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Williams Review into gross negligence manslaughter in healthcare published today


Williams Review of Gross Negligence Manslaughter in Healthcare recommends the Removal of the GMC’s right of appeal against decisions of the Medical Practitioner’s Tribunal

The report of Professor Sir Norman Williams following his review of Gross Negligence Manslaughter in Healthcare has today been published.

The review was set up to consider the wider patient safety impact resulting from concerns among healthcare professionals that simple errors could result in prosecution for gross negligence manslaughter, even if they occur in the context of broader organisational and systemic failings.  This was particularly in light of the much-publicised case of Dr Bawa-Garba who was found guilty of gross negligence manslaughter in respect of a child who died whilst a patient in the hospital where she was working.  She was subsequently suspended by the Medical Practitioner’s Tribunal but that sanction was changed to one of erasure following an appeal to the High Court by the GMC.  Dr Bawa-Garba’s appeal to the Court of Appeal is due to be heard shortly.

This review was not set up to recommend changes in the law but to look at how decisions are made within the current legal framework.

The letter at the start of the report notes that “Testimony to our panel also raised concerns about the regulatory system which had wider implications than those limited to gross negligence manslaughter”.  As such the report is of general significance to the regulation of medical practitioners and other healthcare practitioners.

The report’s recommendations include:

  • the setting up of a working group to set out a clear explanatory statement of the law of gross negligence manslaughter;
  • steps to improve assurance and consistency in the use of experts in gross negligence manslaughter cases, including recommending that the Academy of Royal Medical Colleges should lead work to provide and deliver high standards and training for health care professionals providing expert opinions or appearing as expert witnesses;
  • steps to improve the quality of local investigations, including a requirement that the CQC be informed where a suspected gross negligence manslaughter case in a healthcare setting has been referred to the CPS.  This is so that the CQC can carry out a parallel but separate investigation of the healthcare provider to determine the role of systemic and human factors in the incident and to identify any changes which might need to be made;
  • regulators should clarify their approach to the use of the practitioner’s own reflective material when considering a registrant’s fitness to practise;
  • the PSA should retain is right of appeal but the duplicate power of the GMC should be removed;
  • in order to address the lack of understanding of what actions by a healthcare professional might lead to the public losing confidence in the profession, the PSA, working with professional regulators, should review how the impact on public confidence is assessed in reaching fitness to practise decisions about individual healthcare professional and develop guidance to support consistent decision making in this area;
  • regulators should ensure that fitness to practise panel members have received appropriate equality and diversity training;
  • the PSA should review whether the outcome of fitness to practise procedure is affected by the availability of legal representation;
  • regulators should review and improve the support provided to patients and family members whose care and treatment is in issue during fitness to practise hearings.

The GMC’ has stated that it is “disappointed by the Review’s recommendations”.

The full report can be found here.

Summary written by Nicola Newbegin.


nicola newbegin, healthcare, GMC, gross negligence

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