council meeting, 19 april 2016€¦ · agenda item: 4 report title: chief operating officer’s...

Council meeting, 19 April 2016

Agenda item: 4

Report title: Chief Operating Officer’s Report

Report by: Susan Goldsmith, Chief Operating Officer [email protected], 020 7189 5124

Action: To consider

Executive summary This report provides an update on our operational performance and Council priorities including the following delivery items:

Change Programme 2015 key metrics Implementation of Recognition of Professional Qualifications Directive Measuring Fitness to practise performance Revalidation assessment Overseas visits

Recommendations Council is asked to: a Consider the report (and Annex A, Annex B, Annex C, and Annex D). b Agree to introduce a fee of £2,350 for second revalidation assessments, from

1 July 2016.

mailto:[email protected]

Council meeting, 19 April 2016 Agenda item M4 – Chief Operating Officer’s Report

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Issue 1 This report provides an update on our operational performance and Council

priorities.

Operational KPIs

2 All operational key performance indicators (included at Annex A) were met between up to the end of January 2016 other than the exception set out below.

Red - ‘2016 Deficit within budget % variance’

3 At the end of January there is a surplus of £327k against a budget deficit of £45k on operational costs. Income is £70k, 1%, higher than expectations predominantly due to holding two more PLAB 2 tests due to demand. Expenditure is £302k, 4% under budget as headcount is less than expected even when taking into account churn. This results in a 4.5% variance to expectations however this does result in a financial benefit to the GMC.

4 The key reasons for the variance are:

Additional income from holding two extra PLAB 2 test days due to demand.

Reduced expenditure on legal costs compared to expectations. This is a combination of the costs being volatile and the impact of a drive to save costs on external legal reports.

We are under budget on staff costs – this is in part due to the Change Programme and also the timing of recruitment.

Some further cost savings on IT support contracts, reduced travel volumes and rent negotiations at Hardman Street.

Council Priorities

5 As of February 2016, all Council priority work has a green status. A summary of the position can be found at Annex A.

Change Programme

6 We have now concluded the statutory staff redundancy consultation process and communicated the outcome to colleagues. We are now finalising the dates when redundancies will become effective. This process has helped give us a clear picture of the timings for recruitment for relocated posts Manchester from London. This informs the timing of the accommodation changes we need to make and we are


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now redesigning the Manchester footprint of our Hardman Street office with architectural advisers. In addition we are also firming up our plans for extended home/flexible working following feedback sessions with staff.

7 The statutory 60 day Pension consultation concluded at the end of March 2016. We are considering feedback and will respond in due course.

8 We are holding workshops with staff to understand how we manage risk and make decisions throughout the business to see whether this can be refined or improved as part of the Organisational Capability and Design portfolio of the Change Programme. To complement this, our Siebel development team is also working with colleagues from operational parts of the business to automate and visualise our underlying business-as-usual data to inform the speed of our decision making in vital areas like Fitness to Practise and Registrations. This work includes our major business measures and key performance indicators which we will refine throughout 2016 under this portfolio of work.

9 Internal audit work will continue to provide assurance to Council through Audit and Risk Committee oversight with a forthcoming spot check planned for our Project Management Office and processes which we are using to underpin the Change Programme as a whole. This work will be carried out in April and reported to the Audit and Risk Committee in May 2016.

2015 key metrics

10 Details of 2015 key metrics are at Annex B.

Implementation of Recognition of Professional Qualifications Directive

Internal Market Information and the alert mechanism

11 The Internal Market Information (IMI) alert mechanism is working well operationally. As of 9 March 2016, we have received 18 incoming alerts regarding actions taken by others European regulators. However, none of these alerts relate to doctors registered with us. We have sent approximately 280 alerts via IMI since 18 January 2016.

12 Around one third (89 out of 274) of EU authorities currently have access to the IMI system, although this number is rising week on week. So far we have only received alerts from authorities in Finland, Denmark and the Netherlands.


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Temporary and occasional registration

13 As of 9 March 2016 we have received 13 new applications (declarations) for temporary and occasional registration and two declarations to renew temporary and occasional (T&O) registration. Eight doctors did not meet the criteria, four are still under consideration and one has been approved.

14 Although T&O declarations have slightly increased on the previous year (five applications were received in January 2015, six applications were received in January 2016), the number of doctors who have gained T&O registration has decreased. Operationally, we are continuing to monitor IMI alerts and T&O declarations closely.

Measuring Fitness to Practise performance

15 Pursuant to a paper presented to the Performance and Resources Board in March 2016, it was agreed that we would liaise with the Professional Standards Authority (PSA) for Health and Social Care to seek its view on the proposal to review the way we calculate some of our fitness to practise data. We have already had some high level discussions with the PSA to consider changing some of our measures to ensure they provide a more transparent view of our underlying performance and accurately reflect the age of our cases and the timeliness of our case management.

Revalidation assessment

16 Doctors without a prescribed connection are required to submit an annual return to us for a fee of £250. If we consider it reasonable, a doctor may be asked to undertake an assessment, for a fee of £1,100.

17 However, if a doctor fails to reach the required standard in the test, we will need further objective evidence of their fitness to practise before we can make a revalidation decision.

18 We therefore propose to introduce a second assessment in the form of an ‘expert review’. A GMC-appointed expert will review a fair sample of the doctor’s work - for example, recent patient records or written reports - to identify if there are any concerns about the doctor’s fitness to practice. The number of doctors likely to require a second assessment is expected to be very small as we estimate only 100 doctors might sit the first assessment in 2016.

