Remediation 

 

This guidance and template has been developed by the NHS Practitioner Health patient forum and is intended to assist practitioner-patients needing to demonstrate the insight, reflection and remediation they have undertaken with a view to returning to clinical practice. 

The regulator (GMC/GDC) will be looking for these three key things: 

  1. That you can demonstrate INSIGHT into the circumstances of your case. 
  2. That you can REFLECT on who you may have harmed (individual, institution, profession) and how this has affected them 
  3. That you have undertaken REMEDIATION to ensure the event does not happen again. 

This is a generic template and individuals should adapt to meet their own circumstances. 

Please note that completing a remediation folder can be distressing, particularly when you are having to look back at past situations that you may have found difficult.  

Take your time, do small chunks at a time, if necessary, just spend 10 minutes and then take a break.  

Important: Nothing in this template should be considered as definitive or legal advice. Always seek help and advice from your legal representative before submitting a folder to the regulator. 

 

Contents: 

Section 1 – Correspondence relating to GMC/GDC investigation and outcomes 

Section 2 – Personal statement 

Section 3 – Evidence related to keeping medical skills and knowledge up to date 

Section 4 – Evidence of further remediation 

Section 5 – Reflective diary 

Section 6 – Testimonials 

Section 7 – Reflective statements 

 

Section 1 – Correspondence relating to investigation and decision 

Include all correspondence, statements, letters etc related to your case in chronological order. 

Where appropriate anonymise this and ensure that no identifiable patient details are included, for example refer to Patient X 

If you have legal representation, they may assist with pulling this together as part of the case bundle, but you can save both time and money (if you are paying for your own defence) by putting your papers in order.Page Break 

 

Section 2 – Personal statement  

This is a key section of your portfolio – think about the charges and the outcome of your case. It is not important now to say whether you were guilty or not, but to accept that what has happened has happened and focus on where you go from here. 

The GMC/GDC will be looking for insight into what occurred and reflection on why this happened as well as what you have done to remediate against this occurring again.  

A vital aspect will be to reflect on the regulators duty to protect the profession and the public and to comment on how your case would have impacted on this duty.  

Think about which aspects of Good Medical Practice (GMP) or the GDC Standards guidance were breached by your case and why the regulator need to act the way they have in order to fulfil their duty. Comment on why the breach in your case is a vital component of GMP/Standards, for example why is probity important for a doctor, or why does conduct impact on the way a doctor (and the profession as a whole) is perceived. 

Reflect on the charges and the outcome in your case, describe the actions you have taken during your period of suspension/erasure, what it has taught you, how you will behave differently in future. 

Try to demonstrate and describe why you believe the incident will never occur again. 

Ask for help and get lots of input on your statement – ask others to read it through and help you refine it – particularly those that know you well. Consider sitting with a friend to prepare and write it as this can be a particularly difficult statement to write. 

Ask your defence team to review it and help you finalise it. 

What to include e.g.: 

  1. What happened? 
  2. What was your role? 
  3. Why did it happen?  
  4. What were your personal circumstances at the time? (not excuses just facts) 
  5. How many occurrences or what was the duration of your case? 
  6. What was the impact/harm on others? (Think- patients, public, profession, colleagues, organisation, family) 
  7. What has the experience taught you? 
  8. What steps have you taken to stop this happening again? 
  9. What will you do to manage risk of reoccurrence? 
  10. How do you feel now? (regret/remorse) 

 

Section 3 - EVIDENCE THAT I HAVE KEPT MY MEDICAL SKILLS AND KNOWLEDGE UP TO DATE  

Even when suspended or erased there are activities you can undertake to keep your clinical knowledge up to date. This does not need to involve attending expensive courses or conferences. Many colleges have free online courses and journals and publications often feature new research or findings from clinical trials. These can all be a rich source of material for you to review and think about how it impacts on what you already know and how it may affect the treatment you offer in the future. 

Describe the activities you have undertaken.  

These may be from a variety of sources, for example:  
  • Sitting as an observer in clinics – check any regulator guidance related to observer roles or clinical attachments 
  • Attending clinical and non-clinical meetings  
  • Doing an audit  
  • Write-ups from latest guidelines such as NICE  
  • Reflections on journal articles  
  • Attending courses clinical and non-clinical  
  • Doing online courses  
  • Discussions with colleagues  
  • And so on….. 

Example text: 

Throughout my various written reflections from the XXXX to date, there is regular evidence of keeping my medical skills and knowledge up to date. Below I describe the activities I have undertaken and how this helped to to keep my medical skills and knowledge up to date. In some cases I have provided a further level of detail, please refer to my full written reflections from those events.  

Describe the activities…… 

This list is not exhaustive. 

Include a statement about how this has helped you, what you have learnt as a result overall etcPage Break 

 

Section 4 - EVIDENCE OF FURTHER REMEDIATION  

There will be many occasions in your daily life which will throw up an opportunity for remediation. This could stem from an article you read or a discussion you are part of that prompts you to consider your past actions and beliefs. 

Describe the activities you have undertaken.  

