Doctors’ Apologies in GMC Cases

How to Write a Letter of Apology in GMC Cases (& the Duty of Candour)Writing a Letter of Apology in GMC Cases

In fitness to practise proceedings, a doctor’s apology can go a long way to reassure the GMC and MPTS that a doctor is being true to their words of regret, where they have acted in a way that has caused or could have caused some form of harm. It is also helpful to demonstrate the sincerity of the apologies that are made within written submissions or orally during evidence.

Further, there is evidence to show that apologies can be therapeutic to recipients, which is in the best interests of the individuals affected. For example, in cases where a doctor has inappropriately touched a colleague, leading to an allegation of sexual assault, it has been documented that there is a benefit to victims who receive sincere apologies. However, apologies can be made in a whole variety of circumstances, including to victims of theft, assault, rudeness, absence, other poor conduct.

There is also a section on issuing apologies to patients, within the GMC/MPTS Sanctions Guidance, at page 16 para 42 – 44 (Nov 2020). See also the GMC guidance on Duty of Candour, when explaining to patients that things have gone wrong. The department of health has also issued guidance on the duty of candour in NHS settings

Note that an apology is not necessarily an admission of negligence or breach of statutory duty. Statutory legislation offers some protections. However, Scottish legislation excludes the GMC and so apologies could be taken into account by the GMC. The English legislation is silent on the point, but the wording of the legislation probably permits the GMC to take into account formal apologies as admissions. In any event, regulators like to see apologies.

See the Compensation Act 2006 (c.29) and Apologies Act (Scotland) 2016. A carefully crafted letter of regret that does not make formal admissions of fault may be sufficient. See also the CQC’s guidance on the duty of candour. And the CIW guidance on the duty of candour. Any CQC or CIW regulated organisation (including the private sector) would be obligated to follow this regulation. See also the Welsh guidance (Social Care Wales) on the duty of candour

There is little by way of guidance on writing letters of apology to those individuals who are not patients, but similar principles will apply. A doctor who apologises and accepts full responsibility is more likely to be found to have demonstrated a good level of insight by any regulator scrutinising their conduct. See also our article: Showing Insight in GMC/MPTS Cases.

Apologising to the GMC

On occasions, some doctors, and some applicants for registration, are not entirely honest with the GMC about their personal or professional histories.

When such conduct is discovered (which it often is, as the GMC usually seeks to verify everything a doctor claims), fitness to practise concerns may well be raised, procedurally.

A doctor who has misled the GMC (by act or omission), or who has deliberately lied to the GMC, is likely to be seen as unfit to practise medicine, unrestricted (or at all), or be denied registration.

Some doctors, when confronted by the GMC about their lies, suddenly panic and make things worse by failing to come clean, making further untruthful claims by way of attempted cover up. This will obviously make things worse.

By submitting further untruthful and elaborate explanations, the GMC will often investigate the doctor and bring formal allegations of misconduct. Deliberately misinforming the GMC is viewed as dishonest, or lacking in probity, and will likely be detrimental to a doctor’s registration status with the GMC, longer term.

To make false representations to the GMC could also constitute a criminal offence under the laws of the UK, and a doctor needs to bear in mind that an admission of wrongdoing could also be an admission to a crime. In many instances, a doctor has little choice but to come clean, by way of admissions to the GMC, if they are to improve their position.

An apology letter to the GMC should therefore be written with considerable care, in such circumstances.

Content of a Letter of Apology

An apology should be written to the relevant individual person or a number of people, or (in some cases) the organisation. It should me marked “strictly private and not for publication”. It should include either the use of the word “apology” or “regret”. Letters and expressions of regret and apology should be drafted with care, so as not to prejudice any civil case or criminal investigation. The letter should acknowledge the incident or conduct, and recognise the impact or potential impact it had, as well as explaining why things occurred in the way they did. Taking full responsibility is a important step in ensuring that a doctor’s apology is not paying lip-service and superficial.

How to send the Letter of Apology or Regret

The GMC can often assist doctors by forwarding written apologies on to the appropriate recipient. In some instances, it may be acceptable for a doctor to write direct to an organisation or professional. But each letter of apology must be given thought. Some patients or colleagues might be made to feel very uncomfortable about a doctor who writes directly to them, without going through the GMC. Some classes of concern might mean that it is wholly inappropriate to write directly, without going via the GMC.

If the apology is to the GMC itself, either the case officer dealing with the case, or the registrar of the GMC, may be the person best suited to receive the apology.

Other Articles on Apologies (external sites)

Articles Critical of the Misuse of Apologies:

The New Puritan (September 2021, The Atlantic) – See especially the challenges of issuing an apology

The Apology Non Apology (Wikipedia 2021) – How people speak the hollow words of apology

Articles on the Effectiveness of Apologies:

The Art and Science of Apologising (February 2016, The Atlantic) – Research on best methods of apologising

Fake Apologies and What Makes for a Good Apology (Psychcentral, June 2018) – The best and worst apologies

Further Reading on Apologies:

Google Scholar: Apologies

For more information on writing letters of apology or regret, call Doctors Defence Service on 0800 10 88 739