19 Regulations permit us to charge a fee to doctors who sit an assessment to support their revalidation. We have calculated a fee for the second assessment on a full cost recovery basis, based on fee levels for assessors used in fitness to practise cases


5

plus the allocation of relevant overheads. The proposed fee is £2,350, which was scrutinised by Performance and Resources Board at its meeting on 1 March 2016. Subject to Council’s approval of the recommendation, we propose to introduce this fee from 1 July 2016.

Overseas visits

20 The European and International Affairs (E&I) Team coordinates and delivers a growing programme of visits by overseas delegations to the GMC, with a total of 25 overseas visits hosted in 2015.

21 There is recognised scope for the visits programme to serve as a means of identifying and pursuing potential commercial opportunities for the organisation.

22 In summary, the E&I team therefore plan to introduce:

A new visits classification and triage process designed to limit the length and complexity of visits to a number of agreed formats whilst maintaining enough flexibility to react to urgent or senior GMC leadership ‘sponsored’ requests. This will enable us to focus time and resources on those delegations that have clear visit objectives and where there are implications for GMC reputation/relationships, or those which are more likely to provide further commercial opportunities to the GMC.

A targeted pre-visit questionnaire to gather concrete, detailed intelligence to supplement the GMC’s existing data on, and understanding of, overseas regulation and related visiting organisations. This is to include intelligence on the nature of the delegation (e.g. seniority) and information needed to develop an objectives driven specification for the visit.

Improved visit feedback request forms to ensure we continue to improve the service we offer to overseas visitors and capitalise on any emerging commercial opportunities. These would also assess the impact/value of the visit on regulators/regulation around the world.

A commercial model for specific visits arranged through third parties and other visits as opportunities arise, with a more proactive approach to marketing the visit programme being developed later this year when the Head of Section returns from maternity leave.

A network of colleagues in Manchester to build capacity and help support the delivery of the visits programme.


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Collaboration with the Nursing and Midwifery Council

23 We continue to work closely with colleagues from the Nursing and Midwifery Council (NMC) to progress joint working, building on the success of the release of joint guidance on the Duty of Candour in 2015.

24 I recently took part in the recruitment exercise for the new Chief Operating Officer role at the NMC and with this appointment we are looking to build upon our established relationships and consider more formal joint working.

25 We have already seconded staff to the NMC to support nurse revalidation and the creation of educational standards for nurses and we will seek to build upon this in the coming months. We are currently setting up workshops for senior operational colleagues and have begun to think about possible areas of collaboration including but not restricted to panel delivery, panel training, accommodation sharing and advice on topics ranging from project management through to standards production.

Annex A Council Priority Report

Data accurate as of 31 January 2016

M4 – Chief Operating Officer’s Report


2

Key to RAG ratings

Progress

Cost

Resource

Overall RAG status

Green - Project on track compared with initial time scales Amber - Change to project time scales but without overall change to end deadline Red - Change to overall end deadline Complete / cancelled

Green - Project cost within 5% tolerance of original cost Amber – Project cost is under / over spending by between 5% - 10% Red – Project cost is under / over spending by more than 10% Complete / cancelled

Green – Relevant skillsets and FTE resource secured to deliver the project Amber – Relevant skillsets and FTE resource are not secured / being secured but this will not impact on the project delivery overall Red – Relevant skillsets and FTE resource are not secured / being secured but this will impact on the project delivery overall Complete / cancelled

Green – 3 greens or 2 greens + 1 amber Amber – 3 ambers or 1 green + 2 ambers Red – Any combination with a red Complete / cancelled



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Council Priorities Previous Period

Current period

Delivery Risk

Trend

Next period

1 Implementation of the Change Programme All items on track: Accommodation and extension of new ways of working;

Pensions; People – Redundancy, recruitment, knowledge transfer; GMC Services G G G

2 Taking forward legislative reform/the legislative programme arising from the Law Commissions’ report

All items on track: S60 Reforms; ISG Phase 3; Legislative Reform - Engage and influence key stakeholders to press for alternate routes for legislative reform including Section 60 Orders. G G G

3 Understand the context in which doctors practise

All items on track: Promoting Professionalism event programme in 2016; Hold Regional KIG Dinners in England in 2016; Organise and host UKAF meetings in Northern Ireland/Wales/Scotland; Implementation of Confidentiality Project; Cosmetic Practice Project; Standards App. G G G

4 UK Medical Licensing Assessment All items on track: Medical Licensing Assessment; Implement PLAB review G G G

5 Revalidation review All items on track: Revalidation operations; Evaluation of Revalidation;

Skills & competency testing for doctors without a prescribed connection G G G

6 Respond to the Shape of Training review All items on track: Credentialing; Generic Professional Capabilities G G G

7 Fairness and proportionality All items on track: Interim Orders Tribunal Research; Deliver the E&D

strategy 2014-17; Differential Attainment – Quality Assurance Framework; Differential Attainment – Research; Standards for Curricula and Assessment G G G

8 Supporting doctors, patients and relatives involved in fitness to practise investigations

All items on track: Monitor & TDA Information Sharing; Vulnerable Doctors project; Whistleblowing (formerly Hooper report)

