Medicolegal issues high on 2009 agenda

Justice, complaints and regulation under the spotlight

Looking ahead to 2009, the legislative calendar already looks busy for those with an interest in medicolegal issues. We await further details about the Coroners and Justice Bill, the Health Bill and the draft Civil Law Reform Bill that were announced in the Queen’s speech. These Bills will be covered in more detail in the next edition of Check Up.

In addition, we will be closely monitoring the regulatory reforms, namely the introduction of responsible officers and GMC affiliates, which will be the subject of secondary legislation following parliament’s approval of the Health and Social Care Act 2008. We also look forward to the introduction of the new NHS complaints system, which should be in place in April 2009. Details of these reforms and timelines are summarised below.

Responsible Officers

Responsible Officers (ROs) willbe senior doctors with responsibility for clinical governance. They will provide a link to the GMC by monitoring the performance and conduct of doctors and overseeing the processes which support medical revalidation. MPS has raised concerns about ROs as, in most cases, the role will beundertaken by medical directors who already have an onerous workload.

Timeline: It is envisaged that ROs will be in post by October 2009 and, therefore, we expect secondary legislation to be introduced around Spring 2009.

GMC Affiliates

GMC affiliates will be based regionally and will provide support and advice to ROs in their area, thereby providing a link between local workplace regulation and central professional regulation (by the GMC). Controversially, it has been suggested that GMC affiliates will potentially have the power to issue recorded concerns which would appear on a doctor’s record.

It has also been suggested that a refusal to accept a recorded concern would result in automatic referral to the central GMC. MPS has serious concerns about the value and fairness of this new sanction, and hopes it will be dropped.

Timeline: Two separate pilots have been running since autumn 2008 – one based in London and one in West Yorkshire – and will run for 12 months. Depending on the outcome of the pilots and evaluation, GMC affiliates could be introduced in late 2009.

Reformed NHS Complaints System

The new two-stage unified complaints system for health and social care will place much greater emphasis on local resolution. Those complaints which remain unresolved will be referred to the Health Services Ombudsman. The Healthcare Commission’s current role in the second stage of the NHS complaints system will be abolished.

Although MPS hopes this will replace the often lengthy and bureaucratic procedures inherent in the current system, we believe that there is a need for training on proficient, excellent complaints handling at all levels, and that this may have a significant impact on many GP practices which are already stretched. We also anticipate an increase in the volume of cases which the Ombudsman will have to manage.

Timeline: The pilot schemes have been running since summer 2008 and it is expected that the new complaints system will be in place by April 2009, to coincide with the introduction of the Care Quality Commission.