The Rapid Review Of Gross Negligence Manslaughter In Healthcare - What Happens Now?

Now that the dust has settled on the Williams Report into gross negligence manslaughter (GNM) in healthcare, how has it been received and what can we expect now?

The common theme, both underpinning the review itself and the commentary since its release on 11 June 2018, is the need for a dramatic shift away from the current culture of blame when things go wrong in a healthcare setting, to an open learning culture. It remains to be seen whether implementation of the recommendations, focussed on changes to how medical deaths are investigated, will bring the momentum needed to achieve the shift from the well embedded culture of fear and blame and "dispel fear and within the healthcare professions and improve patient safety."

The rapid policy review was requested by the Health Secretary Jeremy Hunt in February 2018 and his initial response to the review indicates a commitment to supporting a change in culture to an environment where learning from individual and systemic errors is encouraged: "I was deeply concerned about the unintended chilling effect on clinicians' ability to learn from mistakes following recent court rulings, and the actions from this authoritative review will help us promise them that the NHS will support them to learn rather than seek to blame."

Recommendations for change

The review's recommendations included:

A working group is to be set up to set out a clear explanatory statement of the law on GNM: although the timescale is unclear, this a long overdue opportunity to ensure that there is clarity for everyone involved; Recommendation that the Chief Coroner should review guidance on GNM in response to the working group statement; Developing a framework of good practice for medical expert witnesses in GNM cases and the role that medical Royal Colleges should play; A new Memo of Understanding should be agreed between relevant bodies including healthcare regulators in relation to the investigation of deaths in a healthcare setting; and The General Medical Council (GMC) to lose their right of appeal of decisions by the Medical Practitioners Tribunal Service (MPTS) - requiring a repeal of s40A of the Medical Act 1983 - and the recommendation that they should no longer be able to compel a doctor to produce reflective material during Fitness to Practise (FTP) investigations. However, the way in which this material is used by authorities requires further clarification and so this will remain an area of deep concern for the medical...

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