G G G

9 Communications strategy and engagement All items on track: Communications and Engagement Work 2016; Board

Engagement through 2016; Digital media strategy G G G

10 Develop the Register and deliver Data Strategy Phase 2

All items on track: DS1 Unstructured qualitative data; DS2 Common & core dashboard development; DS3 Sharing GMC data externally; DS4 Organisational approach to key data capture; LRMP development G G G

11 Speeding up fitness to practise procedures All items on track: FtP Operations; Provisional Enquiries roll-out / further

piloting G G G

Delivery risk greater this period

Delivery risk the same this period

Delivery risk less this period



Operational KPIs



# Area BAU Operational KPIs [monthly] Oct Nov Dec Jan RAG for

next period

Commentary

1 R&R Decision on 95% of all registration applications within 3 months 98 98 100 98 G On track

2 R&R Decision on 95% of all revalidation recommendations within 5 days 96 97 96 97 G On track

3 R&R 90% of calls answered within 15 seconds 94 96 97 93 G On track

4 E&S Respond to 90% of ethical/standards enquiries within 21 working days 100 91 88 95 G

The number of late enquiries in December was due to a mixture of staff absences and a need to gather further information to fully answer the enquiry.

5 E&S 80% of enhanced monitoring concerns where action plan is being adhered to 95 97 97 96 G On track

6 E&S 90% of visits completed in within agreed timescales 100 100 100 100 G On track

7 FtP Conclude 90% of fitness to practise cases within 12 months 93 91 93 91 G On track

8 FtP Conclude or refer 90% of cases at investigation stage within 6 months 91 93 92 90 G On track

9 FtP Conclude or refer 95% of cases at the investigation stage within 12 months 96 95 96 96 G On track

10 FtP Commence 100% of IC hearings within two months of referral No referrals

No referrals

No referrals

No referrals G On track

11 MPTS Commence 90% of MPT’s within nine months of referral 100 100 100 100 G On track

12 MPTS Commence 100% of IOT’s within 3 weeks of referral 100 100 100 100 G On track

13 R&QA Rolling twelve month staff turnover within 8-15% 11.51 11.58 12.01 G On track

14 R&QA 2015/16 Income and expenditure [% variance] 4.81 4.72 3.91 4.49 R

At the end of January there is a surplus of £327k against a budget deficit of £45k on operational costs. Income is £70k, 1%, higher than expectations predominantly due to holding 2 more PLAB 2 tests due to demand. Expenditure is £302k, 4%, under budget as headcount is less than expected even when taking into account churn. This results in a 4.5% variance to expectations however this does result in a financial benefit to the GMC. The key reasons for the variance are: • Additional income from holding 2 extra PLAB 2 test days due to

demand. • Reduced expenditure on legal costs compared to expectations.

This is a combination of the costs being volatile and the impact of a drive to save costs on external legal reports.

• We are under budget on staff costs – this is in part due to the Change Programme and also the timing of recruitment.

• Some further cost savings on IT support contracts, reduced travel volumes and rent negotiations at Hardman Street.

15 R&QA IS system availability [%] 100 100 100 100 G On track

16 S&C Monthly media score 204 1,799 201 79 N/A On track.



# Area BAU Operational KPIs [monthly] Oct Nov Dec Jan RAG for

next period

Commentary

17 S&C Doctors and medical students surveyed who said they would change their practice as a result of attending a RLS or DO event [%] Q3: 93.61

18 OCCE % of corporate complaints responded to within 10 working days 78 92 82 83 N/A Threshold for KPI still to be determined as part of the ISO implementation process – work ongoing in 2016 but will be reported to Council when completed.

Council meeting, 19 April 2016 M4 – Chief Operating Officer’s Report

# Area BAU Operational KPI [Annual] Previous period

Current period Commentary

19 S&C Percentage of policy influencing partners1 who agreed their engagement with us during 2015 had positive influence on their impression of the GMC as an organisation and a positive effect on their work and the work of their organisation.

92.31% N/a

20 S&C Level of confidence in the GMC’s regulation of doctors (from biennial tracking survey) 79%² N/a

21 R&QA Staff engagement score³ 78% N/a

22 S&C Award in Employers Network on Equality and Inclusion (annual) Silver Award

Silver Award

23 S&C Inclusion in Stonewall Equality Index as ‘Top 250 Employer’ (annual) N/a 285

We achieved 285th place out of 415 organisations. Stonewall’s feedback was that organisations taking part in the index for the first time would usually place within the top 300. We did well in a number of areas, including: 1. Having policies in place to ensure that LGBT staff are treated fairly. 2. Collecting equality data on LGBT staff. 3. Engaging with the wider LGBT community, for example, through our participation in PRIDE and work with the Gay and Lesbian Association of Doctors and Dentists (GLADD).

Business As Usual – Operational KPIs (annual / biennial)



Detailed Appendix



Data accurate as of 31 January 2016

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1) Implementation of the Change Programme Overall Priority Status

Previous Period

Current Period Trend Next

period

G G G

Linked Strategic Aim(s) • Strategic aim 5: Work better together to improve our overall effectiveness, our responsiveness and the delivery of our

regulatory functions.

Delivery Activities

Governance Last Current Forecast

Iain McMillan

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU

Overall status last report

Progress Cost Resource Overall

Status Trend Forecast overall status

GMC Services

G G A G G G

Summary comments

GMC Services is progressing in line with plan. Focus is on scoping opportunities and providing assurance that the market appetite exists, and the price point can generate acceptable level of surplus. The activity will be reported to Council in June 2016. Cost is amber in January, this will be green in February.

