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Reflective learning: GMC submits this should not be considered in fitness to practise investigations

The Williams Review will form part of a rapid policy review into gross negligence manslaughter (GNM) in the context of healthcare provision. The deadline for written evidence for consideration was 13 April 2018.

Dr Bawa-Garba

A related process commissioned by the General Medical Council (GMC), and led by Dame Clare Marx, will consider how reflective learning ought to be protected in the aftermath of the Bawa-Garba case.

The Court of Appeal will shortly consider Dr Bawa-Garba’s appeal against the decision of the Divisional Court to erase her name from the medical register. The High Court judgment can be found by clicking here.

Marx Review

The Marx Review will look at the relationship between the GMC’s fitness to practise sanctions guidance and the approach where doctors have been convicted of GNM. It will also explore ways of ensuring the role of reflective learning, openness and transparency is protected where a healthcare professional believes that a mistake has been made.

Williams Review

The GMC’s submissions to the Williams Review, which can be accessed here, argue that doctors’ reflections should benefit from privilege, such that they would be protected from disclosure in legal proceedings. Legislative change would be required to achieve that aim. For its part, the GMC has committed to not asking for a doctor’s reflective records in the course of its fitness to practice processes.

However, in the absence of legislative change the following observation by the GMC is one which merits the attention of healthcare professionals:

‘The likelihood of records needing to be produced in court may be reduced if reflective records focus on reactions to, and learning from, an incident.’


Practitioners can learn from their own mistakes and from the mistakes of others. They can also learn from instances where they recognise that things might have been done differently, potentially better. That practice does not require practitioners to record factual accounts of the underlying events in any detail and certainly not in a detailed way which would identify those involved.

Our colleague Bridget Miles has previously addressed guidance on reflections issued by the Academy of Medical Royal Colleges here.

This Williams Review will not change the current law in relation to gross negligence manslaughter, nor will it affect the autonomy of decision making of the CPS or the courts. The Williams Review will aim to report by the end of Spring 2018, and the Marx Review is expected to be completed by the end of 2018.

For more information or guidance please contact:

Stewart Duffy
020 7227 7418


This briefing is for guidance purposes only. RadcliffesLeBrasseur LLP accepts no responsibility or liability whatsoever for any action taken or not taken in relation to this note and recommends that appropriate legal advice be taken having regard to a client's own particular circumstances.

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