about us working with doctors€¦ · in england, our offices in london and manchester. we also...

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WORKING WITH DOCTORS WORKING FOR PATIENTS

Our annual report: 2016

About us 02

Our role 02

The impact of our work 03

Our priorities for 2017 03

Medical Practitioners Tribunal Service 03

Delivering our Corporate strategy 2014–17 04

Our five strategic aims for 2014–17 04

Raising standards in medical education and practice 05

Improving our handling of concerns about patient safety 06

Making best use of our intelligence 08

Working more closely with patients, doctors and medical students 09

Working better together 11

Delivering our role 14

Setting the standards for doctors 14

Overseeing doctors’ education and training 14

Taking action where concerns are raised 15

Managing the UK medical register 18

Helping to raise standards through revalidation 18

Our structure, governance and management 20

2016 financial review 30

Audit and Risk Committee’s report 36

Independent auditors’ report to the trustees of the General Medical Council 40

Accounts 2016 42

Reference and administrative information 66

General Medical Council | 01

CONTENTS

Contents

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02 | General Medical Council

ABOUT US

Our roleWe are an independent charitable organisation that helps to protect patients and improve medical education and practice across the UK.

n We decide which doctors are qualified to work here and we oversee UK medical education and training.

n We set the standards that doctors need to follow, and make sure they continue to meet these standards throughout their careers.

n We take action to prevent a doctor from putting the safety of patients, or the public’s confidence in doctors, at risk.

We have a dedicated presence in all four countries with offices in Wales, Scotland and Northern Ireland,* and in England, our offices in London and Manchester. We also have a regional presence through our Regional Liaison Service and our Employer Liaison Service.

Our Corporate strategy 2014–17 † outlines how we will continue to change to meet an increasingly challenging external environment.

Our trustees present this report and financial statements for the year ending 31 December 2016. They confirm they have taken into account the Charity Commission’s public benefit guidance when reviewing our aims and objectives, and have had regard to this guidance when exercising any powers or duties, or when making a decision to which the guidance is relevant. The trustees are satisfied that at all times we have operated for public benefit, and the activities as described in this report and accounts fully meet the public benefit requirements and support our charitable purpose.

The statements are in the format required by the Charities SORP (FRS 102) Accounting and Reporting by Charities: Statement of Recommended Practice.

* See www.gmc-uk.org/about/devolved_offices.asp

† See www.gmc-uk.org/Corporate_strategy_2014_17.pdf_54828872.pdf


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ABOUT US

The impact of our workIn addition to this report, we have also produced an impact report which gives further insight into some of the ways we made a difference to protecting patients and improving standards of medical education and practice. The report is organised around four key themes:

n Protecting the safety of patients and supporting doctors

n Helping doctors maintain and improve standards

n Assuring the quality of education and training

n Learning from our environment.

This is available on our website, and includes statistics, case studies and illustrations of our work in action.

Our priorities for 2017 Our priority during 2017 will remain to deliver high quality services across our core regulatory functions.

Alongside this, we will continue to deliver against the five strategic aims of our Corporate strategy, including:

n Continuing to develop our data strategy so we can better understand trends and areas of risk, and share this capability to benefit our partners and the public.

n Completing our review on making training pathways more flexible.

n Evaluating our pilot of how we handle cases where doctors are alleged to have made a one off mistake involving poor clinical care.

n Strengthening our approach to working across the four UK countries through our liaison services.

n Continuing to make sure our organisational design and capability will allow us to carry out our ambitious programme of reform.

Our Business plan 2017 * sets out our priority work for the year. In late 2017, we will publish our corporate strategy for 2018–2020.

Medical Practitioners Tribunal ServiceOn 31 December 2015, the Medical Practitioners Tribunal Service (MPTS) was written into the Medical Act 1983, creating the MPTS as a statutory committee of the GMC.

This change has strengthened the operational separation of the MPTS from the GMC’s investigation function. MPTS tribunals make independent decisions, which the GMC can now appeal against to the relevant court when it believes patients have not been adequately protected.

The MPTS is now required to provide its own annual report to Parliament. You can read more about the service’s performance in MPTS Parliamentary Report 2017.

* See www.gmc-uk.org/2017_Business_plan_web.pdf_68792858.pdf


DELIVERING OUR CORPORATE STRATEGY 2014–17

Our five strategic aims for 2014–17 To deliver against the ambition of our strategy we are now focusing our work on the following strategic aims.

01 HELPING TO RAISE STANDARDS IN MEDICAL EDUCATION AND PRACTICE

We will develop our standards, our guidance and the way we support particular groups of doctors to help them deal with professional challenges. We will make sure medical education equips doctors to meet these standards.

02 IMPROVING HOW WE HANDLE CONCERNS ABOUT PATIENT SAFETY

We have seen a significant rise in the number of complaints about doctors in recent years. To respond to this, we will continue to press for much-needed reform of the legislative system. We will make sure that concerns about doctors are first addressed locally wherever possible. We will continue to develop new ways to reduce the stress for those involved in our fitness to practise procedures.

03 USING INFORMATION IN SMARTER WAYS

We will use and share information in smarter ways to support high standards of medical practice and to help reduce risks to patients. Putting the information we hold to best use will help to create a more open system and to safeguard the interests of patients.

04 WORKING MORE CLOSELY WITH PATIENTS, DOCTORS AND MEDICAL STUDENTS ON THE FRONTLINE OF CARE

We will have more contact with doctors, medical students and patients so that we have a better understanding of their lives and work. More of them will be aware of our guidance and use it to help them maintain standards of patient care.

05 WORKING BETTER TOGETHER

We recognise there are often barriers to better collaboration within and between organisations – we will work across teams within the GMC to make the best use of all available knowledge and skills to help us deliver effective regulation.



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Raising standards in medical education and practiceMedical Licensing Assessment: towards a unified assessment for all doctors

We are proposing that UK qualified doctors and international medical graduates wishing to practise in the UK would take the Medical Licensing Assessment (MLA). We believe this common threshold for safe practice will give everyone – especially patients and the public – confidence that doctors, wherever they have qualified, have met the same benchmark of competence.

We have made significant progress with our proposals during 2016, working closely with assessment and legal experts and with the four UK governments. We undertook a range of formal and informal engagement to seek views in developing these proposals. This included visiting all 32 medical schools in 2016 to seek their feedback. We also set up an MLA Expert Reference Group, chaired by Professor Neil Johnson, who chairs the Medical Schools Council Assessment Alliance, and an international reference community of individuals interested in developing the MLA.

We ran a full public consultation at the start of 2017 on the proposals, the results of which we hope to publish by the end of the year.

You can read more about the MLA on the dedicated webpage* of our website.

Implementing changes to the PLAB test

We have made a number of significant changes to the PLAB (Professional and Linguistic Assessments Board) test† which is the main route for international medical graduates wishing to practise in the UK.

The improvements – based on recommendations by an independent review – have made the test more rigorous and more reflective of real life practice, giving patients and employers even greater confidence in the abilities of overseas doctors practising in this country.

Changes to the two-part test came into force from September 2016. You can find full details of the changes‡ we made in 2016 on our website.

Developing standards in curricula and assessment

In 2016 we developed new standards for the design and development of postgraduate curricula and programmes of assessment, Excellence by design, which we published in May 2017.

The standards had not been updated since before the Postgraduate Medical Education and Training Board merged with us in 2010. We consulted closely with stakeholders in developing these standards. The new standards simplify, clarify and improve the process around approving and quality assuring all curricula. They create more flexibility for doctors in training to move between specialties. They also make sure the generic professional capabilities** (GPC) framework is embedded into every postgraduate curriculum, which in turn will simplify our approvals process.

You can read more about our review of the standards†† on our website.

* See www.gmc-uk.org/education/29000.asp.

† See www.gmc-uk.org/doctors/plab.asp.

‡ See www.gmc-uk.org/news/28848.asp.

** Generic professional capabilities are broader human skills, such as communication and team working, needed by a doctor to help provide safe and effective patient care. For more information visit www.gmc-uk.org/education/23581.asp. †† See www.gmc-uk.org/education/29569.asp.



Taking revalidation forward

We introduced revalidation in 2012, with UK partners. It is the system by which doctors who wish to maintain their licence to practise medicine in the UK must demonstrate on an ongoing basis that they are up to date and fit to practise.

To check how revalidation is working in practice, we commissioned an independent review by Sir Keith Pearson in 2016. As part of his review Sir Keith focused on seeing revalidation through the eyes of a patient. With support from our offices in Northern Ireland, Scotland and Wales, Sir Keith spoke to over 100 individuals across the UK, including patients and patient organisations, doctors and medical leaders.

The report, Taking revalidation forward* found that revalidation is settling in and beginning to impact positively on clinical practice, professional behaviour and patient safety. But it is still relatively new, and we acknowledge the difficulties and challenges identified in the report.

We agree with Sir Keith’s recommendation that more should be done to raise the profile and understanding of revalidation with the public. We also agree with recommendations about how the public can be involved and encouraging more feedback about doctors. It is concerning that some doctors are asked, as part of their revalidation, to provide evidence, or carry out activities, above and beyond what is required in our guidance. We want everyone to be clear on what is required for revalidation – and what isn’t. We are committed to reducing unnecessary burdens and bureaucracy for doctors.

We will work with the four governments of the UK, healthcare organisations and others to take Sir Keith’s recommendations forward. You can find out more about this in our formal response to the recommendations.† You can read more about the impact of revalidation on doctors in the impact report.

Improving our handling of concerns about patient safetyFitness to practise reforms

Focused, fast and fair investigation

Legislation, introduced in 2004, requires that we investigate any allegation that a doctor’s fitness to practise is impaired and sets out in some detail, the steps that must be carried out during an investigation. We are seeking change to that legislation so we work better with local systems and focus our investigations on the most serious of cases where a doctor poses a risk to the public or public confidence in the profession.

While waiting for legislative change, we are looking for new ways to work within our current legislation to streamline the fitness to practise process. This has led to greater use of a power to make provisional enquiries. We are using this to obtain more information at an early stage to clarify if a full investigation is needed. An initial pilot of the provisional enquiries approach resulted in three quarters (76%) of the 225 enquiries carried out providing assurance that a full investigation was not needed. The median time taken was 63 days compared to 245 in a full investigation.

* See www.gmc-uk.org/Taking_revalidation_forward___Improving_the_process_of_relicensing_for_doctors.pdf_68683704.pdf.

† See www.gmc-uk.org/RT___Our_response_to_Sir_Keith_Pearson_s_review_of_revalidation___DC9676.pdf_68684817.pdf.



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We are currently piloting using this approach to obtain information (such as medical records and clinical input) to clarify if a full investigation is needed where a doctor appears to have made a one-off mistake involving poor clinical care. Launched in July 2016, it is too early to draw firm conclusions, however the interim evaluation suggests the pilot is running well and information is being gathered more quickly.

More information can be found in our report to Council* in December 2016.