This may be from a variety of sources, for example:  

  • Mentorship sessions, coaching and tutorials – consider any regulator guidance on the use of mentors 
  • Attending treatment sessions or therapy meetings  
  • Reflections on publications and articles  
  • Attending courses or meetings  
  • Doing online courses  
  • Discussions with colleagues  
  • And so on 

Example text: 

Throughout my various written reflections from the XXXXX to date, there is regular evidence of further remediation. Below I describe the activities I have undertaken and how this assisted in my remediation. In some cases, I have provided a further level of detail, please refer to my full written reflections from those events.  

Describe the activities you have undertaken.  

This list is not exhaustive 

Include a statement about how this has helped you, what you have learnt as a result overall etc 

 

Section 5 - REFLECTIVE DIARY 

INTRODUCTION  

Please find below my Reflective Diary.  

Some entries are taken from my remediation sessions from mentorship sessions, tutorials, clinics, meetings, courses etc. In these cases please refer to my full written reflections from those events, in order to provide more detail and context to those individual diary entries.  

Add an entry for each date, activity and thoughts 

Activities could include: 
  • Attending a course/lecture/meeting 
  • Discussion with a colleague/friend 
  • Mentorship session 
  • Consultation with practitioner health clinician 
  • Reading an article/watching a documentary 
  • Undertaking a new activity 
  • Voluntary work 
  • Etc etc 

This list is not exhaustive. 

Consider best how to present this to capture your reflection, insight and remediation. 

E.g.:  

Date 

Activity 

What have I learnt? 

How do I feel about this? 

What will I do now? 

1st Jan 2020 

I read through my case and reflected on the circumstances around it. I thought back to all of my positive contributions which I had made in my years of medical practice and where for example, I had: 

List examples of things you are proud of having achieved.  

 

That I was lacking insight into……. 

This filled me with regret and personal disappointment over what has happened…... 

The suspension period is a golden opportunity to remediate myself and concentrate on my failings.  I will focus on activities that ….. 

 

6th Jan 2020 

I contributed to a group discussion on XXXXX 

 

I found this lecture/group discussion very interesting as …… 

 

It really struck a cord with me in terms of my  

personal situation and remediation…… 

As a result I plan to research  XXXX and look in more detail at XXXXX 

 

10th Jan 2020 

I signed up to the Headspace App on my phone, mindfulness and meditation. 

This is a helpful application where I can concentrate on myself, de-stress and channel my energies to become more positive and rested. 

Why might this be useful in the future? Would it have been helpful to have known about this in the past? What might it change about the way you work in the future? 

 

I feel this will be a useful tool on my planned return to work as I can perform this for 5 minutes either at work or home and it will help to boost my mental and physical well-being………. 

 

15th Jan 2020 

Mentorship session with XX 

Discussed XXXX -what thoughts has this prompted? 

Insights and reflection on that discussion…. 

What are you planning to do as a result? Further reading, investigation on a topic? How might this help you moving forward? 

 

Keep going – add as many entries as you believe are relevant during your suspension/erasure period 

 

Section 6 – Testimonials 

Testimonials need to be specific and ideally linked to Good Medical Practice/Dental Standards. Ideally you will have a small number which are high in quality, but if you are struggling to think who might be best placed to write a testimonial for you consider the following. 

Testimonials from colleagues, supervisors, trainers, mentors, clinicians who have treated you: 

  • Can include people who have known you professionally and personally 
  • Can include people who have known you prior to the event and during your remediation period 

Ask them to include, for example: 

  • their relationship with you 
  • how they have observed you during your suspension period 
  • what they know regarding you keeping up to date with clinical skills and remediation particularly in relation to GMP/Standards 
  • activities and your remorse in relation to the incident 
  • their impression of your character 

 

Section 7 – Full reflective statements 

These will be a longer reflection than your diary entry and should include specific details, references, comments. Usually they will be 2-3 sides and be a meaningful reflection on all aspects of the activity you have undertaken. 

Activity and date 

Describe in full the activity, the date, location and who was involved in the event  

E.g. I sat in as an observer at a XXXX clinic at XXXX hospital. The lead consultant for this was XXXX and there were also XXXX present. The clinic took place on a Tuesday afternoon with XXXX patients presenting for a range of conditions including XXXX and XXXX 

Clinical observations: 

Describe each patient you observed (being careful to preserve anonymity) – include any history or diagnosis and any conclusions 

Describe how this links to your personal professional knowledge, competence and capability and any ethical issues – does it identify any learning needs for you?  

Mentorship sessions: 

Describe in full what was discussed, why this was an important topic for you, how it may have challenged your thinking or prompted you to act differently, how it may have prompted you to consider further research. Describe the relevance to your case and how this may impact on the way you act in the future. 

Articles/Research papers: 

Describe in full what the article covers, include references where appropriate. Describe how this is relevant to your clinical work, how it has developed your thinking in terms of your professional knowledge and competence. Has it prompted you to research further?  

Include any evidence you have eg agendas and notes of meetings, diagrams or pictures that illustrate a point you are making, certificates of attendance 

And so on… 

© Tree View Designs Ltd 2021