The General Medical Council has revised its guidance for triage decision makers on considering cases involving low level violence and dishonesty.

Under the GMC’s old thresholds guidance, all allegations of violence and dishonesty carry a presumption of impairment, which means they ought to be referred to the medical practitioners tribunal service, unless there are exceptional reasons not to do so.

It noted however that “Given the wide range of behaviour that can be defined as violent or dishonest, this has resulted in a number of cases being concluded with no action or a warning at tribunal as the doctor’s fitness to practise was not found to be impaired.”

Presenting the proposal to its Executive Board this month, Anna Rowland, Assistant Director Policy and Business Transformation said:

“We have also reflected on research into promoting and maintaining public confidence in the medical profession. Participants were asked to consider a range of scenarios including where a doctor had punched someone in a nightclub fight and one where a doctor had stolen a low value item from a shop. The detailed findings showed that the vast majority of respondents felt that the GMC should take no action or give doctors a warning for lower level violence and dishonesty issues that occurred outside the workplace.”

Changes to decision making guidance

The GMC has introduced revised guidance for decision makers at triage (including provisional enquiries) to support them in considering the risk posed by doctors in cases involving low level violence and dishonesty outside the doctor’s professional practice.

The guidance sets out that allegations of violence and dishonesty outside a doctor’s professional practice are unlikely to raise a question of impaired fitness to practise, and therefore require a full investigation, where the conduct that gives rise to such allegations:

  • is minor in nature; and
  • occurred outside the doctor’s professional practice; and
  • was investigated by the police or another relevant body, such as the doctor’s employer.

Cases that meet the above criteria will be closed with no further action.

Case examiner guidance

The GMC has also updated its advice for Case Examiners to reflect the changes above.  Updated guidance now allows Case Examiner, at the end of the investigation stage, to conclude some allegations of violence and dishonesty with a warning or, more rarely, advice or no action.

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