Supporting vulnerable doctors

We recently commissioned leading mental health expert Louis Appleby to oversee a review of the impact of investigations on vulnerable doctors, with a particular focus on doctors with health problems.

The first phase of the proposed improvements was introduced during 2016. This included new guidance and training for staff on handling interactions with doctors who have expressed suicidal thoughts and obtaining more detailed information about local arrangements to manage any risk to patients as a result of a doctor’s health. By getting more information about local arrangements we aim to ensure we only investigate concerns associated with a doctor’s health where necessary to protect the public.

Other changes planned include a specialist investigation team to handle cases that involve concern about a doctor’s health, and pausing investigations where doctors are very unwell to allow them to obtain treatment.

You can read more about our work to support vulnerable doctors in our Impact report.

Safeguards for whistleblowers who raise concerns in the public interest

Our guidance requires doctors to raise concerns about safety in order to ensure a safe environment for patients. We are running pilots in each of the UK’s four countries of safeguards to reduce the risk of our procedures being used to disadvantage whistleblowers, a concern raised by Sir Anthony Hooper QC who was commissioned by the GMC to undertake an independent review of how the GMC deals with whistleblowing.

The changes include new referral forms requiring any health organisation raising a concern about a doctor to disclose whether the doctor had previously raised concerns about patient safety. In those cases, we seek at an early stage evidence to support the referral that is from a source independent of the organisation about which the doctor raised concerns.

The pilot is due to be reviewed later in 2017.

Appealing Medical Practitioners Tribunal decisions

In December 2015, an important new power to improve patient protection was introduced into the Medical Act 1983, enabling us to appeal a decision made by a Medical Practitioners Tribunal if we consider it to be insufficient to protect the public. An appeal is made to the High Court of Justice in England and Wales, the Court of Session in Scotland, the High Court of Justice of Northern Ireland.

During 2016 we lodged four appeals and we expect the first appeal to be heard in 2017.

* See www.gmc-uk.org/15___Update_on_piloting_the_Provisional_Enquiry_Process_for_Single_Clinical_Incidents.pdf_68560248.pdf.



Flexibility in postgraduate training review

In 2016 we began a review of flexibility in postgraduate training. We committed to doing this following talks in May 2016 between the government in England and the British Medical Association over the new contract for doctors in training.

The aim of the review was to identify ways in which doctors in training across the four countries of the UK could move more flexibly between postgraduate training programmes. However, we also looked at some of the deeper-seated issues the contract dispute highlighted, including the inflexibility of current training pathways noted in the independent Shape of Training Review.*

In March 2017, we delivered a paper to the health ministers of the four UK governments: Adapting for the future: a plan for improving the flexibility of UK postgraduate medical training.† You can read more about the outcome of the review on our website.‡

Developing new standards

Confidentiality

We published revised and expanded guidance on confidentiality for all doctors practising in the UK. The new guidance,** which you can find on our website, came into effect in April 2017.

Capacity and consent

We produced a new interactive online†† tool to help doctors make decisions about treating someone where there are doubts about their mental capacity.

The tool includes case studies and a range of downloadable resources. It takes account of the legal frameworks in different parts of the UK. We’re also in the process of updating our guidance on the good practice principles of consent.

Cosmetic procedures

In recent years, we’ve received a number of concerns about the risks associated with some cosmetic procedures. As a result, we launched new guidance‡‡ in 2016 to underline doctors’ ethical obligations to patients as well as the standards of care that must be provided.

In Scotland, we worked with Healthcare Improvement Scotland (HIS) to publicise the guidance to both patients and doctors. Our joint training sessions with HIS made sure they had the latest information on the standards expected of those working in this field. And in Northern Ireland, we worked with the Regulation and Quality improvement Authority to promote the new guidance amongst clinics and practices.

We also produced advice for patients considering cosmetic procedures.*** The advice explains what patients should expect of doctors who carry out cosmetic procedures and what to do if they have any concerns.

Making best use of our intelligenceData strategy

Since launching the development of our data strategy in 2014, we have been working to use the information we hold to develop more intelligent


* See www.shapeoftraining.co.uk.

† See www://www.gmc-uk.org/Adapting_for_the_future___a_plan_for_improving_the_flexibility_of_UK_postgraduate_medical_training_FINAL.pdf_69842348.pdf.

‡ See www.gmc-uk.org/education/30540.asp.

** See www.gmc-uk.org/guidance/ethical_guidance/confidentiality.asp.

†† See www.gmc-uk.org/Mental_Capacity_flowchart/.

†† See www.gmc-uk.org/guidance/ethical_guidance/28687.asp.

*** See www.gmc-uk.org/guidance/ethical_guidance/29004.asp.



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ways of regulating the profession. We now have a range of systems that pull together both our own information and that of external bodies to give us a clearer picture of trends and areas of risk.

One of the keys to this work has been the development and implementation of the Agora reporting system. For the first time, all our staff now have access to core data we hold about any organisation. This lets us analyse our data more effectively across all our functions.

We have also led on piloting UKMED (UK Medical Education Data) which for the first time brings together undergraduate and postgraduate information in a central database for the purposes of research applications.

We’ll continue to develop our intelligence model, designed to help us identify risks to patients at an earlier stage, and to try to support doctors early on.

GMC Services International

Last year we launched a new venture – GMC Services International Ltd. The aim is to offer services that could help to raise standards of medical practice while generating additional revenue for our organisation, which will be reinvested back into the organisation to help us to achieve our long-term goals.

During 2017, we’ll develop the business plan and operational framework, and we will formalise the operational relationship and cost sharing arrangements between GMC Services International Ltd and the GMC. The operating framework will make sure offering services on a commercial basis will not in any way detract from our regulatory activities or charitable purpose.

Working more closely with patients, doctors and medical students Digital media strategy

Now in year two, we are well into our four-year digital media strategy aimed at transforming the way we engage with our customers, from doctors to the public, and providing a better customer experience on all our digital channels.

A key strand of our strategy will involve a major overhaul of our website. We’ve held a number of workshops with our teams to examine how we can make the site clearer and easier to use, and rolled out training to make sure staff understand the importance of considering how best to engage with our audiences when developing new material.

Other activities covered by the strategy include improvements in our audience insight and analysis capabilities, investments in social media and email newsletter communication, and engagement in the co-creation of contents with external partners.

Acting on customer complaints

We take feedback from our customers very seriously. We have central coordination of teams who deal with these customer complaints, which focus on the service we deliver. We also have a separate team that deals with all escalated complaints from within the business.

During 2016, we received 2,010 complaints – 22% fewer than in 2015 (2,575). We replied to 80% of these complaints (1,605) with an explanation, and 7% (142) were concluded with us formally apologising for a service failure.

22% fewer complaints in 2016 than in 2015



In 2016 we increased dialogue with colleagues across the whole organisation, to work towards more consistency in terms of both how we report and deal with complaints. This allows us to respond more quickly and effectively to resolve issues wherever we can. We receive and act on a range of complaints, which results in improvements to our business delivery. These include improvements that we can put in place very quickly. For instance, we:

n reviewed the format and wording of our guidance, to make sure it is user friendly and clear. For example, when a complaint pointed towards a gap in the knowledge of doctors, we refreshed our communications on our guidance around mental capacity assessments,* reminding doctors of their obligations

n increased the number of PLAB places in Lagos, Nigeria in response to complaints about lack of availability

n introduced a standard, more streamlined process for when doctors get in touch with us to set up a late direct debit.

Some complaints point to more fundamental issues that require us to redraw or reframe aspects of our policy or processes. Examples include:

n In one case we had instructed a legal expert who had been the subject of civil litigation that we were unaware of. We have now changed our guidance to experts so that they now make sure they alert us to any civil action that they may have been named in, before we decide whether to instruct them.

n We are in the process of implementing full electronic marking for PLAB assessments following an incident where original marking sheets had been misplaced.

As part of our ongoing commitment to listen and learn from our customers, we are accredited to the International Organization for Standardization’s (ISO) standard for quality management and customer satisfaction, ISO 10002:2014. Our certification was renewed in November 2016. We also review our performance each year through an independent external review of our customer complaints handling through Verita.† And we will continue to develop our customer service and complaints handling which is a central priority for our Council.

Verita reviewed our complaints handling for the first time in August 2016. While the findings were positive, they included some useful recommendations for further improvements. We regularly update Audit and Risk Committee and Council on the progress we’re making to implement these recommendations.

* See www.gmc-uk.org/guidance/29385.asp.

† See www.gmc-uk.org/06___Update_on_external_review_of_corporate_complaints.pdf_67612334.pdf.


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Working better togetherEngaging at home and overseas

n Medical professionalism matters events across the UK

n Held two European Network for Medical Competent Authority meetings

n Hosted 34 visiting delegations from across the world

n Circulated four editions of Crossing Borders Update* for healthcare professionals

n 1,595 Employer Liaison Service meetings with employers and responsible officers about fitness to practise concerns

You can read more about our engagement work in our impact report.

n Government and Parliament Scotland: We submitted evidence on

statutory duty of candour and joined the government implementation group. We provided evidence on unintended consequences of the Apologies (Scotland) Act 2016. We advised government on ethical standards.

Wales: We delivered an introductory event for new Assembly member

Northern Ireland: We delivered a briefing to Assembly members ahead of a debate on proposals for a second medical school.

n Advisory forums In March 2016 and October 2016, we held

advisory forum meetings in our Scotland,

Wales and Northern Ireland offices.

England: 790 events in England about

Standards topics

Scotland: Provided data to support policy making and improvements to health services in Scotland. Worked with Healthcare Improvement Scotland to publicise our guidance for doctors who offer cosmetic interventions.

Wales: Led work on the move towards Welsh language standards. Delivered a series of joint roadshow events to promote our new standards for education and training and Promoting excellence.

Northern Ireland: Delivered first ever regulation fringe event at Northern Ireland Confederation of Health and Social Care conference in partnership with other Northern Ireland based regulators. Worked with a group of Northern Ireland doctors to deliver training on GMC guidance and communication skills to sixth form pupils considering applying for medicine.

48,022

doctors, students, educators, patients, patient organisations and members of the public engaged with

In 2016, we engaged with the following people across the UK.

n 25,003 doctors.

n 1,120 patients, patients organisations and members of the public.

n 21,899 students and educators.

* See www.hpcb.eu/news/update_briefings.aspx.



The change programme

In 2015 we launched an ambitious change programme affecting every part of the organisation and implementation continued through 2016.

We launched the programme to make sure we are financially stable for the foreseeable future and provide the foundations to increase our organisation agility, capacity and capability as we seek to continuously improve our regulatory model.

The first phase of the change programme involved 130 posts relocating from London to our Manchester offices. A total of 150 posts in London were affected through a mix of relocation and restructuring.