Progress Last Current Forecast

Andrew Bratt

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Pensions G G G G G G

Summary comments

The project is in a very early stage and currently on track. The consultation period commenced on schedule on 18 January 2016 and will run to 31 March 2016. All members of the scheme have been issued with a letter detailing the proposed change and their impact. A detailed communication plan has been compiled. There are no major issues or risks to highlight at this stage.

Click to go back to main table M4 – Chief Operating Officer’s Report


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1) Implementation of the Change Programme Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic aim 5: Work better together to improve our overall effectiveness, our responsiveness and the delivery of our

regulatory functions.

Delivery Activities


Andrew Bratt

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




People: Redundancy, recruitment, knowledge transfer

G G G G G G

Summary comments

Group and individual consultation meetings are under way. Initial drafts of transition plans have been collected and collated, and HR are now reviewing these with the transition managers from around the business. This will allow for a variety of factors to be taken into consideration for the next version of the plan.


Chris Ollerhead

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Accommodation and extension of new ways of working

G G G G G G

Summary comments

We have engaged architects to provide concept designs for the Manchester workspace and sent an all staff questionnaire on home / flexible working which has produced a significant return. This has been complimented by discussion with other orgs about how they accomplish more flexible working [e.g. NSPCC and Vodafone]. We are holding face to face meetings with all ADs to review the current flexible working arrangements and complement the information gathered through the questionnaire.



11

2) Taking forward legislative reform/the legislative programme arising from the Law Commissions’ report

Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s)

• Strategic Aim 3: Improve the level of engagement and efficiency in the handling of complaints and concerns about patient safety.

• Strategic Aim 5: Work better together to improve our overall effectiveness, our responsiveness and the delivery of our regulatory functions.

Delivery Activities


Anthony Omo

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




S60 Reforms

G G G G G G

Summary comments

S60 projects all implemented at the end of 2015. BAU processes now running and remain under review. No issues to report. Any changes to be implemented will follow review in Q3/Q4.


Anthony Omo

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




ISG Phase 3

G G G G G G

Summary comments No risks or issues to highlight currently. Work is not expected to begin on this until Q4.



12

2) Taking forward legislative reform/the legislative programme arising from the Law Commissions’ report


Previous Period


period

G G G


• Strategic Aim 3: Improve the level of engagement and efficiency in the handling of complaints and concerns about patient safety.

• Strategic Aim 5: Work better together to improve our overall effectiveness, our responsiveness and the delivery of our regulatory functions.

Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Legislative reform

G G G G G G

Summary comments

We have pursued influence of DH consultation through attendance at policy lead and CE level meetings. We are finalising policy instructions for any s60 work that we will be seeking DH support to progress.



13

3) Understand the context in which doctors practise Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic aim 2: Help raise standards in medical education and practice.

Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Promoting Professionalism event programme in 2016

G G G G G G

Summary comments All events are identified on Op Plan and are on track for April, July and October. Planning for the final report and launch are in progress and on track.


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Hold Regional KIG Meetings in England in 2016

G G G G G G

Summary comments

The first is booked for April 19th, in Birmingham. Planning is underway on the invites to be issued. The remaining three this year will be in London, Northumberland and Kent/Surrey/Sussex.



14


Previous Period


period

G G G


Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Organise and host UKAF meetings

G G G G G G

Summary comments Meetings have been identified and listed, as have subsequent reports.


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Implementation of Confidentiality project

G G G G G G

Summary comments Project is on track, consultation period extended to 19 February and analysis team being identified.



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Previous Period


period

G G G


Delivery Activities


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Cosmetic Practice

G G G G G G

Summary comments Project on track. Preparation for launch, waiting for final confirmation. Guidance has been approved by SPB and has now been for approval to Council.


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Standards App

G G G G G G

Summary comments

Project on track. Development of the app and the integration with the GMC website continues, analysing reporting requirements and technical capabilities. Preparing to confirm the date for soft launch.



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4) Medical Licensing Assessment Overall Priority Status

Previous Period


period

G G G


Delivery Activities


0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Medical Licensing Assessment

G G G A G G

Summary comments

The MLA project continues to progress well, we are visiting all UK medical schools and the Executive Board has been established. Resource flag showing as amber as Programme Manager has not been appointed, which is currently under recruitment.


0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Implement PLAB review

G G G G G G

Summary comments

The project is on-track with 8 months to go until planned completion. We have commenced piloting of new OSCE stations with 2 days of piloting using final year students from Lancaster and Liverpool Universities taking place on 19/20 January, which was deemed a success. 6 further days are planned in 2016. A significant amount of work has taken place to develop a comms plan of activities for the remaining 8 months of the project. This will commence with updating the PLAB web pages in March, so that we give candidates and other interested parties six months notice of the changes that are taking place, especially to the Part 2 test. Meetings to review progress are taking place fortnightly. A meeting has been organised for May with IMG doctors groups to advise of the changes. EMS development is being monitored on a weekly basis.



17

5) Revalidation review Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic aim 2: Help raise standards in medical education and practice

Delivery Activities


Una Lane

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Evaluation of revalidation

G G G G G G

Summary comments

We received the interim report from our researchers UMbRELLA (Uk Medical Revalidation Evaluation coLLAboration) in January 2016 and we plan to publish it in April 2016. The final report is expected in 2018.


