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RCS statement following the publication of the independent review of gross negligence manslaughter and culpable homicide in medical practice

06 Jun 2019

Today, Leslie Hamilton and his working group, have published their independent review into how the law on gross negligence manslaughter and culpable homicide are applied to medical practice.  The working group’s final report includes 29 recommendations for the General Medical Council (GMC) and a range of organisations across the UK, covering local, coronial, criminal and regulatory processes.             
Responding to the review reports, Professor Derek Alderson, President of the Royal College of Surgeons, said: 
“We welcome this independent review of how gross negligence manslaughter (GNM) and culpable homicide are applied in medical practice across the four nations of the UK. The recommendations should help ensure there is greater consistency around how GNM cases are initiated and investigated.  Our health and legal systems must protect patients from avoidable and unnecessary harm, while also providing clarity about the difference between gross negligence manslaughter and basic human error in medical practice.
“Currently, there appears to be wide variation over which suspected GNM cases are referred to the police for investigation. We therefore support the recommendation that if a coroner feels that a doctor’s conduct might reach the threshold for GNM, they should discuss this with the Chief Coroner’s Office before the police are notified.
“Patient care is almost never delivered by an individual in isolation, but by a multidisciplinary team, and within corporate structures responsible for the provision of training, supervision, audit and clinical governance. We therefore support the recommendation that where a doctor is being investigated for gross negligence manslaughter or culpable homicide the system within which the doctor worked should be scrutinised; and where the doctor is a trainee, this should include the education and training environment.
“In our consultation response to the review, we expressed concern about the way independent experts in criminal investigations and prosecutions are sometimes selected, instructed and have their opinions used.  We therefore welcome the recommendation that the GMC should make transparent its processes for recruitment and quality assurance of those doctors providing expert reports.  We would also support a register for expert witnesses in criminal cases as long as it is fully funded and properly scoped. The RCS is keen to work with other organisations to produce guidance setting out the expectations on those appearing as expert witnesses and those commissioning them.”


Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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