The changes will help rationalise our functions, improve communications and reduce duplication. The total costs over 2016–17 will be about £10 million but should yield savings of around £6–7 million a year from 2018. We have also introduced reforms to our defined pension scheme, without which our future pension costs would have increased by around £2.5 million from 2017. Introducing these pension changes cost around £150,000.

This programme of transformation will continue throughout 2017, supporting new and innovative ways of working, such as the implementation of our digital media strategy, and making sure that we are ready to introduce a new corporate strategy in 2018.


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Continuing our work on being a fair employer

Our equality and diversity strategy sets out our vision to be a fair regulator and employer, and to be recognised as such. A review by our auditors in July 2016 described the quality of our equality and diversity work as ‘easily alongside the very best in the not-for-profit sector’.

Examples of the work delivered during 2016 include the following.

n We made progress in our programme of work to understand the variations in performance on exams for some cohorts of doctors in postgraduate education and training. We collected and analysed exam data on progression, and shared these data with others to help narrow the gaps in attainment.

n We continued to roll out our programme of training on bias and fair decision-making for staff and associates involved in making decisions about doctors, and their role in making sure our regulatory activities are delivered fairly.

n We continued our engagement with networks of doctors, including the BME Doctors Forum, the Gay and Lesbian Association of Doctors and Dentists and the Medical Women’s Federation, to make sure our work is informed by a diverse range of opinions and perspectives.

n We reflected on the findings of our participation in two external benchmarking schemes (Stonewall and the Employers Network on Equality and Inclusion) making the links with our people strategy around staff wellbeing. We have an ongoing programme of work to support staff and managers when they work with vulnerable individuals, and to help managers address any equality and diversity issues that arise in managing staff.


DELIVERING OUR ROLE

Setting the standards for doctorsOur standards define what makes a good doctor by setting out the professional values, knowledge, skills and behaviours required of all doctors working in the UK.

The core professional standards expected of all doctors are set out in our guidance, Good medical practice. We want to do everything we can to make sure our guidance is widely known, understood, and applied by doctors in their day-to-day lives.

Our Regional Liaison Service and our offices in Northern Ireland, Scotland and Wales played a key part in 2016 in raising awareness and understanding of our standards.

In 2016, we engaged with the following people across the UK.

n 25,003 doctors.

n 1,120 patients, patients organisations and members of the public.

n 21,899 students and educators.

You can read more about how we have helped doctors to maintain and improve standards in our impact report.

Overseeing doctors’ education and trainingWe set the educational standards for all UK doctors through undergraduate and postgraduate education and training. We visit medical schools and training environments to check that our standards for education are being met.

In 2016, we carried out 35 quality assurance visits, and found:

n 39 areas of good practice

n 49 areas where our standards were met but we identified improvements that could be made

n 43 areas that required improvement.

Enhanced monitoring† is the process by which we support deaneries, local education and training boards and medical schools to manage concerns about quality and safety in medical education and training. In 2016 we dealt with 95 issues that needed enhanced monitoring‡.

You can read more about how we assured the quality of education and training in our impact report.

* See www.gmc-uk.org/guidance/good_medical_practice.asp.† See www.gmc-uk.org/education/enhanced_monitoring.asp. ‡ Including new concerns, existing concerns and resolved concerns.

DELIVERING OUR ROLE


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459CONCERNSCLOSED

6,753 CONCERNS CLOSED

7,212 CONCERNS CLOSED

475 REFERRED TO EMPLOYER OR RESPONSIBLE OFFICER

155INVESTIGATIONSOPENED

1,296 INVESTIGATIONS OPENED

1,451 INVESTIGATIONS OPENED

2REFERRED TO EMPLOYER OR RESPONSIBLE OFFICER

477REFERRED TO EMPLOYER OR RESPONSIBLE OFFICER

616 CONSIDERED UNDER PROVISIONALENQUIRY*

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9,140 CONCERNS REVIEWED AT TRIAGE

Taking action where concerns are raisedWhen a serious concern is raised about a doctor’s behaviour, health or performance, we investigate to see if the doctor is putting the safety of patients, or the public’s confidence in doctors, at risk.

In 2016 we reviewed a total of 9,140 concerns about doctors. Of these, we opened investigations into 1,451 potentially serious concerns. We have reduced our total open caseload from 2,530 at the start of 2016 to 1,955 by the end of the year.

2016 Outcomes of triage

9,140 concerns about doctors were reviewed in 2016.

* A provisional enquiry involves gathering limited information to help us decide whether we should investigate further, refer the complaint to the doctor’s responsible officer or close it with no further action.

DELIVERING OUR ROLE


144 UNDERTAKINGSWhen there is a realisticprospect of a fitness topractise tribunal findinga doctor’s fitness to practiseimpaired, and bindingundertakings by the doctorwill be sufficient toprotect patients.

997 CONCLUDED with no further action. When there is no evidence that the doctor’s fitness to practise is impaired or they have not followed our standards.

1,824 OUTCOMES *

333 CONCLUDEDwith advice.

105 WARNINGS issued. When there is no evidence that the doctor’s fitness to practise is impaired, but the concerns raised indicate a significant departure from our standards.

245REFERRED †

for an MPT. When there is a realistic prospect of establishing that a doctor’s fitness to practise is impaired to a degree warranting action on registration.

2016 Outcomes of investigating concerns

of case were concluded or referred at the investigation stage within six months.92%

* This figure shows the total outcomes from ongoing and new investigations in 2016 which have a case examiner decision. Because cases opened in 2016 will not necessarily reach an outcome in the same year, the figure does not track a single cohort of complaints. Therefore, the total number of investigations (1,824) is higher than the number of investigations from triage (1,428).

† This figure represents the number of decisions made by the case examiners to refer a doctor to a medical practitioners tribunal. 232 doctors were referred to a medical practitioners tribunal.

DELIVERING OUR ROLE


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We continue to meet all the Professional Standards Authority’s standards of good regulation for fitness to practise. These include standards relating to fairness, transparency, public protection and timeliness.

You can read more about how we responded to concerns about doctors in our impact report.

2 VOLUNTARYerasure.

17CONDITIONSto place conditions onthe doctor'sregistration.

93SUSPENDEDthe doctor's registration.

34NO ACTIONWhen there is no evidence that the doctor’s fitness to practise is impaired or they have not followed our standards.

229 OUTCOMES

2 IMPAIRED no action. In exceptionalcircumstances a tribunal may take no action, if it is satisfied a finding of impairment is sufficient to protect patient safety.

11 WARNINGSWhen there is no evidence that the doctor’s fitness to practise is impaired, but the concerns raised indicate a significant departure from our standards.

70 ERASEDthe doctor's name from the Medical Register, so that they can no longer practise.

2016 Outcomes from MPTS fitness to practice tribunals

DELIVERING OUR ROLE


Managing the UK medical registerWe check each doctor’s identity and qualifications before we allow them to practise in the UK. We maintain a list of all the doctors that meet our requirements – this is called the List of Registered Medical Practitioners and is often referred to as the medical register.

In 2016 we granted 21,132 applications for registration:

n 14,696 applications were from doctors who qualified in the UK

n 2,573 in the European Economic Area (EEA) or Switzerland

n 3,863 from the rest of the world.

We also maintain a Specialist Register and a GP Register. In 2016, we granted 8,188 applications (including new applications and restorations) for entry onto the Specialist Register or the GP Register.

During 2016 we carried out consultations on how to improve and complement the information provided in the medical register. Based on the feedback received, we will implement a number of changes during the course of 2017.

You can read more about how we maintained the integrity of the medical register in our impact report.

Helping to raise standards through revalidationAll doctors who are registered with a licence to practise have to revalidate every five years. Since we introduced revalidation in December 2012, and up to December 2016, we had revalidated over 165,000 doctors.

In 2016, we received 42,049 revalidation recommendations. Of these, we:

n revalidated 28,666 doctors

n deferred the revalidation of 12,028

n received 181 recommendations of non-engagement.*

We withdrew the licences of 949 doctors for failing to meet our requirements of revalidation.

You can read more about how revalidation has had positive impacts in our impact report.

21,132 applications for registration were granted in 2016.

* See www.gmc-uk.org/doctors/revalidation/13646.asp.

DELIVERING OUR ROLE


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Number of licensed doctors at 31 December 2016

ENGLAND

UK 127,710

IMG 48,117

EEA 17,219

Total 193,046

SCOTLAND

UK 16,409

IMG 2,101

EEA 1,116

Total 19,626

N. IRELAND

UK 5,074

IMG* 407

EEA† 572

Total 6,053

WALES

UK 6,526

IMG 2,397

EEA 576

Total 9,499

OTHER‡

UK 3,789

IMG 3,259

EEA 1,962

Total 9,010TOTAL

UK 159,508

IMG 56,281

EEA 21,445

Total 237,234

* IMG = International medical graduate.

† EEA = European Economic Area graduate.

‡ To establish where a doctor is located we use their registered address. The ‘other’ category mostly represents doctors who are based overseas, but a small number are where the postcode is not included in the Office of National Statistics look up.


OUR STRUCTURE, GOVERNANCE AND MANAGEMENT

Council and other governance groups Council is our governing body. Its role is to provide strategic direction, hold the executive to account, and take major high-level policy decisions. It comprises 12 members, six of whom are medical members and six of whom are lay members. The GMC is a registered charity and our Council members are also the trustees of the organisation. Council contains members from the four countries of the UK.

The trustees between 1 January 2016 and 31 December 2016 were:

n Dr Shree Datta, MBBS BSc (Hons) MRCOG LLM MD

n Lady Christine Eames, OBE LLB MPhil

n Professor Michael Farthing, MD DSc(Med) FRCP FMedSci MD

n Rt. Hon. Baroness Hayman, MA PC GBE

n Rt. Hon. Professor The Lord Kakkar, BSc (Hons) MBBS (Hons) Phd FRCS PC (demitted as a member of council on 30 September 2016)

n Professor Deirdre Kelly, CBE MD FRCP FRCPI FRCPCH DL

n Dame Suzi Leather, DBE MBE MA BA BPhil CQSW LLD (Hons) FRCOG (Hons) FRSH (Hons) DL

n Mr Julian Lee, FCA (demitted as a member of council on 31 May 2016)

n Professor Jim McKillop, BSc MB ChB PhD FRCP FRCR

n Dame Denise Platt, DBE BSc Econ

n Mrs Enid Rowlands, BSc CCMI

n Professor Terence Stephenson, BSc (Hons) DM FRCPCH FRCP FRACP (Hons) FRCPI (Hons) FRCS (Hons) FHKAP (Hons) FRCGP (Hons) FRCA (Hons) FCAI (Hons) FRCS Edin (Hons) FRCOG (Hons) FAcadMEd (Hons) FRCP Edin (Hons).



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The trustees were all independently appointed by the Privy Council, through a process that followed the Professional Standards Authority’s guidance for making appointments to healthcare professional regulatory bodies.

Council business is conducted in an open and transparent manner and the agenda and papers for each meeting are published on our website.