Una Lane

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Revalidation operations

G G G G G G

Summary comments All SLA targets were met.



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5) Revalidation review Overall Priority Status

Previous Period


period

G G G


Delivery Activities


Una Lane

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Skills & competency testing for doctors without a prescribed connection

G G G G G G

Summary comments

We began to invite doctors to book their revalidation assessment from 18 January 2016 onwards. The first revalidation assessments will take place in May 2016. We expect to start making revalidation decisions about these doctors around June 2016.



19

6) Respond to Shape of Training review Overall Priority Status

Previous Period


period

G G G


Delivery Activities


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Credentialing

G G G G G G

Summary comments

A paper will be going to SPB in March and Council in April, after which a decision will be made about the next phase of credentialing. This project remains in initiation stage as we are awaiting governance decisions for more detail about the next phase of the project, this will then allow us to start taking the project forward.


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Generic Professional Capabilities

G G G G G G

Summary comments

Project on track. Framework has been approved by SPB and Council with a few amendments. Second phase is part of the wider revision of the standards for curricula and assessment, which will ensure that GPC is embedded in future curricula and assessment blueprints. We’re also working closely with the AoMRC to develop guidance to support implementation of GPCs, which will start in 2017.



20

7) Fairness and proportionality Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic aim 1: Make the best use of intelligence about doctors and the healthcare environment to ensure good

standards and identify risks to patients.

Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Interim Orders Tribunal Research

G G G G G G

Summary comments

There has been delay commencing this following prolonged contract negotiations. However the contract was agreed in February, the researchers have completed appropriate GMC training, case bundles have been transferred and the researchers are now progressing this work.


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Deliver E&D Strategy 2014 - 17

G G G G G G

Summary comments

The implementation of the E&D strategy is on track. There are 5 priority themes for our work this year which include: telling our story, understanding and addressing the differentials in outcomes for some registrants from our activities, complying with equality and human rights legislation, considering the E&D issues in the change programme, and making fair decisions.



21


Previous Period


period

G G G


standards and identify risks to patients • Strategic Aim 2: Help raise standards in medical education and practice

Delivery Activities


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Differential Attainment – Quality Assurance Framework

G G G G G G

Summary comments

The QAF describes how we quality assure against our standards, and incorporates how we ensure standards around fairness are being met. We are currently working on a new web version of this document, which should be live by 31 March.


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Differential Attainment - Research

G G G G G G

Summary comments

The (UCL) research team completed focus groups and one to one interviews with trainees and trainers across six Local Education and Training Board in England and the Wales Deanery. Interim findings were delivered on schedule and the research team is on track to complete engagement with employers and medical royal colleges in the next few months.



22


Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic Aim 2: Help raise standards in medical education and practice

Delivery Activities


Judith Hulf

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Standards for Curricula and Assessment

G G G G G G

Summary comments

Engagement plans have been developed for discussions with external and internal stakeholders over the next three months. Strategy and Communication has agreed a consultation launch date of on or near 1 June 2016. Expert consultancy advice commissioned last year is on track for delivery on 1 June 2016, with interim reports in February and April.



23

8) Supporting doctors, patients and relatives involved in fitness to practise investigations


Previous Period


period

G G G


• Strategic Aim 2: Help raise standards in medical education and practice • Strategic Aim 3: Improve the level of engagement and efficiency in the handling of complaints and concerns about

patient safety. • Strategic Aim 5: Work better together to improve our overall effectiveness, our responsiveness and the delivery of our

regulatory functions

Delivery Activities


Anthony Omo

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Monitor & TDA Information Sharing

G G G G G G

Summary comments

An Information Sharing Agreement has been agreed with NHS TDA and working documents with both NHS TDA and Monitor are close to final draft. Monitor and NHS TDA are currently joining together under the umbrella of NHS Improvement, and due to this the Joint Working Groups with each organisation have been combined. We anticipate further work to combine information sharing procedures where possible.


Anthony Omo

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Vulnerable Doctors

G G G G G G

Summary comments

Progress across all recommendations and action points following the Sarndrah Horsfall report in 2015. Tone of voice review of doctors’ letters is completed, we have given expert Professor Appleby an overview of the history of fitness to practise, together with detailed maps of the current processes within each team and are discussing proposals to be presented to a stakeholder event on 7 April.



24

8) Supporting doctors, patients and relatives involved in fitness to practise investigations


Previous Period


period

G G G


• Strategic Aim 2: Help raise standards in medical education and practice • Strategic Aim 3: Improve the level of engagement and efficiency in the handling of complaints and concerns about

patient safety. • Strategic Aim 5: Work better together to improve our overall effectiveness, our responsiveness and the delivery of our

regulatory functions

Delivery Activities


Anthony Omo

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Whistleblowing

G G G G G G

Summary comments

Project also includes implementation of Government proposals to introduce mandatory reporting of disclosures made to the GMC in its role as a prescribed body. Having discussed with R&R colleagues, it is clear that these proposals will have a corporate impact and a separate project board will be established to deal with this work



25

9) Communications strategy and engagement Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic aim 4: Work more closely with doctors, medical students and patients on the frontline of care

Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Comms & Engagement work 2016

G G G G G G

Summary comments The narratives are finalised and will soon be on the intranet and publicised to staff. We are now using these to create audience plans and new channel protocols.


