DAUK responds to Williams review report

The Doctors’ Association UK welcomes the report of the Williams review into gross negligence manslaughter in healthcare.

In particular, we welcome the recommendation that the General Medical Council (GMC) loses the right to appeal the decisions of the Medical Practitioners Tribunal Service, and also that regulators, including the GMC, will lose their power to request reflective practice material as part of Fitness to Practise investigations.

We are pleased with the emphasis put by the report on developing a just culture within the NHS, and the ambition to move towards a healthcare environment where human factors and systemic issues are considered integral to any investigation of poor care. However, much work is still to be done, as the report acknowledges, in particular improving the quality of investigations within NHS organisations. Additionally, although the report makes mention of concerns of institutional racism, greater emphasis could have been put on taking steps to address this.

This report has the potential to bring about positive change out of a tragic situation; but this hinges on much work yet to come. Although it has been recommended that regulators are no longer able to compel doctors and their royal colleges to disclose reflective practice from e-portfolios, the fact remains that written reflection can be used in a criminal trial. Following the case of Dr Hadiza Bawa-Garba more reassurance is needed to encourage doctors to engage with reflective practice. The “clear explanatory statement of the law on gross negligence manslaughter” and the Memorandum of Understanding between the College of Policing, the Crown Prosecution Service, the Care Quality Commission, the Health and Safety Executive, the Healthcare Safety Investigation Branch and professional regulators in relation to the investigation of deaths in a healthcare setting will be key.

We were pleased to be able to submit written evidence to this and it is clear that our evidence has been considered. We will be monitoring the outcomes and actions promised in this report, and look forward to engaging with all bodies involved in taking forward moves towards a just culture in the NHS, for patients and for doctors.