What is remediation?
Doctors must be fit to practise. Broadly speaking, fitness to practise, means a doctor must have the skills, knowledge, health and character to do their job safely and effectively.
Where a doctor’s practice falls short on any of these qualities and/or requirements, their fitness to practise might be found impaired. Impairment can be found for a range of circumstances, which are not limited to clinical errors or misconduct. It can also include, amongst other things, adverse health and/or language proficiency. Many healthcare professionals believe that impaired fitness to practise simply applies to their ability to do their job and their level of knowledge, skills, and competence, however the terms encompasses a far wider meaning. Impairment is also about your health and good character, which in turn can have a negative impact on the reputation of your profession, your employer, and your regulator.
The reality is that sometimes things do go wrong. When this happens, reflection is important to gain insight into the circumstances that led to the issue and from this to demonstrate learning. The learning gained must be put into action, taking practical steps to correct behaviour and issues that lead to the impaired fitness to practise. This is remediation. The General Medical Council (GMC) defines remediation as:
“Remediation is where a doctor addresses concerns about their knowledge, skills, conduct or behaviour.”
The GMC makes clear that the quality of the steps taken to remediate the concerns is key to assessing the impact it has had or is capable of having. Remediation should be:
- relevant – in that the steps taken to remediate have directly addressed the concerns identified
- measurable – in that there is objective evidence available that helps understand what has been done and what, if anything, is left to be done, and
- effective – in that there is enough information for the tribunal to see how any learning has been assessed and/or applied and its impact or success.
The value of remediation training
Remediation can take a number of forms, depending on the circumstances of each case.
Remediation training however is often cited as a key feature in remediation.
The GMC’s guidance further states that:
“Remediation can take a number of forms, including coaching, mentoring, training, and rehabilitation (this list is not exhaustive), and, where fully successful, will make impairment unlikely.”
The guidance goes on to say remediation training could, specifically, include “participating in training, supervision, coaching and/or mentoring relevant to the concerns raised” and “attending courses relevant to the concerns raised, for example anger management, maintaining boundaries, ethics or English language courses.”
Remediation training, coaching, mentoring matters in remediation. It also matters when remediation training is undertaken. The GMC places considerable emphasis on timely steps to remediate saying a doctor has gained insight is if they, amongst other things:
“…take timely steps to remediate … at an early stage before the hearing” and “…demonstrate the timely development of insight during the investigation and hearing.”
It is clear from the above therefore that doctors are expected to act quickly on remediation. There is clear evidence, through our experience, that doctors who engage with us at the earliest opportunity in their fitness to practise investigation, generally, achieve better outcomes because we can agree a clear strategy from the outset including remediation.
Impact of remediation on severity of sanctions
Doctors who responded “positively to remediation” might face less severe sanctions if their fitness to practise is found impaired.
A medical practitioners tribunal, in deciding what sanction, if any, to impose should start with the least restrictive sanction. It should also have regard to the principle of proportionality, weighing the interests of the public against those of the doctor.
MPTS guidance states, for example, that undertakings (restrictions on a doctor’s practice or behaviour agreed between the doctor and the GMC) are likely to be workable where … “the doctor has the potential to respond positively to remediation…”
Similarly, conditions are likely to be workable where …” the doctor has the potential to respond positively to remediation”.
Is remediation training right for your fitness to practise case?
Remediation can take a number of forms, depending on the circumstances of each case. However, coaching, mentoring and training often feature strongly in remediation. Remediation training helps doctors facing a fitness to practise investigation or hearing at work or before their regulator to:
- Understand the regulatory process
- Understand what is meant by impairment
- Understand what is meant by reflections, insight, and remediation
- Have the necessary knowledge to be able to formulate a personal plan
- Understand how to prepare for your hearing
- Understand what the Tribunal will expect from you at the hearing
Book you remediation training
Insight Works Training is a leading provider of remediation training delivered by leading defence tribunal barristers and clinicians, widely respected by health and social care regulators.