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Board engagement through 2016

G G G G G G

Summary comments

Internal project team established to track progress against agreed programme of activity. Draft offer to Boards developed following discussions with key individuals (including Julian Lee, Liz Butler and NHS Providers). Early discussions held with organisations that represent employers across all four countries in order to explore speaking and engagement opportunities



26

9) Communications strategy and engagement Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic aim 4: Work more closely with doctors, medical students and patients on the frontline of care

Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Digital Media Strategy

G G G G G G

Summary comments

Pilot projects are underway, and work has begun with contact centre to improve customers’ ability to self-serve. Training sessions to help teams across the organisation make their content more customer-focused is booked for March/April. First meeting of project board took place on 8 March.



27

10) Develop the Register and deliver Data Strategy Phase 2


Previous Period


period

G G G


standards and identify risks to patients

Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




DS 1. Unstructured qualitative data

G G G G G G

Summary comments Work has been progressing on the Unstructured qualitative data workstream and we are on target for delivery.


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




DS 2. Common & core dashboard development

G G G G G G

Summary comments Common and Core is on track for delivery by Q2 as started in the business plan.



28



Previous Period


period

G G G



Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




DS 3. Sharing GMC data externally

G G G G G G

Summary comments The work on sharing data has progressed in the last few weeks and we are on track for delivery.


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




DS 4. Organisational approach to key data capture

G G G G G G

Summary comments Organisational approach to capture key data workstream has been progressing rapidly and is on track in all areas.



29



Previous Period


period

G G G



Delivery Activities


Paul Buckley

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




LRMP development

G G G G G G

Summary comments

Council paper was successfully delivered in February and responsibility for designing and running consultation has now passed to the Regulation Policy Team. The consultation is provisionally scheduled to launch in June.



30

11) Speeding up fitness to practise procedures Overall Priority Status

Previous Period


period

G G G

Linked Strategic Aim(s) • Strategic Aim 3: Improve the level of engagement and efficiency in the handling of complaints and concerns about

patient safety.

Delivery Activities


Anthony Omo

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




FtP Operations

G G G G G G

Summary comments All FtP SLAs were met


Anthony Omo

0. Pre-Project

1. Ideas

2. Research

3. Initiation

4. D

elivery

5. G

o live

6. Review

7. Com

plete

BAU




Provisional Enquiries roll out

G G G G G G

Summary comments

Business process has now been mapped and submitted on time to SAP to start systems analysis. Next steps will include new process launch and training once systems changes have been implemented.





M4 – Annex B

2015 key metrics

1 We have now collated 2015 data and it is interesting to note our changing workload.

2 Email enquiries and other general correspondence dealt with by the Contact Centre team increased by 16% in 2016 (up to 104,178 items). In recent years, emailing has become the preferred channel of communication for many doctors. However, we also experienced a significant increase in requests for Certificates of Current Professional Status (CCPS) in the autumn following a social media campaign by junior doctors.

3 Independent research evaluating revalidation began in January 2015 and we expect a series of interim reports with a final report due in 2018. In 2015, we supported the delivery of two UK-wide surveys: a survey of all licensed doctors (excluding those in training) and a survey of Responsible Officers to understand their perceptions of revalidation and appraisal. We plan to publish an interim report received from the researchers, which contains the emerging findings from the surveys in spring 2016.

4 Throughout 2015, we finalised our policy and processes ready for the revalidation assessment to go-live in 2016. We began to invite doctors without a connection to book their revalidation assessment from 18 January 2016 onwards. The first revalidation assessments will take place in May 2016. We expect to start making revalidation decisions about these doctors around June 2016.

5 We have begun to make improvements to the Professional and Linguistic Assessments Board (PLAB) test. In September 2014, Council accepted all the recommendations from an independent review, which will make the test even more robust and maintain the confidence in it. We started a broad programme of activity to take forward the recommendations early in 2015, which is scheduled to conclude in September 2016 with the launch of a revised and updated assessment.

6 We made sure we were compliant with elements of the EU Recognition of Professional Qualifications Directive in time for the 18 January 2016 deadline. This included making temporary and occasional registration available as an online


B2

application, and the implementation of new alerts system. The alert system allows us to receive messages from and send them to European regulators within three calendar days when a doctor's practice has been restricted or they have fraudulently attempted to access the register.

7 Our register has seen 2% growth from 267,100 doctors at the end of 2014 to 273,700 doctors at the end of 2015. The number of doctors on the GP register has also increased by 2% and the number of doctors on the specialist register by 4%. At the same time we have seen a decrease in the percentage of registered doctors who are licensed – from 89% of our register at the end of 2014 to 86% in 2015 (although the actual number of licensed doctors has only decreased by 1% from 236,800 in 2014 to 234,600 in 2015). We believe this is because we have continued to emphasise that doctors should only hold a licence when they need one and that registration without a licence is a positive choice for doctors who wish to remain registered but who are no longer in clinical practice in the UK.

8 In 2015, the GMC received 9,418 (9,624 in 2014; 2.1% decrease) enquiries. An increase of 116 closed enquiries meant that the overall closure number rose to 6,426 (6,310 in 2014; 1.8% increase). Also, there was a 13% decrease in enquiries promoted for Stream 1 investigation from 2,730 in 2014 to 2,381 in 2015. Both figures were impacted by the introduction of the provisional enquiries process as more investigation work can be undertaken prior to a promotion/closure decision.

