Gross Negligence Manslaughter In Healthcare: What's The Latest?

The fear of potential criminal investigation felt by many healthcare professionals in the wake of an unexpected patient death again comes under the spotlight in a new report.

Almost a year on from the publication of the government-commissioned Williams review into gross negligence manslaughter in healthcare, this new report - 'Independent Review of Gross Negligence Manslaughter and Culpable Homicide' - was commissioned by the GMC following the Dr Bawa-Garba case and focuses on what can be done to improve the local, coronial, professional regulatory and criminal processes which can follow an unexpected death.

We look at the report's key findings and some of the changes it envisages in the ongoing quest for a true 'learning not blaming' culture.

What does the report say? The trigger for this review was the case of Dr Bawa-Garba, the paediatric trainee whose gross negligence manslaughter conviction was followed by an attempt by the GMC to get her removed from the medical register, despite many fellow clinicians feeling that the real fault lay with wider systems failings within her working environment.

Chaired by a former cardiac surgeon, Leslie Hamilton, the review highlights how vulnerable doctors feel to being drawn into a criminal system which many perceive as having 'little understanding of, or interest in, the realities of medical practice in healthcare systems under pressure'.

The review's remit was 'intentionally wide', spanning the full range of processes which might be engaged following an unexpected death, including local investigations, inquests, professional fitness to practise proceedings and criminal investigations, which can sometimes stretch over many years.

With its 29 recommendations, the report covers a lot of ground, but some of the stand-out points to take from it are:

Law on gross negligence manslaughter

One of the factors fuelling the fear of criminal prosecution amongst healthcare professionals is that, under the law as it stands, you can be convicted of gross negligence manslaughter without there having been any intention to cause harm, provided a jury decides that your act or omission was 'truly, exceptionally bad'.

Although the review's remit did not extend to the question of whether the law should be changed, it echoes the Williams review's call for an agreed explanatory statement to provide clarity/consistency of understanding about the existing law on gross negligence manslaughter. The CPS has therefore recently updated its guidance on gross negligence...