When a specialty trainee was asked to self-refer to the GMC after his conduct outside clinical work, Medical Protection provided support and guidance. 

Dr Matthew Allen, a specialty trainee*, attended a music festival where he bought and took cocaine.

Shortly afterwards Dr Allen suffered a seizure and was taken to the emergency department of the local hospital. He was admitted overnight for observations. Dr Allen informed his clinical supervisor who asked him to come to see her before he returned to work and explained she would discuss the matter with the medical director.

Two days later, Dr Allen and his clinical supervisor attended a meeting with the medical director. At the meeting Dr Allen was informed that the hospital was immediately excluding him and requesting an urgent occupational health review. Dr Allen expressed deep regret for his actions and apologised for the disruption to the service that his actions had caused.

The medical director requested that he self-refer to the General Medical Council (GMC) and asked for confirmation he had done so within the next 48 hours.

How did Medical Protection offer support?

Extremely upset, Dr Allen contacted Medical Protection for advice. The Medical Protection advisory team advised him that there was no absolute obligation to self-refer to the GMC, but in light of the medical director’s direction, it was advisable to do so promptly.

Medical Protection also advised Dr Allen to engage fully and openly with occupational health and suggested he consider seeing his own GP.

As the matter arose from Dr Allen’s personal conduct, he was advised that assistance with the Trust investigation was not within the scope of the benefits of Medical Protection membership. He was advised it was likely he would receive correspondence from the medical council, however, and if so, to contact Medical Protection immediately so the issue of assistance could be considered.

Three days later Dr Allen called as he had received a letter from the GMC inviting him to attend a hearing five days later.

How did Medical Protection represent Dr Allen during the investigation?

Medical Protection assisted Dr Allen with the GMC investigation and a Medical Protection solicitor was instructed. At the hearing, the GMC solicitor recommended to the panel that conditions should be placed on Dr Allen’s registration.

On Dr Allen’s behalf, the Medical Protection solicitor submitted that imposing conditions on Dr Allen’s registration would be premature and unnecessary. She highlighted that Dr Allen had shown insight into his wrongdoing, been open and candid from the outset and complied fully and promptly with occupational health. She further submitted that Dr Allen was currently not practising clinically and that arrangements were in place for hair testing by occupational health. If the results of those tests were positive, the GMC could invite Dr Allen to a further hearing; imposing conditions while those tests were pending would be disproportionate.

The panel determined no order was necessary and the matter could be reconsidered when further information was available.

What happened next?

Shortly afterwards the results of Dr Allen’s hair testing became available, which showed recent use of cocaine but no evidence of prior usage. The hospital convened a meeting with Dr Allen and they agreed he could resume clinical duties and would have regular meetings with his clinical supervisor to support his return to practise. Further unannounced hair testing was arranged by occupational health.

The GMC investigation of the case continued, and Dr Allen attended two health assessments arranged with two GMC-appointed health assessors, who liaised with his GP and occupational health. They concluded he had no underlying addiction and that this was likely to be a one-off event.

Over the next eight months Dr Allen had two more negative hair tests. He reflected at length on what happened, discussed it in his appraisal and devoted time to teaching medical students and junior colleagues about the importance of ensuring their behaviour at all times reflects the standards of the profession.

How did it end?

At the conclusion of the GMC investigation, the GMC wrote to Dr Allen with a letter setting out the allegations in relation to his misconduct, and explained they were minded to conclude the case with a warning.

Dr Allen had a further meeting with Medical Protection to prepare a response. He was advised that a warning was potentially a proportionate outcome; however, given the extent of Dr Allen’s remediation, it was decided that the response would propose the case could be concluded with a letter of advice. A detailed response was drafted, supported by Dr Allen’s reflections, feedback from his clinical supervisor, the teaching sessions he had undertaken and positive testimonials from medical students and colleagues.

After an anxious wait, Dr Allen received a letter from the GMC advising him that the matter was concluded with a letter of advice. Two years on from this event, Dr Allen secured a consultant post in another hospital.

Take aways

It is important doctors are aware that their conduct outside their clinical work can have consequences for their professional life and their registration.

Dr Allen’s early contact with Medical Protection ensured that the team were able to advise him on the important step of a self-referral to the GMC. In this case it was inevitable the hospital would inform the GMC and it was preferable Dr Allen did so first.

Being excluded from all duties can be a deeply isolating and difficult experience for any healthcare professional.

Expert advice is essential when navigating GMC procedures. The suggestion that the case could be concluded with a letter of advice was a finely balanced and carefully considered decision, which was only possible with an in-depth knowledge of all aspects of the case.

The preparation of a detailed response to the GMC was a pivotal point in the case as it was Dr Allen’s opportunity to respond to the allegations, demonstrate insight into his actions and explain the steps he had taken to remediate.

Demonstrating insight takes time and effort; it is a process that should be started as soon as possible.

By Dr Jo Galvin, Cases Team Lead at Medical Protection

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*Names and locations have been changed to protect member confidentiality.