An in-depth look at Remediation in Fitness to Practise

Reflection is important for any healthcare professional to gain insight into the circumstances that led to things going wrong, and from this to demonstrate remediation

In the last of three series of articles, we take an in depth look at remediation in fitness to practise.

Reflection is important for any healthcare professional to gain insight into the circumstances that led to things going wrong, and from this to demonstrate remediation

In the last of three series of articles, we take an in depth look at remediation in fitness to practise.

What is remediation in fitness to practise?

Things do go wrong in medical practice and mistakes are made.  When this happens, reflection is important for any healthcare professional to gain insight into the circumstances that led to things going wrong and from this to demonstrate remediationIt is not possible for someone to remediate if they do not have insight.

In broad terms, remediation refers to rectifying or correcting a certain behaviour that has generated fitness to practise concerns. More specifically, in the context of fitness to practise, remediation is where a health and care professional addresses concerns about their conduct, behaviour or health.

Why does remediation in fitness to practise matter?

Generally speaking, a health and care professional is fit to practise if they have the training, skills, knowledge, character and health to do their job safely and effectively. Where a regulator has concerns about a health and care professional’s fitness to practise, they can take action, including suspending or removing the health and care professional from practice.

In circumstances where a health and care professional’s fitness to practise is called into question,  they should, and be given the opportunity, to remediate.  This is important because demonstrable remediation could give regulatory bodies confidence that a health and care professional’s fitness to practise is no longer impaired, and they can continue to practise.

It is important to remember that impairment can be found in 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. 

Irremediable concerns

Certain fitness to practise concerns are deemed so serious that they are, either, very difficult to remediate or are irremediable.  

In general, these are concerns are serious or persistent actions that, despite steps subsequently taken, action is needed to protect patients and/or maintain public confidence. This might include where a health and care professional knew, or ought to have known, they were causing harm to patients, and should have taken steps earlier to prevent this. 

Irremediable concerns can also relate to specific circumstances, such as, but not limited to: 

  • Criminal convictions
  • Cases involving dishonesty
  • Sexual misconduct and/or impropriety
  • Drug or alcohol use

Remediation is often a long process.  It is important that remediation is genuine and demonstrable to ensure good outcomes for doctors facing fitness to practise investigations and other issues.  In many cases, remediation steps can take many months to fully achieve. 

Kings View are rated excellent and have successfully represented many doctorsWe can advise doctors on the best remediation strategy for their individual circumstances. 

Examples of remediation

The correct remediation will depend on the individual circumstances of each case.  However, some common examples include: 

  • Training courses and learning – Probity and ethics courses in cases of dishonesty, professional boundaries courses in cases involving sexual impropriety or language proficiency training in cases involving language concerns.
  • Reflective accounts – are written statements reflecting on the circumstances of each case to demonstrate that a doctor has gained sufficient insight.
  • Supervision – this might be appropriate in cases involving lack of clinical competence or performance.
  • Apologising – can be the simplest example of insight and remediation. (Is apologising an admission of guilt?)
  • Professional help – Seeking support and help from professional services such as the AA for alcohol abuse issues and/or other professionals for behavioural issues.

Insight Works Training will help give you a clear and easy to follow understanding of the regulatory process, explanation of the central role of impairment, how to approach insight and remediation, how to evidence this at your hearing and a directed approach to presenting your learning with evidence in writing and verbally.

Remediate or contest?

In certain cases, a health and care professional might choose to contest the allegations made against them instead of seeking to remediate, which is often a long and expensive process.  In these cases, the doctor should seek legal advice. 

How long does remediation take?

Remediation is often a long process, and in many cases, remediation steps can take many months to fully achieve and demonstrate. 

Kings View are rated excellent and have successfully represented many doctorsWe can advise doctors on the best remediation strategy for their individual circumstances. 

Insight Works Training

Developed by leading legal representatives for medical professionals facing health and social care tribunals, Insight Works Training have designed unique and practical courses with focus on impairment, reflections and remediation. 

Courses are delivered by both leading healthcare experts with years of experience in mentoring and coaching who also sit on regulatory tribunal panels and, leading legal experts in the field of defence at health and social care regulatory tribunals. 

Insight Works Training will help give you a clear and easy to follow understanding of the regulatory process, explanation of the central role of impairment, how to approach insight and remediation, how to evidence this at your hearing and a directed approach to presenting your learning with evidence in writing and verbally.

Is legal representation the answer?

It is widely accepted and proven that legal representation makes a real difference to the outcome of investigations and results in lesser sanctions for doctors.

What is also unquestionably clear is that GMC investigations and MPTS hearings are complex, daunting, prolonged and legalistic leaving doctors stressed and anxious.  Where legal advice and representation can have the biggest impact on this, is helping doctors understand the process, what to expect and how to engage with the GMC during an investigation and hearing.

Research has shown that registrant’s engagement and legal representation can impact on decisions about seriousness, and that the lack of legal representation has been identified as being associated with more severe sanctions outcomes in fitness to practise cases, stating:

“Legal representation was seen as important by participants because legal advice could support and guide registrants through the FtP process, which is complex and legalistic. Legal advice was seen as important in aiding registrants to understand regulators’ expectations, especially in terms of the need for registrants to demonstrate insight and perhaps to show evidence of remediation activities. Lack of legal representation was, therefore, seen to potentially have an impact in terms of the seriousness of the outcome for registrants who are perhaps unaware of how to present their case to best effect.”

 A compassionate approach to legal representation

The right legal advice and representation is not just about the legalities and technicalities of a case.  Our barristers fully understand the stress and anxiety that doctors experience during prolonged GMC investigations.

We also understand that we are working with people who are anxious and worried about what investigations might mean for them, their professions and the reputations.

We never lose sight of the human aspects of FtP investigations and hearings.  We will always give an open and honest assessment of cases, but we will marry that with an approach that also supports health and care professionals through the duration of a case.

“I was not optimistic about the case, I felt that it is a lost case that we couldn’t do much about and especially just before the start of the trial I lost my confidence and was very nervous. Mr McCaffrey was there to prove me wrong. He turned everything around in a victorious , panegyric manner. I was stunned.” – CL

Catherine is professional, empathic and very knowledgeable. She provided all the necessary assistance throughout the long thorough investigation. – AR

A colleague recommended me to Catherine. She was very experienced , professional, empathetic , non-judgemental and listened to me. – Mel

I found myself consumed with dark thoughts, isolated and afraid. Stephen worked with me and slowly but surely formulated a plan not to just to fight my case and win, but to build me back up bit by bit so as to prepare me to face external scrutiny and present with confidence to panels where this was necessary. – FJ

What you can Expect when Instructing Kings View

All clients are entitled to an initial, no obligation and free telephone consultation about their case.  During this consultation, we will outline the stages and next steps, including indicative timeframes and fixed price quotations for preparation and representation and confirmed in writing at each and every stage.

We understand that timescales are entirely dependent on the stage you are at in proceedings, what work needs to be done and dictated by internal investigations or hearing dates.  We always meet those timescales however should more time be needed, then we will apply for such on your behalf and with your permission.

Contact us today for a no obligation and free telephone consultation about your case in the knowledge that you are speaking to one of the best in the business.

Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.

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