In 2016, Council agreed its arrangements for the Council member appointments and reappointments process. An appointment campaign began in June 2016 under the same independent process used for existing Council members, to fill the vacancies from four members (Rt. Hon. Professor The Lord Kakkar, Mr Julian Lee, Professor Jim McKillop and Mrs Enid Rowlands) who demitted office and for the seven members who were eligible for reappointment having reached the end of their first term of office.

Mr Steven Burnett, Professor Anthony Harnden, Professor Paul Knight and Ms Amerdeep Somal were appointed as Council members in 2016. All were appointed by the Privy Council for a four-year term with effect from 1 January 2017.e

Dr Shree Datta, Lady Christine Eames, Professor Michael Farthing, Baroness Helene Hayman, Professor Deirdre Kelly, Dame Suzi Leather and Dame Denise Platt were reappointed by the Privy Council for a further term with effect from 1 January 2017.

An induction programme began in late 2016 to make sure that the Council members appointed in 2016 had the information they needed to support them in taking up their appointment on 1 January 2017 and will continue throughout 2017, as required.

Council members participated in appraisal reviews in 2016. The appraisal process formed the basis of the Chair of Council’s reappointment recommendations made to the Privy Council. Member appraisals also included consideration of any learning and development needs and revisiting actual or perceived conflicts of interest to make sure any conflicts identified are manageable. Council members appointed in 2016 were also asked to declare any conflicts of interests. The register of interests, which contains the declared interests of Council members is published on our website.*

Council reviewed its own effectiveness in 2016 and was content that it continued to work well as a group and that its working arrangements were fit for purpose. A further Council effectiveness review will be conducted in 2017.

Council also considered plans for its regular governance review which will be carried out in the latter half of 2017.

The diagram overleaf shows the different governance groups that assist Council in discharging its responsibilities. These have all been agreed by Council to help it oversee our work effectively.

* See www.gmc-uk.org/about/council/register.asp.



Cou

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Gov

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Council

MPTS Committee

GMC/MPTS Liaison Group

Audit and Risk Committee

Investment Sub-Committee

Board of Pension Trustees

Exec

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over

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Performance and Resources Board

Directorate work plans

Form

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Advisory Forums Scotland

Wales Northern Ireland

Advisory Boards Education and Training

Revalidation Advisory Board

Liaison Groups

Task and Finish Groups

External input to programme or project boards

Remuneration Committee

Strategy and Policy Board

Assessment Advisory Board



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Audit and Risk Committee

You can find the Audit and Risk Committee’s report on page 36. The Audit and Risk Committee was chaired by Professor Jim McKillop in 2016. Mr Julian Lee demitted as a member of the Committee on 31 May 2016.

Remuneration Committee

The Remuneration Committee is chaired by Dame Denise Platt. It advises Council on the remuneration, the terms of service and the expenses policy for Council members, including the Chair. It also determines the appointment process for the Chief Executive and MPTS Chair and the remuneration, benefits, and terms of service for the Chief Executive, Chief Operating Officer/Deputy Chief Executive, directors, and MPTS Chair and MPTS Committee members. It also has responsibility for making sure the assessment and measurement of performance, and the assessment of recruitment and succession planning, take place within an appropriate framework for the senior management roles within its remit. The Committee reports annually to Council.

Professor The Lord Kakkar demitted as a member of the committee on 30 September 2016 and Mrs Enid Rowlands demitted as a member on 31 December 2016.

Investment Sub-Committee

The Investment Sub-Committee is chaired by Dame Suzi Leather.

Two external coopted members were appointed in 2016.

Mrs Enid Rowlands was appointed as a member of the Sub-Committee on 1 January 2016 and demitted as a member on 31 December 2016. Mr Julian Lee demitted as a member of the Sub-Committee on 31 May 2016.

The Sub-Committee is responsible for implementing and reviewing our investment policy, making sure the management of assets is consistent with the investment policy, appointing and managing fund managers, and monitoring performance. The Sub-Committee reports on investment performance to Council through the Chief Operating Officer’s report, as well as reporting annually on its activities to Council.



Board of Pension Trustees

The GMC’s defined benefit staff superannuation scheme is managed and administered by a board of trustees and chaired by Lord Kirkwood of Kirkhope, in accordance with the scheme’s trust deed and rules. The trust makes sure the pension scheme’s assets are kept separate from those of the employer.

The scheme’s trustees are responsible for the proper running of the scheme including the collection of contributions; the investment of assets and payment of the pension benefit commitments made by the employer.

Professor Deirdre Kelly was appointed as a new employer-nominated member from 1 January 2016.

Medical Practitioners Tribunal Service

The Medical Practitioners Tribunal Service (MPTS) has responsibility for overseeing the adjudication of fitness to practise hearings and in 2016 was led by the Chair of the MPTS, His Honour David Pearl.

The MPTS Committee and joint GMC/MPTS Liaison Group continue as part of the governance framework. The GMC/MPTS Liaison Group oversees the working relationship between the MPTS and the functions of the GMC with which it interacts. The GMC/MPTS Liaison Group is chaired by Professor Terence Stephenson, Chair of Council. The MPTS Committee was chaired by His Honour David Pearl.

In March 2015 a Section 60 Order was agreed by the UK Parliament, Scottish Parliament and Privy Council, amending the Medical Act 1983. The

Section 60 Order was enacted on 31 December 2015, creating the MPTS Committee as a statutory committee of Council. The MPTS Committee has significant responsibilities, including making sure the hearings service is delivered in an efficient and effective way and making sure tribunals maintain high-quality standards of decision making.

During 2016 the operational separation of the MPTS has been underlined with a GMC right of appeal against tribunals’ decisions, allowing the MPTS discretion to appoint legally qualified chairs, run review hearings ‘on the papers*’ and issue binding case management decisions.

We ran recruitment campaigns in 2016 to appoint a new MPTS Chair, and a new MPTS Committee member. Dame Caroline Swift was appointed as MPTS Chair for a four-year term with effect from 1 January 2017. An induction programme began in late 2016 to ensure the smooth transition in leadership.

Professor Jacky Hayden was appointed as a medical member of the MPTS Committee for a four-year term with effect from 1 September 2016. A recruitment campaign is expected to take place in 2017 to appoint a new MPTS Committee member following one member’s term of appointment coming to an end.

* Cases are reviewed without the need for the doctor or the GMC to attend a hearing.



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Strategy and Policy Board *

Our Strategy and Policy Board is an executive board, and is chaired by the Chief Executive Niall Dickson (to 31 October 2016)/Charlie Massey (from 1 November 2016). It includes members of our Senior Management team. The board is an advisory forum for the Chief Executive, which gives advice and recommendations on areas including:

n supporting Council in strategy development

n policy development priorities and significant changes to existing policy, including information and research to support strategy and policy development

n linkages between policy development and legislation

n external engagement in the organisation’s strategy and policy development.

The board reports its work through the Chief Executive’s reports and an annual report to Council.

Performance and Resources Board *

The Performance and Resources Board is an executive board, chaired by our Chief Operating Officer Susan Goldsmith. It includes members of our Senior Management team.

The board is an advisory forum for the Chief Operating Officer and gives advice and recommendations to the Chief Executive on areas including:

n business and operational planning

n performance management and reporting

n resource management

n risk management and related controls

n quality assurance, efficiency and continuous improvement

n making sure that equality and diversity are integrated into our core activities, including monitoring action plans and compliance with the equality duty.

The board also oversees the advisory Management Committee, which monitors and reviews our staff defined contribution pension scheme. The board reports its work through the Chief Operating Officer’s reports and an annual report to Council.

The board oversaw delivery of the change programme in 2016. You can find more information on the change programme on page 12.

* From June 2017, the Strategy and Policy Board and Performance and Resources Board will be replaced by a single Executive Board.



UK advisory forums

We have established advisory forums in Scotland, Wales and Northern Ireland, which are chaired by Professor Terence Stephenson, Chair of Council. The forums support Council’s role in making sure we have effective engagement with interest groups and that our policies are suited to the context in all parts of the UK.

The forums are an addition to our existing arrangements for engagement and are intended to give a structured setting for us to engage on medium- and long-term priorities, and to share and discuss any early-stage views on policy development. The forums report their work to the Strategy and Policy Board.

Education and Training Advisory Board

The Education and Training Advisory Board is chaired by Professor John Connell. It gives us advice on the delivery of undergraduate and postgraduate medical education and training, and career progression.

The board’s advice is crucial in developing our policy and in making sure that Council is fully briefed before major decisions are made. The board’s invited membership reflects the diverse range of those who have an interest in medical education and training across the UK. The board reports its work to the Strategy and Policy Board.

Revalidation Advisory Board

The Revalidation Advisory Board is chaired by Sir Keith Pearson. It gives us advice about how effectively revalidation has been operating since it was introduced in December 2012.

The board gives insight from a range of perspectives about how the system is working on the ground and how different groups, including doctors, responsible officers, patients, the public and employers, are experiencing revalidation.

It is an important part of how we monitor implementation and evaluate whether revalidation is being delivered as envisaged. The board reports its work to the Strategy and Policy Board.

Assessment Advisory Board

The Assessment Advisory Board is chaired by Professor Val Wass. It gives us expert advice on the development and operation of GMC-led assessments and assessments that we oversee.

The membership of the board includes a range of experts in assessment and assessment design, including those with expertise in differential attainment and statistical analysis of examination performance (psychometrics). Its work is reported to the Strategy and Policy Board.



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Member attendance at Council, boards and committees in 2016

Member and trustee Number of meetings attended

Dr Shree Datta

Council 7/7

Remuneration Committee 2/2

Investment Sub-Committee 2/4

Lady Christine Eames

Council 6/7

Audit and Risk Committee 6/6

UK Advisory Forums – Northern Ireland* 2/2

Professor Michael Farthing

Council 7/7


Baroness Helene Hayman

Council 7/7


Professor The Lord Ajay Kakkar †

Council 3/5


Professor Deirdre Kelly

Council 6/7

Board of Trustees of the GMC’s Superannuation Scheme 6/6


Dame Suzi Leather

Council 7/7



* Council member attendance at the forum meetings is on a voluntary basis on the invitation of the Chair of Council.

† Demitted as a Council member on 30 September 2016. Attendance data reflects the total number of meetings where attendance was possible.



Member and trustee Number of meetings attended

Mr Julian Lee‡

Council 1/2



Professor Jim McKillop

Council 6/7


Board of Trustees of the GMC’s Superannuation Scheme 6/6

UK Advisory Forums – Scotland* 2/2

Dame Denise Platt

Council 7/7


Mrs Enid Rowlands

Council 6/7



UK Advisory Forums – Wales* 1/2

Professor Terence Stephenson

Council 7/7


GMC/MPTS Liaison Group 2/2

UK Advisory Forums – Northern Ireland 2/2

UK Advisory Forums – Scotland 1/2

UK Advisory Forums – Wales 1/2

* Council member attendance at the forum meetings is on a voluntary basis on the invitation of the Chair of Council.