9 The number of referrals to Medical Practitioners Tribunal also increased by 13% in 2015 (from 303 to 343), which is due to the progression of a large number of cases against one specific doctor, and large efforts by the investigation teams to resolve older casework.

10 Last year we delivered our first guidance jointly with the NMC in June 2015. The guidance on Duty of Candour reminds doctors of the importance of being open and honest with patients and colleagues, and to report errors and near misses. We began our review of our confidentiality guidance and explored different ways of engaging doctors at each stage in development; working with the Regional Liaison Service and Devolved Offices, we were able to reach just over 1,000 individuals face to face, we launched our first App on Continued Professional Development and we developed a series of ‘hot topics’, including one on prescribing unlicensed medicines.

11 In 2015, also for the first time, we published online reports on pass rates for all national specialities, including GP exams, together with results of trainees’ annual reviews and recruitment outcomes. These reports increased the transparency of postgraduate training outcomes. It also enabled the GMC and local education managers and providers to review the quality of training in the context of the outcomes that learners are achieving.


B3

12 The number of Enhanced Monitoring QA visits continued to increase last year (we undertook 29 EM visits in 2014 and 53 in 2015). These are reviews of local education providers where we are concerned about progress on identified concerns. We are streamlining our Regional (routine) visits process to reallocate Education QA resources to respond to this increase.

13 Learning from this increase in enhanced monitoring, we published Promoting Excellence: Standards in Medical Education and Training. The new standards cover undergraduate, foundation and postgraduate training across the UK. They highlight the importance of the learning environment and put patient safety, quality of care, and fairness at the heart of the training received by both medical students and doctors.



M4 – Annex C

2016 Income and Expenditure

Revenue Budget

1 The income and revenue expenditure figures to the end of January 2016 are:

Financial Summary as at January 2016

Budget January

Actual January Variance

Budget Jan - Dec

£000 £000 £000 % £000

Income Annual retention fees 7,703 7,724 21 0% 94,787 Registration fees 147 154 7 5% 3,817 PLAB fees 86 139 53 62% 1,796 Certification fees - CCT 150 165 15 10% 2,474 Certification fees - CESR/CEGPR 67 62 (5) (7)% 853 Investment income 70 51 (19) (27)% 1,048 Other income 20 18 (2) (10)% 1,371

Total Income 8,243 8,313 70 1% 106,146

Expenditure by cost type Direct staffing costs 4,568 4,412 156 3% 56,410 Indirect staffing costs 188 164 24 13% 3,598 Office costs 513 458 55 11% 6,188 Accommodation costs 587 560 27 5% 6,847 Legal costs 429 330 99 23% 5,141 Professional fees 83 77 6 7% 1,744 Council & members costs 52 29 23 44% 503 Panel & assessment costs 1,202 1,291 (89) (7)% 16,309 Depreciation 618 602 16 3% 7,457 New Initiatives Fund 0 0 0 0% 250 PSA Levy 60 60 0 0% 736 Consultancy 3 3 0 0% 700 Medical Licensing Assessment 0 0 0 0% 500 Unallocated efficiency savings (15) 0 (15) 100% (464) Total Expenditure 8,288 7,986 302 4% 105,919

Surplus/deficit (45) 327 372 227


C2

2 There is a surplus at the end of January of £327k, compared to a budgeted deficit for the period of £45k. Income is 1% above expectations and expenditure is 4% under budget.

Principal variances

3 Income is generally in line with budget. There is additional PLAB income in the period as we held two additional PLAB 2 test days in January 2016 due to demand. Investment income is under budget as funds have not yet been placed under management in the light of current market conditions.

4 Direct staffing costs are under budget due to vacancies. There are 51 vacancies as at

the end of January 2016, some of which is linked to the Change Programme.

5 Indirect staffing costs are under budget mainly on staff travel.

6 Office costs are currently under budget. Expenditure on IT equipment and contracts is lower than budgeted in January but we expect costs to move in line with budget over the coming months. Also, printing costs are under budget, partly due to uncertainty around the timing of work to support the Welsh Language Standards.

7 Accommodation costs are under budget following successful rent review negotiations on Hardman Street which will result in a saving in 2016. Also, there was reduced demand for in hearing security in January compared to expectations and lower costs for general maintenance to date.

8 Legal costs are lower than budget due to not commissioning as much external advice on rule 12 work as budgeted. Legal costs tend to fluctuate over the year, so we will monitor costs closely over coming months.

9 Council and member costs budget included an element for new recruitment. These costs will now be incurred from February 2016 onwards.

10 Panel and assessment costs are currently over budget as the budgeted number of hearing days was 233: 191 MPT days and 42 IOT days. The actual number was 284: 32 IOT days and 252 MPT days. Some seasonality in hearing volumes is emerging and work is underway to quantify this and re-profile the budget accordingly.

11 Depreciation is slightly under budget due a difference between the forecast and actual capital spend in 2015.

12 The PSA levy has now been confirmed. Costs from April 2016 onwards will be slightly lower than budgeted.


C3

13 Efficiency targets are budgeted separately initially and then reallocated to specific expenditure heads as projects are identified. Work is underway to identify potential efficiency projects in 2016.

Capital expenditure

14 In addition to our revenue expenditure on day to day operational business, the GMC incurs capital expenditure on major projects and assets that will generate benefits over a number of years. The standard accounting treatment is to spread capital costs over the lifetime of the asset, rather than accounting for the whole cost in the year of acquisition. This is achieved through an annual depreciation charge to the revenue account.

