Williams review into gross negligence manslaughter in healthcare

Following on from many comments by medical professionals in England (and some in Australia) after Dr Gawa-Barba conviction and disciplinary action, the UK Department of Health and Social Care has published a ‘Review’ entitled ‘Gross negligence manslaughter in healthcare‘. The Review was chaired by Professor Sir Norman Williams (a medical practitioner).

The review makes recommendations in relation to:

  • the process for investigating gross negligence manslaughter
  • reflective practice of healthcare professionals
  • the regulation of healthcare professionals

Somewhat suprisingly, the Review recommends that the General Medical Council should have its right to appeal fitness to practise decisions by its Medical Practitioner Tribunal Service removed.  This is said to help address mistrust that has emerged between the GMC and the doctors that it regulates. However the Professional Standards Authority will retain its right to appeal these cases to ensure public protection, in the same way that it does for the other eight regulatory bodies for healthcare professionals.

The two key legal process recommendations appear to be:

  • Though the legal bar for conviction for gross negligence manslaughter is high, investigations that have little prospect of conviction cause uncertainty and distress. Revised guidance to investigatory and prosecutorial bodies and a clearer understanding of the bar for gross negligence manslaughter in law should lead to criminal investigations focused on those rare cases where an individual’s performance is so “truly exceptionally bad” that it requires a criminal sanction; and
  • Systemic issues and human factors will be considered alongside the individual actions of healthcare professionals where errors are made that lead to a death, ensuring that the context of an incident is explored, understood and taken into account.