† Demitted as a Council member on 30 September 2016. Attendance data reflects the total number of meetings where attendance was possible.

‡ Demitted as a Council member on 31 May 2016. Attendance data reflects the total number of meetings where attendance was possible.



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Management

In 2016, our staff were under the direction of Chief Executive Niall Dickson/Charlie Massey and Chief Operating Officer and Deputy Chief Executive Susan Goldsmith.

Niall Dickson stepped down as Chief Executive and Registrar on 31 October 2016 and Charlie Massey took up the role on 1 November 2016.

On 31 December 2016, the directors were:

n Paul Buckley, Director of Strategy and Communication

n Judith Hulf, Interim Director of Education and Standards and Senior Medical Adviser and Responsible Officer

n Una Lane, Director of Registration and Revalidation

n Anthony Omo, General Counsel and Director of Fitness to Practise

n Neil Roberts, Director of Resources and Quality Assurance.

In memoriam

Mr Julian Lee, Council member between January 2015 and May 2016 sadly passed away on 22 September 2016.


2016 FINANCIAL REVIEW

The accounts for the year ended 31 December 2016 have been prepared in accordance with the Charities Statement of Recommended Practice (FRS 102).

Our total income and expenditure in 2016In 2016, we generated a total income of £107.0 million, and our operational expenditure was £100.7 million. Our income in 2016 increased by £7.7 million compared with 2015, largely due to an increase in the annual retention fee, coupled with growth in the number of registered doctors. We also introduced some changes to our fee structure in 2016, by increasing PLAB fees and introducing transaction charges for doctors paying fees by instalments and by credit card.

Our expenditure in 2016 reduced by £0.5 million compared with 2015; while we had budgeted for a higher level of expenditure, we were able to contain costs through proactive management.

As set out on page 12, in addition to our normal operational activities we undertook a major change programme in 2016 to reduce our costs and increase our income over the medium term. We spent £5.7 million in 2016, on making structural and other changes to implement the change programme, and plan to spend £2.7 million in 2017 to complete the change programme. We generated savings of £1.8 million in 2016 and forecast savings of £4.6 million in 2017. We forecast that the change programme will generate a net saving of £14.0 million over a five year period.

We also achieved £1.9 million of cashable efficiency gains on our operational activities in 2016, against a target of £0.5 million. These were generated by making changes in our fitness to practise and

adjudication functions, deferring recruitment across the organisation and reviewing external support contracts.

Each year we set a business plan and budget based on our strategic aims and a forecast of likely work volumes. Our actual performance against our strategic aims is set out earlier in this report, and our financial performance against budget in 2016 is summarised below.

Our income in 2016 was in line with budget. While the number of registered doctors increased over the year, the timing of doctors joining and leaving the medical register during the course of the year differed from our budget assumptions. Demand for PLAB tests was higher than anticipated, but investment income was lower than budgeted, as we placed funds under management later in the year than originally planned.

Our operational expenditure in 2016 was £3.0 million under budget.

Fitness to practise costs are a significant proportion of our total expenditure. Expenditure in 2016 was £2.8 million under budget, due to more legal work being carried out in-house rather than using external advisers, reducing the volume of expert reports commissioned, fewer performance assessments, and staff vacancies.

Our registration and revalidation costs were £0.6 million under budget, largely due to staff vacancies, reallocating work across teams and deferring recruitment.

Education and standards costs were £0.5 million under budget mainly due to fewer visits being carried out while we implemented the change programme.



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ABOUT US

Our external consultancy costs were £0.5 million under budget. We have been steadily reducing our expenditure on external consultants in recent years.

MPTS costs were £0.3 million less than budgeted, due to lower hearing costs from using legally qualified chairs in place of separate chairs and legal assessors, and reduced transcription costs.

Our strategy and communication costs were £0.3 million under budget through greater use of e-communications and savings on printing and stationery, and a more cost-effective approach to some research work.

Our resources and quality assurance costs were £0.2 million under budget mainly due to staff vacancies and reduced demands for staff training during the year.

Accommodation costs were £0.2 million under budget following successful rent negotiations on our Manchester office space, and a lower level of landlord building and maintenance works.

As part of the change programme in 2016 Council agreed to reform our defined benefit pension scheme to reduce the costs of the scheme to us as an employer. This allows us to avoid a cost pressure of approximately £2.5million per annum from 2017 onward. Towards the end of 2016, Council further considered the funding of the scheme. While the scheme was fully funded following the triennial actuarial valuation on 31 December 2015, the scheme had been adversely affected following the EU referendum and subsequent changes to bond yields and other economic factors. In the light of this Council made a payment of £2.4 million into the scheme in 2016, and agreed further payments of £0.5 million per annum for five years, starting

in 2017. The defined benefit pension scheme was closed to new joiners on 1 July 2013 and replaced by a defined contribution scheme.

During 2016, we spent £6.2 million on major projects to improve our information systems infrastructure and accommodation.

Trustees’ responsibilities for the financial statementsThe trustees are responsible for preparing the trustees’ report and the financial statements in accordance with applicable law and regulations. Charity law requires that the trustees prepare financial statements for each financial year in accordance with the Charities Statement of Recommended Practice FRS 102 and applicable law. Under charity law, the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charity and of its net incoming resources for that period. In preparing these financial statements, the trustees have:

n selected suitable accounting policies and applied them consistently

n made judgements and estimates that are reasonable and prudent

n followed applicable accounting standards without any material departures

n prepared the financial statements on the going concern basis

n observed the methods and principles in the Charities Statement of Recommended Practice (FRS 102).



The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charity’s transactions and disclose, with reasonable accuracy at any time, the financial position of the charity. The trustees are also responsible for making sure the financial statements comply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008, the provisions of the trust deed, the Charities and Trustee Investment (Scotland) Act 2005, the Charities Accounts (Scotland) Regulations 2006 and the Privy Council Directions issued under the Medical Act 1983. The trustees are responsible for safeguarding the assets of the charity and for taking reasonable steps to prevent and detect fraud and other irregularities.

Related party transactionsInternational Standards on Auditing (ISAs), place significant emphasis on the identification, recording and disclosure of relationships and transactions with related parties. For ISA purposes, related parties are defined as close family members, members of the same household and business partners.

All trustees and senior managers must disclose details of any organisations in which they hold a position of authority or other material interest and whose business could bring them into financial contact with the GMC; and details of any actual transactions between the GMC and related parties in the year must also be disclosed. We also publish a register of interests on our website.

In 2016 all disclosures were made and there were no issues of concern.

Reserves policy and going concernOur level of reserves and our reserves policy are reviewed annually, and any financial implications are addressed as part of the budget-setting process.

We hold reserves:

n to fund working capital and manage the normal day-to-day cash flow of the business because our expenditure is broadly linear whereas income is concentrated in summer and winter peaks

n to provide funds to address the risks we have identified that may result in an unexpected increase in expenditure and/or a reduction in income

n to provide funds to respond to new initiatives and opportunities that come up during the year

n to fund the time period between taking a decision to increase income and it taking full effect.

There is no standard formula that can be used to calculate the ideal level of reserves. We follow the Charity Commission’s guidance and set a target range of reserves based on our cash flow requirements and an assessment of the risks facing the organisation. We aim to hold reserves at a level that is not excessive, but does not put our solvency at risk.

We operate a defined benefit pension scheme. In line with the accounting standard FRS 102, the value of the pension scheme assets and liabilities is recognised on the balance sheet. While the operation of the defined benefit pension scheme does create a financial risk for the organisation, any deficit or surplus in the scheme can be managed over the medium term, and so has no immediate



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impact on our cash flow requirements. Any risks associated with changes in the level of pension scheme assets and liabilities are therefore disregarded for reserves policy purposes.

A significant proportion of our total reserves is represented by fixed assets, which cannot easily be converted into cash at short notice without adversely affecting our ability to fulfil our charitable aims. The value of fixed assets is therefore disregarded for reserves policy purposes.

Based on our analysis of cash flows and the risks facing the organisation, our policy is to maintain free reserves in the range of £25 million to £45 million. However, we recognise that the level of reserves will inevitably fluctuate over time, reflecting variations in actual levels of income and expenditure compared with the budget. Our policy is to maintain actual free reserves in line with the target level over the medium term. If our actual reserves vary significantly from the target range set out in the reserves policy, we will address the variation as part of the annual budget-setting process to bring actual reserves back into line within a reasonable period.

Our free reserves at the end of 2015 stood at £34.1 million. As our income in 2016 exceeded expenditure, our free reserves on 31 December 2016 increased to £37.3 million. Total reserves at the end of the year were £65.5 million, made up of free reserves, plus £14.7 million of reserves represented by fixed assets, and a pension reserve of £13.5 million.

The defined benefit pension scheme surplus of £13.5 million comprised assets of £213.6 million and liabilities of £200.1 million, valued in accordance with the financial reporting standard FRS 102. This is set out in more detail in note 16 of the accounts.

The defined benefit pension scheme was closed to new joiners on 1 July 2013 and replaced by a defined contribution scheme.

Our change programme involves additional costs in 2016 and 2017 to generate significant savings in future years. We also aim to deliver £2.6 million of operational efficiency savings in 2017, and in the light of these changes we decided to freeze the 2017–18 registration fees and annual retention fee at the same level as the previous year. We estimate that our free reserves at the end of 2017 will increase to around £41.4 million.

The majority of our income comes from registration fees paid by doctors. All doctors must be registered with us to practice medicine in the UK, and so our income is relatively certain. The trustees are therefore of the view that the GMC is a going concern.

There are no material uncertainties related to events or conditions that cast significant doubt on our financial stability over the medium term.

Investment policyDuring 2016 we reviewed our investment policy to improve yield while maintaining an appropriate degree of security and liquidity.

Our previous policy was to hold general reserves in cash or near cash equivalents to minimise risk in terms of both loss of capital and volatility of investment returns. The new investment policy separates our funds into four categories:

n those which are required as working capital for the normal day to day operation of the business

n those which we invest under management



n those which we may decide to invest in a trading subsidiary

n the remaining cash balance which fluctuates during the year.

We hold £20 million as working capital, as cash in instant access interest-bearing accounts. We have invested £10 million under management, and the balance of our funds in 2016 were held in medium term deposits. For accounting purposes we show funds held as cash for the normal day to day operation of the business within current assets and funds held for the longer term are shown as investments.

For funds under management, we have a low risk appetite and wish to protect against volatility, capital loss and the erosion of asset value by inflation. We aim to achieve a target rate of return on funds under management of consumer price inflation plus 2% over a rolling five year period. We have appointed CCLA as our fund manager, investing through their COIF Ethical Fund and COIF Deposit Fund towards the end of 2016.

We have adopted a comprehensive ethical investment approach. We seek to avoid those investments that we believe conflict with our charitable aims, and we may invest in companies whose activities are consistent with, or supportive of, our charitable aims. We may also use our position as an investor to influence the corporate behaviour of those companies we invest in.

