Disclosure after an incident or complaint
Telling people that you have been involved in an incident or complaint can often be one of the hardest things to do, but it is so important to get the right support and advice to help you through the process.
Ensure you are ok and feel safe speak. You may be in shock, upset and not thinking straight.
Speak to someone who understands professional regulatory issues – if you have a medical defence organisation (MDO) get some advice from them or call the BMA/LMC or equivalent for advice. If the issue/complaint concerns something outside of the scope of your medical defence organisation (e.g., criminal offence) ask them for a list of firms who understand health professionals’ regulatory issues.
If you have been charged with an offence get some legal advice and ensure you notify the GMC as soon as possible – this is your responsibility as the registrant, not the responsibility of the police.
Remember you are not on your own – other people will have been through this before and your defence team/BMA and others will be able to help you.
Write an account of what has happened – this is for your personal use to help you get your thoughts in order. It is not for sharing and you do not need to disclose it to anyone. Sometimes doctors can feel guilty in the aftermath of an event and can pile blame on themselves. By taking the time to think through and write down what has happened you will also identify the roles others played or system issues that may have affected the outcome.
Do not feel the need to write a formal report or respond to any enquiry until you have sought advice (legal or otherwise).
Letting work know – who you need to inform will depend on your role and employment status. If you have a number of roles you may need to inform multiple workplaces.
In primary care, it will be important to let the senior partner know who can then cascade information within the practice for you as appropriate. In secondary care you may need to inform your senior consultant, clinical or medical director – again you can agree how the information will be cascaded and to whom. As a trainee you will also need to ensure your HEE LETB is aware – this may be through your training/educational supervisor, or through your workplace contact. Consider whether your Responsible Officer needs to be informed and who will inform them.
Should you be at work?
Consider whether you are mentally well enough to be at work in the aftermath of an event – it may be sensible to take some time off sick whilst you deal with matters. You may want to seek the advice of Occupational Health, your GP or a specialist doctor health service such as PH.
If you have been charged with an offence and you are not sure how this will affect your registration it may be best to remove yourself from clinical duties whilst the GMC investigates. This will demonstrate immediate insight.
After discussing with your workplace they may also take the decision to suspend or exclude you whilst an investigation takes place. It may not feel like it, but this is a neutral act and you are not being punished. You may also be entitled to be paid your salary during this process.
Informing the Regulator (GMC/GDC)
GMC or GDC processes can take a long time so be prepared for this. Your Responsible Officer may inform the GMC directly if they believe it is not a situation that can be resolved within the organisation. GMC employment liaison advisors, are available for the RO to seek advice from (without naming the person involved) to determine whether the GMC feels it is an appropriate case for them to be involved in.
If you are informing the GMC yourself you will need to do so in writing. Ask someone else to read your letter and ensure you state only facts and that you understand why this is a matter for the GMC. Explain any immediate actions you have taken to ensure patient safety, such as temporarily removing yourself from the workplace until you are advised you can continue patient care.
Do not include what you don’t have to – for example if you have been charged with drink driving, you do not need to include the amount you regularly drink or how frequently. The information is not relevant at this stage. The GMC will write to you explaining the next steps and also should offer you a contact in their support service as they will understand that this will be a stressful process for you. https://www.gmc-uk.org/concerns/information-for-doctors-under-investigation/support-for-doctors/doctor-support-service
What support do you have?
It is important to consider the support mechanisms around you – family, friends, support group, health support, who is going to be in your corner? Who is likely to be negative towards you?
How do you tell people what has happened and how you are affected?
Is there a deadline or is the timeline out of your hands e.g., is something going to appear in the media or internet? Would it be better to tell one person you trust and ask them to tell others? Would it be better to write something down to explain without you getting emotional and ask someone to read it?
This is a very personal situation and will depend on what has happened and who the people are, how they are going to feel. It is normal to feel guilt or shame but one incident does not detract from all the good you have already done as a doctor.
It is important to remember that although this one thing has happened it does not change the person you are. The people who care about you will continue to care about you and hopefully, they will understand and want to support you.
Former junior doctor and now successful author and comedian left medicine after a serious incident in which a patient died. He describes how felt in limbo, not opening up to his friends and family about his reasons for stopping.
"They knew I'd left medicine, they didn't know why. I didn't tell them because I felt shame. I felt I'd failed and didn't want to relive what had happened.”
Adam Kay, Author and Comedian
Social media can be brutal at the best of times. The best advice is to take yourself away from social media for a while – especially if there is going to be any comment or coverage of the incident online. Do not get involved in online discussions about what has happened and don’t feel the need to respond to criticism or comment.
Dealing with the media
Many defence organisations will be able to offer advice regarding dealing with the media.
We have considered what would be the best approach to disclosure when applying for a future job