Exploring remediation in Fitness to Practise at the GDC

Researchers used documentary analysis and qualitative interviews to understand views and approaches to remediation. Researchers reviewed current approaches to remediation and relevant evidence to identify areas of best practice, potential barriers to successful implementation and appropriate next steps.

Key findings identified by the researchers were:

• Remediation was generally regarded as the right approach to improving fitness to practise processes at the GDC amongst those interviewed, but there were mixed views on the acceptability of remediation as a case outcome.
• There was a common understanding that effective remediation could support improvements in patient safety and the quality of care. Those interviewed agreed that some issues, particularly certain attitudinal and behavioural issues, were irremediable, although in some cases, could be mitigated.
• The legal framework around remediation emphasised the need to balance public safety with professional support, and case law indicated that it should be considered as part of the ongoing fitness to practise process with the aim of ensuring and maintaining patient safety and public confidence.
• Reflective practice and tailored opportunities for improvement were found to be crucial to ensuring remediation was impactful and meaningful. And effective remediation needed to provide targeted interventions that allowed registrants to address specific deficiencies.
• Barriers to meaningful and early remediation included lack of trust in the regulator, lack of representation, lack of self-awareness, costs to registrants and the adversarial nature and culture within the process.
• Strategies that sought to fully understand the nature of a case or the allegations raised, before taking any action or making an admission, were also highlighted as a potential barrier to early remediation and an issue that could represent a challenge for an efficient and effective remediation process.   
• Clear guidelines and transparent processes were needed to ensure remediation was considered consistency and effectively across disparate cases. Researchers were also able to identify equality, diversity and inclusion process and support considerations, including generational and cultural differences.

The research was carried out by a collaborative research team from the University of Manchester, Newcastle University, the University of Nottingham and Queen Mary University of London. The full report is available below.