Our policy is to invest only through fund managers who demonstrate the strongest environmental, social and governance credentials. We seek to specifically exclude investments in companies whose principal purpose is involvement with tobacco, alcohol,

gambling, pornography, high-interest rate lending, cluster munitions and landmines.

Our Council is responsible for determining and reviewing the overall investment policy, objectives, risk appetite and target returns. Council has delegated to the Investment Sub-Committee responsibility for implementing the investment policy, appointing and managing fund managers, monitoring performance and reporting to Council.

Our 2016 accounts show cash required for normal day-to-day working capital on our balance sheet within current assets, and cash held for the longer term is shown as investments.

In 2016, our investments generated interest of £0.7 million, equivalent to an average annual rate of return of 0.78%.

GMC Services International LimitedIn December 2016, Council agreed to the incorporation of GMC Services International Limited, as a trading subsidiary of the GMC. Council also agreed that the Investment Sub-Committee would oversee investment in the trading subsidiary.

The trading subsidiary was incorporated on 16 December 2016, but carried out no trading in 2016 and so no accounts have been prepared for the trading subsidiary, and no consolidated accounts have been prepared for the GMC. For 2017 it has already secured a sizeable contract for consultancy work in the Middle East and several training contracts, and is developing its business plan. Once its business plan is finalised it is likely to require capitalisation by the investment of share or



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loan capital or a combination of the two. This will be considered by the Investment Sub-Committee during 2017.

At the end of 2017 we will prepare separate company accounts for the trading subsidiary and consolidated accounts for the GMC.

Key management personnel – pay and remuneration policyThe Remuneration Committee is responsible for determining the remuneration, benefits, and terms of service for the Chief Executive, Chief Operating Officer/Deputy Chief Executive, Senior Medical Adviser and GMC Responsible Officer, Chair of MPTS and directors. The committee sets all aspects of salary or honoraria, the provision of any other benefits, and any other arrangements or contractual terms for this group of staff.

The committee considers that we should provide remuneration and rewards that will attract and retain the high-calibre staff necessary to enable us to fulfil our statutory remit and deliver our strategic objectives.

In setting the base pay for individual posts the committee will take external advice on roles within its remit and align salaries with an appropriate market rate subject to resource considerations.

An annual consolidated pay award is considered with reference to the organisation’s level of performance, the financial implications of any award, the award agreed for other GMC employees and wider market trends. An annual variable non-consolidated element is considered, reflecting personal performance, with regard to the same considerations applied to any consolidated award.

We review the effectiveness of these arrangements on an annual basis.

Staff within the Remuneration Committee’s remit will usually be entitled to the benefits package available to all GMC employees on the same terms. The committee retains the ability to withdraw, adjust or change any benefits for staff within its remit, subject to any consultation and contractual requirements. The committee considers any additional benefits in kind (such as relocation payments) on a case by case basis.

New external staff appointees within the committee’s remit are automatically enrolled into our defined contribution pension scheme. Where employees have existing agreed pension arrangements, such as membership of our defined benefit scheme, they retain this for the course of their employment, subject to any changes to the rules agreed by trustees and the employer.

The committee will make sure the equality and diversity implications of remuneration policy and related decisions are considered appropriately. Specifically, it will make sure:

n any salary differentials are supported by formal a job evaluation or independent external market advice

n any decisions relating to variable pay are supported by an objective assessment of performance

n any adjustment or changes to remuneration arrangements do not discriminate unlawfully

n other decisions relating to terms of service are supported by appropriate advice on any equality and diversity implications.


AUDIT AND RISKCOMMITTEE’S REPORT

The Audit and Risk Committee has eight members – six Council members and two co-opted members – providing relevant experience and knowledge of finance, governance and risk. The committee continues to be a key part of our governance structure, giving Council independent assurance on the effectiveness of arrangements to ensure the:

n integrity of the financial statements

n effectiveness of the systems of internal control, governance and risk management

n adequacy of both the internal and external audit services.

The committee bases its advice and decisions on guidance issued by the Financial Reporting Council and, where appropriate, independent external advice.

In 2016, the committee held six meetings and submitted two formal reports on its work and findings to our Council. Key activities during the year were:

n overseeing a programme of continuous assurance activity to support the delivery and risk management of an internal change programme

n challenging the Corporate Risk Register at every meeting and scrutinising specific risks in seminar sessions

n continued support for our risk maturity in line with the principles of effective risk management set out in the international guidance standard ISO31000:2009. In particular, it oversaw the development of a risk appetite statement articulating the organisation’s approach to risk in decision-making

n reviewing our whistleblowing policy for staff

n overseeing delivery of year two of the 2015–17 internal audit programme, scrutinising all audit findings to satisfy itself that the actions proposed were appropriate and monitoring the implementation of recommendations to make sure they were being managed effectively by senior management

n approving the external audit letter of engagement and reviewing the outcome of the external auditor’s work.

AUDIT AND RISK COMMITTEE’S REPORT


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Risk management statementContext

We manage the risks and implications of external events and internal activities sensitively but responsibly as a regulator for patient safety and as an employer.

Our approach to risk management is set out in the risk management framework which continues to be at the heart of how we effectively manage the risks and opportunities facing not only our organisation but those we serve in the wider health environment. Both Council and our Audit and Risk Committee have discussed risks and opportunities regularly throughout the year. Our executive Performance and Resources Board has continued to regularly monitor existing corporate and emerging risks and mitigating actions. Directorates and teams have captured and monitored local operational and project risks through directorate and project risk registers.

Managing risks in 2016

We have faced and managed a number of new risks during the year, including arrangements to make sure we were compliant with Directive 2005/36/EC, the Recognition of Professional Qualifications European Directive; handling the implications and opportunities of the European referendum result, and responding appropriately to the junior doctors’ industrial action. We have had to remain vigilant and understanding of the impact of significant uncertainty on patients, doctors and doctors in training but have continued to remind all doctors of their responsibilities to patients and the need to raise concerns when necessary. We have sought to make our interventions relevant, appropriate and proportionate.

We have also faced risks in implementing our ambitious internal change programme. In 2016 an independent risk review, with a particular focus on risk management in the delivery of the change programme, concluded that ‘risk management within the change programme has been well planned and executed' and that this ‘displays a measure of the successful implementation of the risk framework across the organisation’. The staff and accommodation changes are now complete. As set out on page 12, we have much more to do in 2017 to complete the transformation in the way we work. We will continue to monitor the risks associated with our ambitious agenda as well as reporting on the progress we make.

Understanding and responding to patient safety and promoting good medical practice throughout a doctor’s training and professional career lies at the core of our organisational purpose. We have maintained robust operational systems and procedures to make sure that we deliver our statutory functions and only those who are fit to practise safely have access to the register. We have a strong culture of continuous improvement and are aware more needs to be done with our education regulatory procedures, particularly when there are concerns about patient safety and the training quality and experience for medical students and doctors in training. This year we are reviewing our entire framework for how we approach the quality assurance of medical education so that we can be confident that medical students and doctors in training are working in safe environments and patients are receiving good quality care. We also continue to work with partners in the wider system to pre-empt risks and manage issues as they arise.



Examples of where we have sought to improve patient safety in 2016 include successfully introducing greater rigour into the knowledge and skills testing for international medical graduates taking the Professional and Linguistic Assessments Board test and running the first revalidation assessments for doctors who do not have a responsible officer or suitable person to provide a revalidation recommendation to show their medical knowledge is up to date.

We are also alert to the inherent internal risks of being an employer of over 1,000 staff. High standards for recruitment, induction and ongoing training and development have been key to delivering the change programme. Our mandatory information security training is core for all staff and we remain certified to the Information Security Management international standard ISO 27001.

This year we also gained certification to BS 10008, a standard that underpins the legal admissibility and evidential weight of electronic information and the documents that are scanned to our systems. This means we can now give comprehensive evidence and assurance in the event of legal challenge against electronic versions of documents rather than the original paper ones (such as in our MPTS hearings). This also gives efficiency savings, which offset the increasing cost of holding paper documents at offsite storage facilities.

Longer term risks and opportunities

Council, the Audit and Risk Committee and senior management continue to discuss longer term horizon risk matters. At Council’s away day in July 2016, these discussions were integral to the start of the development of our 2018–21 corporate strategy, which we will launch later in 2017. Understanding these longer term risks and the direction of health services delivery will be key to making sure we have a strategy that is fit for purpose, providing a genuine contribution to the future of doctors’ education, ongoing professional development and wellbeing.

Strategic risks are largely driven by the external environment, which means we have limited control over the actions that may need to be taken. We therefore play an important role in bringing such issues to the attention of others and working collaboratively where possible to influence and drive appropriate actions and outcomes. We seek to work collaboratively with regulators and improvement bodies in Scotland, Wales, Northern Ireland and England and with partners in the healthcare system to drive proactive, risk-based and proportionate regulation in pursuit of a shared objective of patient safety.


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But alongside risk there are also opportunities and we have a number of key areas we will focus on in 2017. Our 2017 business plan gives further detail.

n The result of the European referendum gives us a real opportunity to improve consistency in standards when doctors apply to join our register. In January 2017 we launched our Medical Licensing Assessment consultation. (The aim of the assessment is to create a single, objective demonstration that those applying for registration with a licence to practise medicine in the UK can meet a common threshold for safe practice.)

n Following the junior doctors’ industrial action in 2016 we were asked to undertake a review of the flexibility doctors have while in their training. This is an important review which gives us an opportunity to address one of the key concerns junior doctors raised and is one of our key priorities for 2017.

n Following the review of revalidation by Sir Keith Pearson we have an opportunity to work with the four UK governments and health organisations to take Sir Keith’s recommendations forward. We will also work with the royal colleges and employers to make sure our guidance and theirs are clearer about the mandatory requirements for revalidation and where there is scope for flexibility.

n An internal audit review of the way we conduct our regulatory monitoring when we have concerns about training environments has given us a chance to fundamentally review how we work with medical schools, deaneries and other partners in the healthcare system to improve training quality and experience for medical students and doctors in training as well as ensuring public protection.

n Using our internal skills and expertise to the benefit of others around the world we can build on an initial income stream which has developed over the last few months through our trading subsidiary, GMC Services International.

Conclusion

Like other bodies in the healthcare sector, we continue to face significant external challenges, including the continuing strain on healthcare finances and the impact this has on patients, our registrants and those in medical training. We will continue to play our part as a regulator in future discussions and debates and to make sure our interventions are relevant, appropriate and proportionate. We will continue to make sure risk management remains a live issue throughout the business and to value its contribution to our overall effectiveness as a relevant, modern and forward looking regulator.

Approved by the trustees on 7 June 2017, and signed on their behalf by:

Dame Denise Platt

Deputy Chair of Council



Independent auditors’ report to the trustees of the General Medical Council We have audited the financial statements of General Medical Council for the year ended 31 December 2016, which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and the related notes numbered 1 to 18.

