Serious complaints against doctors, suspensions, and erasures all fell in 2011

Fewer doctors are being referred to fitness to practise panels, despite a continuing rise in the number of complaints against doctors, which reached a record high last year, the GMC has said.

In 2011 the GMC received 8781 complaints—a 23% rise from the 7153 in 2010, says the regulator’s second annual report.1 The likelihood that the GMC will investigate a doctor has also risen, from one complaint in 68 in 2010 to one in 64 in 2011.

However, most complaints (4914 (56%)) in 2011 were closed without further action because they did not raise issues of fitness to practise, a rise from 2010, when half of complaints ended this way. Cases that concluded with no further action after the GMC obtained further information from the doctor’s employer also rose in 2011, with 622 cases concluded at this point and 736 doctors being given advice from the GMC.

Serious complaints that led to fitness to practise hearings fell from 314 in 2010 to 212 in 2011. And despite an increase in complaints overall, the number of doctors suspended fell from 106 in 2010 to 93 last year. Fewer doctors were also struck off, down from 73 in 2010 to 65 in 2011.

Almost three quarters of complaints (73%) concerned male doctors, although men make up only 57% of doctors registered with the GMC. GPs make up the largest proportion of doctors registered with the GMC (24%), and they received the most complaints (47%), followed by psychiatrists (5% of registered doctors and 11% of complaints), and surgeons (3.5% of registered doctors and 8% of complaints).

Niall Dickson, chief executive, of the GMC, said, “While we do need to develop a better understanding of why complaints to us are rising, we do not believe it reflects falling standards of medical practice. Every day there are millions of interactions between doctors and patients, and all the evidence suggests that public trust and confidence in the UK’s doctors remains extremely high.”

Dickson also claimed that various factors such as the introduction of responsible officers ahead of revalidation, higher expectations among patients, and the willingness of doctors to speak out could be responsible for the increase.

Older doctors were more likely to be the subject of a complaint, with those aged between 55 and 59 years most likely to have a complaint lodged against them. Doctors who trained outside Europe were less likely to be the subject of a complaint in middle age but were more likely to face allegations when they were older, when compared with the same age group of doctors who qualified in the UK.

Recently qualified doctors tended to receive fewer complaints but were more likely to be investigated over issues such as probity or conduct. The report shows that as doctors get older these particular allegations decline but that there is an increase in the proportion of complaints relating to clinical care and also allegations about relationships with patients.

Complaints expressing dissatisfaction with doctors’ communication skills saw a steep rise (by 69%) in 2011, as did complaints about doctors showing a lack of respect (a rise of 45%).

Peter Rubin, chairman of the GMC, suggested that there may be a correlation between the rise in the number of complaints against older doctors and complaints about communication skills.

He said, “Twenty years ago the GMC realised that poor communication skills featured disproportionately in fitness to practise cases coming our way. In 1993 the GMC published new guidance for medical students that really emphasised the importance of communication skills.

“That generation is now coming through, but there are many doctors that might have come from a different culture or a different educational background who have not had all the expectations about communication drilled into them at an early age.”

Mark Porter, chairman of the BMA, said, “Even though medical standards remain high and the number of complaints is very small, compared with the millions of consultations every year, we should always strive to find ways of improving the quality of care. It is essential that the new system of checking doctors’ fitness to practise, known as revalidation, does protect patients while also being fair to doctors.”

Dickson said that the GMC will continue to analyse what leads to complaints and how it can provide more support to doctors over the course of their career. The GMC is establishing a 15 strong team of employer liaison advisers who will support medical directors and Responsible Officers in managing concerns about doctors as well as providing advice on issues such as revalidation.