreed that wherever possible concerns should be resolved locally
- there was much less agreement on whether the particular approach set out in the CMO report would work
- there was divided view whether the medical director should undertake the role of the GMC affiliate. This was a proposal that provoked strong opinions, with a number of respondents seeing this as a natural extension of the medical director's existing role and a number with an equally clear view that the medical director already has too many roles and should not be seen as both judge and jury within the same organisation
- resources were seen by many as an important issue and a number of respondents pointed out that some organisations did not have a medical director - so this would need to be considered.
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Revalidation of medical staff
- in principle 21 respondents supported the CMO's proposals for the revalidation of doctors
- the main concerns expressed related to the additional resources and support that were felt to be required under these new proposals
- there were also concerns about how the proposals would work in small units, primary care and in respect of those practising without the benefit of being in any organisation.
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Revalidation of non-medical staff
- 22 respondents supported the approach in the Foster review to the revalidation of other health professionals
- the majority agreed with using the KSF as the foundation
- more than half thought that their organisation was not equipped to carry out the role proposed for them
- concerns included lack of resources, expertise and clarity around the aims of revalidation
- there was a general perception that this was a good proposal in principle but difficult to make into reality.
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Role of the PCT in adverse events
- 19 respondents supported the proposals in the CMO's report relating to the monitoring of significant events in general practice and the responsibility of PCTs for assuring that lessons are learned from specific events
- no respondents disagreed
- resources and expertise were identified as limiting factors for PCTs deploying investigatory powers. This was generally felt to be an undeveloped and problematic area for PCTs.
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Standard of proof
- there was support for the proposal for adjudication on a doctor's performance, health or conduct being to the civil standard of proof
- there was a minority view that this could result in injustice to doctors
- there was also a view that there should be consistency across regulators
- there were some concerns about the effect on consultants' morale and the impact with regard to the self-employed.
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Other issues
- proposals were felt to be mainly sound in principle but possibly rather more idealistic than practical - 'the principles and practice may be miles apart'
- one respondent commented 'I welcome the review but it needs more input from the service on the potential impacts, before any processes are put in place to change.' This seems to reflect a widespread view.
* This doesn't include the responses from employers attending NHS Employers' seminar.
Last reviewed 13 Nov 2006