The financial reporting framework that has been applied in their preparation is applicable law and FRS 102, The Financial Reporting Standard applicable in the UK and Republic of Ireland.

This report is made solely to the charity’s trustees, as a body, in accordance with section 154 of the Charities Act 2011 and section 44(1c) of the Charities and Trustee Investment (Scotland) Act 2005. Our audit work has been undertaken so that we might state to the charity’s trustees those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charity and the charity’s trustees as a body, for our audit work, for this report, or for the opinions we have formed.

Respective responsibilities of trustees and auditors

As explained more fully in the Statement of Trustees’ Responsibilities, the trustees are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view.

We have been appointed as auditor under section 144 of the Charities Act 2011 and section 44(1c) of the Charities and Trustee Investment (Scotland) Act 2005 and report in accordance with those Acts.

Our responsibility is to audit and express an opinion on the financial statements in accordance with applicable law and International Standards on Auditing (UK and Ireland). Those standards require us to comply with the Auditing Practices Board’s Ethical Standards for Auditors.

Scope of the audit of the financial statements

An audit involves obtaining evidence about the amounts and disclosures in the financial statements sufficient to give reasonable assurance that the financial statements are free from material misstatement, whether caused by fraud or error. This includes an assessment of:

n whether the accounting policies are appropriate to the charity’s circumstances and have been consistently applied and adequately disclosed

n the reasonableness of significant accounting estimates made by the trustees, and

n the overall presentation of the financial statements.

In addition, we read all the financial and non-financial information in the Trustees’ Annual Report and any other surround information to identify material inconsistencies with the audited financial statements and to identify any information that is apparently materially incorrect based on, or materially inconsistent with, the knowledge


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acquired by us in the course of performing the audit. If we become aware of any apparent material misstatements or inconsistencies we consider the implications for our report.

Opinion on financial statements

In our opinion, the financial statements:

n give a true and fair view of the state of the charity’s affairs as at 31 December 2016 and of its incoming resources and application of resources, for the year then ended

n have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice

n have been prepared in accordance with the requirements of the Charities Act 2011 and the Charities and Trustee Investment (Scotland) Act 2005 and Regulation 8 of the Charities Accounts (Scotland) Regulations 2006 and the Medical Act 1983 and the Privy Council Directions issued thereunder.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters where the Charities Act 2011 or the Charities Accounts (Scotland) Regulations 2006 (as amended) requires us to report to you if, in our opinion:

n the information given in the Trustees’ Annual Report is inconsistent in any material respect with the financial statements

n sufficient accounting records have not been kept, or

n the financial statements are not in agreement with the accounting records and returns, or

n we have not received all the information and explanations we require for our audit.

Crowe Clark Whitehill LLP Statutory Auditor London

Crowe Clark Whitehill LLP is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006.


ACCOUNTS 2016

Statement of financial activities for the year ended 31 December 2016

Total Total

2016 2015

Note £’000 £’000

Income

From Charitable activities

Registration 2 100,786 93,832

Specialist and GP registration 2 3,475 3,557

Revalidation 2 253 –

Other trading activities 3 303 492

Investments 3 1,662 1,264

Other 3 479 116

Total incoming resources 106,958 99,261

Expenditure

Charitable activities

Fitness to practise 49,191 49,901

Registration and revalidation 20,003 20,304

Medical Practitioners Tribunal Service 13,297 13,333

Education 7,580 7,412

External relationships 6,490 5,983

Communications 2,617 2,895

Standards 1,565 1,367

Total expenditure 5 100,743 101,195

Net income/(expenditure) 6,215 (1,934)

Other recognised gains and losses

Actuarial (loss)/gain on defined benefit pension scheme 16 (10,139) 3,670

Net movement in funds (3,924) 1,736

Total funds brought forward 69,406 67,670

Total funds carried forward 65,482 69,406

ACCOUNTS 2016


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Balance sheet as at 31 December 2016

2016 2015

Note £’000 £’000 £’000 £’000

Fixed assets

Intangible fixed assets 7 8,412 6,917

Tangible fixed assets 8 6,312 6,900

Investments 9 60,007 60,000

74,731 73,817

Current assets

Debtors and prepayments 10 19,775 19,862

Cash and bank balances 30,787 26,039

50,562 45,901

Liabilities

Creditors: amounts falling due within one year 11 (71,813) (68,410)

Net current liabilities (21,251) (22,509)

Total assets less current liabilities 53,480 51,308

Provisions for liabilities and charges 12 (1,509) (3,406)

Net assets excluding pension scheme asset 51,971 47,902

Defined benefit pension scheme asset 16 13,511 21,504

Total net assets 65,482 69,406

The funds of the charity

Unrestricted income funds 51,971 47,902

Pension reserve 13,511 21,504

Total charity funds 13 65,482 69,406

The financial statements were approved by the trustees and authorised for issue on 7 June 2017.

They were signed on behalf of the trustees by:

Dame Denise PlattDeputy Chair of Council

ACCOUNTS 2016


Cash flow statement for the year ended 31 December 2016

2016 2015

£’000 £’000 £’000 £’000

Cash flows from operating activities:

Net cash provided by/(used in) operating activities (note 1 below) 12,385 6,514

Cash flows from investing activities:

Dividends, interest and rents from investments 700 512

Purchase of property, plant, equipment and intangibles (8,337) (6,320)

Net cash provided by/(used in) investing activities (7,637) (5,808)

Change in cash and cash equivalents 4,748 706

Note 1

Cash flow from operating activities £’000 £’000

Net incoming/(outgoing) resources 6,215 (1,934)

Investment income and interest (1,651) (1,264)

Net investment movement (7) –

Non-cash items – depreciation and amortisation 7,143 6,720

Non-cash items – assets written off 287 –

Pension past service cost and curtailment – –

Pension scheme current service cost 8,319 9,049

Pension scheme contribution (9,514) (9,008)

Decrease/(Increase) in debtors 87 (1,843)

Increase in creditors 1,506 4,794

Net cash provided by / (used in) operating activities 12,385 6,514

Note 2

Short-term deposits

Cash at bank and in hand

Total

Cash and equivalents £’000 £’000 £’000

Balances at 1 January 2016 – 26,039 26,039

Net increase/(decrease) in cash and cash equivalents – 4,748 4,748

Balances at 31 December 2016 – 30,787 30,787

ACCOUNTS 2016


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Notes to the accounts

1. Principal accounting policiesAccounting convention

Our financial statements have been prepared on a going concern basis and in accordance with the Charities Statement of Recommended Practice (FRS 102), applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland, the Charities Act 2011, the Charities and Trustee Investment (Scotland) Act 2005, the Charities Accounts (Scotland) Regulations 2006 and UK Generally Accepted Practice as it applies from 1 January 2015. The GMC meets the definition of a public benefit entity under FRS 102. There are no material uncertainties about the charity's ability to continue as a going concern.

On 16 December 2016 the GMC incorporated a trading subsidiary, GMC Services International LTD, company number 10530157, which is wholly owned by share capital by the General Medical Council. At 31 December 2016 there had been no transactions within the subsidiary therefore there is no income, expenditure, assets or liabilities to report at the balance sheet date. Consolidated accounts have not been prepared as the trading subsidiary was dormant in 2016 and the accounts have been prepared using the consolidated accounts exemption.

The principal accounting policies adopted in the preparation of the financial statements, which have been applied consistently, are detailed below.

Incoming resources

Income is included in the statement of financial activities when all of the following criteria are met:

n Entitlement – control over the rights or other access to the economic benefit has passed to the GMC

n Probability – it is more likely than not that the economic benefits will flow to the GMC

n Measurement – the value can be measured reliably.

The following specific policies apply:

n Annual retention fees relate to services to be provided over a 12-month period. Income is deferred and released to the statement of financial activities on a straight-line basis over the period to which the income relates.

n Registration fees, including provisional registration fees, are recognised when registration is granted.

n Professional and Linguistic Assessments Board (PLAB) fees are recognised when the examinations are sat.

n Income from investments and funds held on deposit is recognised when it is receivable and the amount can be accurately measured.

All income is recognised gross.

ACCOUNTS 2016


Basis for recognising liabilities

Expenditure includes staffing costs, office costs, committee costs, legal costs, accommodation costs, purchase of assets, and financial, actuarial and professional costs.

Resources expended are included in the statement of financial activities on an accruals basis. All liabilities are recognised as soon as there is a legal or constructive obligation committing the charity to expenditure.

Basis for allocation of resources expended

The majority of our resources are expended directly in pursuit of our charitable aims, and are identified as such in the statement of financial activities.

Accommodation costs, governance costs and other support costs are apportioned to charitable activities on the basis of staff head count across the organisation.

Irrecoverable VAT

Any irrecoverable VAT is charged to the statement of financial activities as part of the relevant item of expenditure, or capitalised as part of the cost of the related asset where appropriate.

Taxation

We can take advantage of the exemptions from taxation on income and gains available to charities, so no taxation is payable on the net incoming resources.

Debtors

Trade and other debtors are normally recognised at the settlement amount due after any trade discount offered. Prepayments are normally valued at the amount prepaid net of any trade discounts due.

Creditors and provisions for liabilities

Creditors and provisions are recognised when the charity has a present legal or constructive obligation as a result of a past event. They are recognised when it is probable that a transfer of economic benefit will be required to settle the obligation and a reliable estimate can be made of the amount of the obligation. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

Critical accounting judgements and key sources of estimation uncertainty

The key sources of estimation uncertainty that have a significant effect on the amounts recognised in the financial statements are:

n All unsettled claims for legal costs made against the GMC are reviewed on a case-by-case basis at the year end. Provisions are based on historical experience and a detailed assessment of the specific details of current cases. The final settlement of cases is dependent on a number of factors, so the accuracy of the provision is subject to a significant degree of uncertainty.

n Provisions for property dilapidation costs are assessed on a case-by-case basis, close to the lease end date when a reasonable estimate of costs can be made.

n Provisions for holiday pay are based on the actual level of accrued days and salaries of each staff member.

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Intangible fixed assets

Intangible fixed assets comprise computer software. They are stated at cost, net of depreciation and any provision for impairment. Expenditure is only capitalised where the cost of the asset or group of assets acquired exceeds £5,000.

Tangible fixed assets

Tangible fixed assets are stated at cost, net of depreciation and any provision for impairment. Expenditure is only capitalised where the cost of the asset or group of assets acquired exceeds £5,000.

Depreciation

Depreciation is provided so as to write off the cost, less estimated residual value, of the assets evenly over their estimated lives. In the case of leased assets, the cost is written off over the period of the lease. The period of the lease is determined as the period up to the first break clause, unless our intention is not to exercise the break.

The estimated useful lives are as follows:

n Leasehold buildings and leasehold improvements – the period of the lease or the useful economic life of the asset.

n Furniture, fixtures, and office fittings – the lesser of five years or the remaining term of the lease.

n Information Technology (IT) equipment and software – three years.

n Other office equipment – three years for IT-related items and five years for all other items.

