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RCOG statement on BMJ paper on the impact of complaints procedures on doctors’ welfare, health and clinical practise

News 16 January 2015

The Royal College of Obstetricians and Gynaecologists (RCOG) welcomes new research published in the BMJ Open today about the impact of complaints against doctors.

As a direct consequence of complaints, the study found that some doctors changed their practice in favour of defensive medicine either through ‘hedging’ (by being overcautious, e.g. over-prescribing or referrals) or ‘avoidance’ (e.g. avoiding difficult cases or procedures). These developments will have an impact on patient care and service provision.

The study also found that the majority of clinicians who were investigated by the General Medical Council (GMC) reported moderate to severe depression, anxiety and suicidal feelings. Several flaws in the existing GMC investigations and complaints procedures have been identified by the authors, including doctors stating that they felt bullied during the complaints process.

Commenting on the study, Dr David Richmond, RCOG President said:

“The GMC plays an important role as a regulatory body in ensuring that UK doctors deliver safe, high quality care on the NHS. However, as this new research has shown, we need to be aware of the immense pressure and stress that some doctors go through during investigations. The knock-on effect, sometimes irrespective of the outcome, may affect clinical decision making and performance in the longer term.

“Medical litigation in obstetrics and gynaecology is high. Maternity care is effectively a 24/7 specialty often with significant delivery suite activity throughout the day and night at times leading to an extremely stressful environment. The RCOG has identified the key areas to prevent burn-out (Getting a Life) and to enable consultants and trainees to have the right levels of skills and experience to provide high quality care to future generations (Becoming Tomorrow’s Specialist).

“Complaints are serious charges and must be thoroughly investigated so that lessons are learned and we maintain trust in the NHS as a transparent and open organisation. But it is also important for doctors to receive pastoral care and support during this difficult time in their careers. In some cases, it isn’t just the individual doctor who is involved, but their partners and family as well.”



Bourne T, Wynants L, Peters M, et al. The impact of complaints procedures on the welfare, health and clinical practise of 7926 doctors in the UK: a cross-sectional survey. BMJ Open 2014;4:e006687. doi:10.1136/bmjopen-2014006687