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Home » Research Projects » An Analysis of Data on Registration and Fitness to Practice Cases Held by the General Medical Council in the Context of Risk-Based Approaches to Medical Regulation

A Risky Business?

How can we identify, and regulate to prevent, risks to patient safety?

While medical care has played a major part in increasing life expectancy and improving the quality of those longer lives, it is a risky business. Up to the Nineteenth Century, hospitals were major sources of killer disease and that problem has by no means disappeared today. Moreover, ‘bad doctoring’ can injure or kill patients in many other ways – some estimates put the number of health-care induced deaths in the US at over 200,000 a year, for example. But we lack systematic evidence about risk factors associated with poor medical performance.  Are some groups of doctor more likely than others to present a risk to patients, and can steps be taken to minimize the risks? In an attempt to start filling this evidence gap, this study will analyse (on a strictly anonymised basis) data from the UK General Medical Council’s records of cases where a doctor’s fitness to practise is called into question. It will explore whether the data can help to identify risk factors for poor medical performance and investigate the implications of a risk-based approach to medical regulation.

What the research means to policy-makers and the wider community?

Research Methods

The research will primarily consist of GMC data on ‘fitness to practise’ cases, in combination with the registration data that the GMC holds. It may be possible to identify risk factors that predispose doctors to come to the attention of the GMC. Are they disproportionately of a certain age or at a certain stage in their career? Are the graduates of certain medical schools over represented in fitness to practise cases? The research will explore the possibility of combining GMC data with other sources, such as that for the National Clinical Assessment Service (NCAS), in identifying risk factors to patient safety. An important element of the research is to understand the potential value of the GMC data more fully by building an understanding of how fitness to practise cases are initiated and processed. It will include some stakeholder interviews, exploring the expectations, perspectives and experiences of complainants, doctors and GMC staff.

Other Project Outputs and Related Webpages

Project Poster 2009

Lloyd-Bostock (2009) ‘Risk-based approaches and professional regulation by the General Medical Council’ , Risk and Public Services,  University of Oxford and LSE

Lloyd-Bostock, S. and Hutter, B.M. (2008) ‘Reforming regulation of the medical profession: the risks of risk-based approaches,’ Health, Risk and Society, 10 (1) : 69-83.

Research Team

Sally Lloyd-Bostock (London School of Economics)

Sally Lloyd-Bostock (London School of Economics)

Professor Sally Lloyd-Bostock is a visiting professor at the ESRC Centre for Analysis of Risk and Regulation at the London School of Economics. Previously she was Professor of Law and Psychology at University of Birmingham. Her research interests include safety regulation and risk, medical negligence claims and hospital complaints, jury decision-making, and the compensation culture.