Today saw the publication of the Williams Review into gross negligence manslaughter in healthcare. The report suggests sweeping changes in the way fatal medical errors are investigated.

Criminalising doctors for errors

The rapid policy review was instigated by Health Secretary, Jeremy Hunt, in the wake of the well-known case of Dr Hadiza Bawa-Garba. Bawa-Garba was a trainee paediatrician convicted of gross negligence manslaughter and struck off following an appeal brought by the GMC.

Professional bodies including the BMA voiced concerns that criminalising doctors for errors would have an unintended chilling effect on clinicians’ ability to learn from mistakes. It was observed that the prospect of criminal sanction could limit medical innovation and decrease candour when errors occur.

Professor Sir Norman Williams who conducted the review, has called for ‘a clearer understanding’ of when manslaughter charges should be brought in healthcare. He concluded that a criminal investigation should be confined ‘to just those rare cases where an individual’s performance is so ‘truly exceptionally bad’ that it requires a criminal sanction.’

Williams report recommendations

The report recommendations, which have been accepted by the Department of Health and Social Care, include:

  • The investigation of every hospital death by a medical examiner or coroner
  • Data on doctors’ performance to be collated, to allow comparison and improvement
  • The General Medical Council (GMC) to be stripped of its power to appeal against MPTS decisions

The Department of Health and Social Care state that the changes will mean that bereaved families will get more information about the circumstances of their loved ones’ deaths and more data will be shared across the NHS to help prevent avoidable deaths in the future. Comments echoed by Sir Norman:

‘These recommendations will, we hope, reassure the families and loved ones of the bereaved that lessons have been learned from their tragic experiences…Where things go wrong and a patient dies, the family and loved ones will be treated fairly and with respect and will be given an honest explanation.’

Hunt said the plans were a promise to doctors that ‘the NHS will support them to learn rather than seek to blame.’

Hunt explained that Medical Examiners would look at all deaths that had not been referred to a coroner, and examine whether they were unnatural or concerning issues that meant a coroner or other investigator should become involved.