15 Capital expenditure to the end of January 2016 is:

Capital Programme as at January 2016

Budget January

Actual January Variance

Budget Jan - Dec

£000 £000 £000 % £000 IT projects 331 316 15 5% 5,490 Accommodation projects 9 0 9 100% 585 Total 340 316 24 7% 6,075

Summary

16 At the end of January 2016 income is 1% over budget and expenditure is 4% under budget which results in a favourable position for the GMC compared to budget.



M4 – Annex D

1 The table below provides a summary of appeals and judicial reviews as at 22 March 2016:

Open cases carried forward

since last report

New cases Concluded cases

Outstanding cases

s.40 (Practitioner) Appeals

15 5 4 16

s.40A (GMC) Appeals

0 0 0 0

PSA Appeals 2 0 2 0

Judicial Reviews

7 0 1 6

IOP/IOT Challenges

2 0 2 0

Explanation of concluded cases

2 Appeals:

a 2 appeals dismissed.

b 2 appeals withdrawn.


D2

3 Judicial Reviews:

a 1 dismissed.

4 Professional Standards Authority (PSA) Appeals:

a 1 appeal conceded by the Doctor, resulting in substitution of direction of erasure for direction of suspension.

b 1 appeal successful at hearing, resulting in substitution of finding of impairment and remittal to Tribunal on sanction, for finding of no impairment.

5 IOP/IOT challenges:

a 1 challenge dismissed.

b 1 challenge successful.

Any new applications in the High Court challenging the imposition of interim orders since the last report with explanation; and total number of applications outstanding

6 There have been no new applications to challenge to an Interim Orders Tribunal (IOT) order since the last report.

New referrals by PSA to the High Court under Section 29 since the last report with explanation, and any applications outstanding

7 There have been no new PSA referrals since the previous report.

Any other litigation of particular note

8 We continue to deal with a range of other litigation, including cases before the Employment Tribunal, the Employment Appeals Tribunal.

9 The table below provides a detailed breakdown of outstanding appeals as of 22 March 2016.

No Case Decision appealed Current status

1 A Appeal against Medical Practitioners Tribunal decision

Appeal reinstated following GMC’s successful appeal to Court of Appeal against previous High Court decision to allow appeal. Awaiting listing for disposal in the High Court.


D3


2 Ca Appeal against Medical Practitioners Tribunal decision.

Appeal has been stayed pending the outcome of the Supreme Court Appeal.

3 Ch Appeal against Medical Practitioners Tribunal decision.

Hearing listed for 10 May 2016.

4 Ge Appeal against Medical Practitioners Tribunal decision.


5 Go Appeal against Medical Practitioners Tribunal decision.


6 Je Appeal against Medical Practitioners Tribunal decision.


7 Jo-O Appeal against Medical Practitioners Tribunal decision.

Hearing listed on 15 March 2016 adjourned on application of the Doctor. Awaiting relisted hearing date

8 K Appeal against Medical Practitioners Tribunal decision.

Awaiting hearing date.

9 L Appeal against Medical Practitioners Tribunal decision


10 M Appeal against Medical Practitioners Tribunal decision.


11 N Appeal against Medical Practitioners Tribunal decision.


12 P Appeal against Medical Practitioners Tribunal decision.

The GMC have agreed that the appeal be stayed until the conclusion of the criminal investigation.

13 Se Appeal against Medical Practitioners Tribunal decision.



D4


14 Sh Appeal against Medical Practitioners Tribunal decision.

Hearing listed for 28 April 2016.

15 T Appeal against Medical Practitioners Tribunal decision.

Hearing date in November 2015 vacated by court. Awaiting further listing or disposal.

16 V Appeal against Medical Practitioners Tribunal decision.

Appeal reinstated following GMC’s successful appeal to Court of Appeal against previous High Court decision to allow appeal. Awaiting listing for disposal in the High Court.

10 The table below provides a detailed breakdown of outstanding judicial reviews as

22 March 2016.

No Case Claim Current status

1 AM Judicial Review to challenge GMC guidance of assisted suicide case

Following dismissal of the application for judicial review by the Divisional Court in July 2015, Claimant has now been granted permission to appeal against that decision to the Court of Appeal. This matter has therefore been re-opened.

2 B Judicial Review against the GMC’s decision not to grant restoration to the register.

Permission was granted by the Court of Appeal for Dr B to appeal against the previous dismissal of her claim by the High Court. The hearing before the Court of Appeal is listed to be heard on either 14 or 15 February 2017.

3 D Judicial Review claim to challenge the Rule 12 decision.



D5

No Case Claim Current status

4 G Judicial Review of the sanction decision of the Investigation Committee.


5 R (B) This is a claim for Judicial Review by the Claimant challenging the lawfulness of Rule 6(b) of the General Medical Council (Legal Assessors and Legally Qualified Persons) Rules 2015.


6 W Judicial Review challenging advice of Case Examiner at Rule 8 stage.

Awaiting decision on permission/hearing date. Application for permission has been adjourned by order of the Court to an oral hearing; meanwhile, case stayed by order of Court pending conclusion of a related Rule 12 procedure which remains ongoing.

council meeting, 19 april 2016€¦ · agenda item: 4 report title: chief operating officer’s...

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