Better information on doctors vital, says Shipman report

Several of the over 100 recommendations made by the fifth report of the Shipman Inquiry relate to making it far easier for members of the public and NHS organisations to find out whether a doctor has had action taken against them for professional misconduct, or have ever been suspended or struck off the GMC register.

Specific recommendations include establishing a permanent electronic record of any restrictions on a doctor’s record which would then follow the doctor as they moved from job to job and making details of restrictions on a doctors’ registration available online to members of the public. 

The GMC have told E-Health Insider that they are working on making information in the public domain available online, and are transcribing the data from their paper-based records.

According to the report, anybody who currently wishes to get information about their doctors online can only receive it if there are no conditions attached to their registration. If there are, then the GMC website will say it’s not possible to display the entry and be invited to call the GMC.

If the doctor has conditions attached to his/her registration, the caller may still be told that the doctor is "fully registered". The caller must then specifically ask if the doctor’s registration has conditions attached.

“It seems to me that this process in unhelpful to the public," wrote Dame Janet Smith, head of the Shipman Inquiry, in the report. "All information about a doctor’s registration is in the public domain and it should be made readily available.

"For those who wish to access the website, the full information including any history of erasure, suspension, conditions and warnings should be shown."

A spokesperson for the GMC told E-Health Insider that work was ongoing to update the information available on their online database: "Over the past year we have been working on this issue to ensure that we provide appropriate information to patients through on-line services. At a meeting held on 30 November 2004, Council agreed that the online register should include information about current restrictions that affect a doctor’s practice, including undertakings given under ‘voluntary’ procedures."

"The main constraint is the volume of fitness to practise data currently held on paper files which will need to be extracted and entered onto the online register. This needs to have been completed before we go live, in order to avoid giving an incomplete picture."

The head of the GMC, Professor Sir Graeme Catto, told the inquiry in December 2003 that not making this information available was a "weakish stance from which to start" and that it was unacceptable that people had to specifically ask whether any conditions were attached to their doctor’s registration. However, the report notes, no changes were made to the availability of this information since that time.

The report suggested a tiered series of information should be made available, subject to public consultation as to what information should be available to whom. However, information already in the public domain about doctors’ registrations and any current warnings or previous suspensions should be volunteered and made available online.

In addition to making information about any restrictions on a doctor’s registration more accessible, the report suggests that a transferable file on each doctor be created, either electronically or on paper. This would then follow the doctor wherever s/he practiced so a full employment history would be at hand.

The report also insists that it should be best practice to keep a mortality database containing medical certificates of causes of death at each PCT, although it may not be feasible to link each patient with a specific clinician.

Shipman Inquiry
GMC