Depreciation rates are reviewed on a regular basis comparing actual lives of assets with the accounting policy rates.

Operating leases

Rent payable under operating leases is charged to the statement of financial activities on a straight-line basis over the period of the lease.

Financial instruments

The charity has financial assets and liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at amortised cost. Financial assets held at amortised cost consist of cash and bank balances, short-term deposits, investments held in cash deposits together with trade and other debtors. Financial liabilities held at amortised cost comprise trade and other creditors, tax and social security creditors and accruals.

Investments

Our investment policy separates our funds into three categories: those which are required as working capital for the normal day to day operation of the business; those which we invest under management; and the remaining cash balance which fluctuates during the year.

Funds held as cash for the normal day to day operation of the business is shown on the GMC’s balance sheet within current assets, while funds held for the longer term is shown as investments.

ACCOUNTS 2016


Pensions

We have a defined benefit pension scheme for permanent employees. The scheme was closed to new members on 30 June 2013, and replaced by a defined contribution scheme. The surplus or deficit of the defined benefit scheme is recognised on the balance sheet. Changes in the assets and liabilities of the scheme are disclosed and allocated as follows:

n Charges relating to current or past service costs, and gains and losses on settlements and curtailments, are included within staff costs and charged to the statement of financial activities.

n Interest on the net defined benefit asset/liability is shown as a net amount of other finance costs or as an incoming resource alongside investment income and interest.

n Actuarial gains and losses are recognised immediately in other recognised gains and losses on investments.

n The assets, liabilities and movements in the surplus or deficit of the scheme are calculated by qualified independent actuaries as an update to the latest full actuarial valuation. Details of the defined benefit scheme assets, liabilities and major assumptions are shown in the notes to the accounts.

Our defined contribution pension scheme was set up on 1 July 2013. Contributions to the scheme are charged to the statement of financial activities in the year in which they are payable to the scheme.

A small number of staff who transferred to the GMC on the merger with the Postgraduate Medical Education and Training Board (PMETB), contribute to the NHS multi-employer scheme and contributions to the scheme are charged to the statement of financial activities in the year in which they are payable to the scheme.

Funds and reserves

All of our funds are unrestricted, and can be expended at the trustees’ discretion, in pursuit of our charitable aims.

ACCOUNTS 2016


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2. Income from charitable activities

Total Total2016 2015

£’000 £’000Registration

Annual retention fees 94,105 88,561

Registration fees 3,446 2,931

Provisional registration fees 685 709

PLAB fees 2,423 1,495

Other fees 127 136

100,786 93,832

Specialist and GP registration

Certificates of Completion of Training fees 2,661 2,583

Certificate of Eligibility for Specialist Registration/ Certificate of Eligibility for General Practitioner Registration fees

776 938

Other fees 38 36

3,475 3,557

Revalidation

Revalidation annual return 183

Revalidation assessment 70

253 –* Charges for revalidation returns and assessment were introduced at 1 April 2016.

3. Income from raising funds2016 2015

£’000 £’000

Activities for raising funds

Other trading activities † 303 492

Other ‡ 479 116

782 608

Investment income

Other finance income – pension scheme (note 16) 951 752

Bank interest 700 512

Investment income § 11 –1,662 1,264

† Other trading activities include sales of the medical register, external hire of the Clinical Assessment Centre, the reimbursement of costs of visiting overseas medical schools and the reimbursement of costs of staff seconded to external bodies.

‡ Other generated funds includes transactional charges introduced at 30 June 2016.§ Investment management fees of £4,800 were incurred to generate the investment income return.

ACCOUNTS 2016


4. Financial Instruments

Total Total

2016 2015

£’000 £’000

Financial assets measured at amortised cost 107,300 103,129

Financial liabilities measured at amortised cost 15,604 14,842

Financial instruments held at fair value 10,007 –

The entity’s income, expense, gains and losses in respect of financial instruments are summarised below:

Total interest income for financial assets held at amortised cost 700 512

5. Total expenditure Direct Direct Allocated Total Total

staffing costs costs costs 2016 2015

£’000 £’000 £’000 £’000 £’000

Fitness to practise 20,845 9,963 18,383 49,191 49,901

Registration and revalidation 8,233 3,079 8,691 20,003 20,304

Medical Practitioners Tribunal Service 3,360 6,715 3,222 13,297 13,333

Education 4,234 720 2,626 7,580 7,412

External relationships* 3,561 660 2,269 6,490 5,983

Communications 1,454 243 920 2,617 2,895

Standards 899 10 656 1,565 1,367

Total charitable expenditure 42,586 21,390 36,767 100,743 101,195

* External relationships include the work done by our Regional Liaison Service, strategic relationships, our offices in Northern Ireland, Scotland and Wales, and our European and international development activities.

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Support costs allocated to charitable activities

Management

£’000

IT

£’000

Human resources

£’000

Finance

£’000

Procurement

£’000

Facilities

£’000

Governance Total2016

£’000

Total2015

£’000

Fitness to practise 2,355 5,632 1,657 577 200 4,934 3,028 18,383 17,283

Registration and revalidation

1,113 2,663 783 273 94 2,333 1,432 8,691 8,910

Medical Practitioners Tribunal Service

413 987 290 101 35 865 531 3,222 3,060

Education 336 804 237 82 29 705 433 2,626 2,701

External relationships 291 695 204 71 25 609 374 2,269 2,026

Communications 118 282 83 29 10 247 151 920 992

Standards 84 201 59 21 7 176 108 656 553

Total charitable expenditure

4,710 11,264 3,313 1,154 400 9,869 6,057 36,767 35,525

Support costs and governance costs are managed centrally, and then allocated to charitable activities on the basis of staff head count across

the organisation.

2016 2015

£’000 £’000

Staffing costs 59,286 58,310

Office costs 3,024 3,458

Council and committee costs 464 411

Panel and assessment costs 13,908 14,801

Legal costs 4,876 4,902

Accommodation costs 6,339 6,717

Financial, actuarial and professional costs 3,021 3,830

Purchase of assets – charged to revenue 2,395 2,046

Assets written off 287 –

Depreciation 3,616 6,720

Amortisation 3,527 –

100,743 101,195

Total expenditure includes:

Operating lease costs: leasehold property and equipment 3,489 3,389

Audit fees 42 41

ACCOUNTS 2016


6. Staff

2016 2015

£’000 £’000

Total costs of all staff

Salaries 43,478 42,165

Social security costs 4,029 3,458

Superannuation costs – defined benefit scheme 6,957 6,187

Superannuation costs – defined contribution scheme 1,633 1,299

Redundancy costs – 2,286

Other staffing costs 3,190 2,915

59,286 58,310

2016 2015

Average staff numbers in the year by category

Fitness to practise 444 423

Medical Practitioners Tribunal Service 78 75

Registration and revalidation 210 218

Standards 16 14

Education 63 66

Communications 22 24

External relations 55 50

Governance 56 51

Resources 171 161

1,115 1,082

ACCOUNTS 2016


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The number of staff whose taxable emoluments (excluding redundancy payments) fell into higher salary bands was:

2016 2015

GMC

£60,000–£70,000 28 32

£70,001–£80,000 28 27

£80,001–£90,000 11 16

£90,001–£100,000 11 11

£100,001–£110,000 8 8

£110,001–£120,000 7 4

£120,001–£130,000 4 3

£130,001–£140,000 – 1

£140,001–£150,000 1 1

£160,001–£170,000 – 1

£180,001–£190,000 2 4

£190,001–£200,000 2 2

£200,001–£210,000 1 –

£230,001–£240,000 – 1

MPTS

£60,000–£70,000 1 –

£70,001–£80,000 1 1

£90,001–£100,000 – 1

£100,001–£110,000 1 –

£110,001–£120,000 – 1

2016 2015

Number of staff included above for whom retirement benefits are accruing

GMC defined benefit pension scheme 87 95

GMC defined contribution pension scheme 18 13

NHS defined benefit pension scheme 1 1

Not in scheme – 2

106 111

The key management personnel of the charity includes the Chief Executive, Chief Operating Officer and all directors.

The total employee benefits of key management personnel were £1,645,208 (2015 £1,533,743).

ACCOUNTS 2016


7. Intangible fixed assets

Computer software and systems development

£’000

Cost

Balance at 1 January 2016 29,718

Additions 5,033

Disposals (385)

Balance at 31 December 2016 34,366

Amortisation

Balance at 1 January 2016 22,801

Amortisation charge for year 3,527

Disposals (374)

Balance at 31 December 2016 25,954

Net book value at 1 January 2016 6,917

Net book value at 31 December 2016 8,412

Intangible assets incorporates all IT software development costs including, but not limited to, the development of our strategic applications,

Siebel, Livelink and Agresso, the development of IT security systems, facilities management systems and website. Intangible assets also include

the systems to support working from home and mobile applications.

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8. Tangible fixed assets

Buildings Fixtures, furniture and

equipment

IT equipment Total

£’000 £’000 £’000 £’000

Cost

Balance at 1 January 2016 5,665 8,548 9,190 23,403

Additions 40 2,423 841 3,304

Disposals (3) (2,013) (883) (2,899)

Balance at 31 December 2016 5,702 8,958 9,148 23,808

Depreciation

Balance at 1 January 2016 5,646 5,047 5,810 16,503

Depreciation charge for year 12 1,348 2,256 3,616

Disposals (2) (1,753) (868) (2,623)

Balance at 31 December 2016 5,656 4,642 7,198 17,496

Net book value at 1 January 2016 19 3,501 3,380 6,900

Net book value at 31 December 2016 46 4,316 1,950 6,312

9. Investments

2016 2015

£’000 £’000

The valuation at the end of the year consisted of:

Cash deposits 50,000 60,000

Managed funds* 10,007 –

60,007 60,000

* Managed funds are placed with CCLA and are split between their deposit fund and ethical fund.

ACCOUNTS 2016


10. Debtors 2016 2015

£’000 £’000

Amounts falling due within one year

Registration debtors 16,128 16,591

Prepayments and accrued income 3,367 2,841

Other debtors 280 430

19,775 19,862

11. Creditors

2016 2015

£’000 £’000

Amounts falling due within one year

Trade creditors 793 941

Other creditors 1 –

Tax and social security 1,456 1,165

Holiday pay 591 581

Accruals 12,847 12,155

Deferred income 56,125 53,568

71,813 68,410

Income from annual retention fees is deferred and released to the statement of financial activities on a straight-line basis over the period to

which the income relates. All deferred income brought forward from the previous year is automatically released to the statement of financial

activities in the following year.

Annual retention

fees

PLAB fees

Specialist and GP

registration fees

Revalidation assessment

fees

Transaction charges

Total

£’000 £’000 £’000 £’000 £’000 £’000

Deferred income at 1 January 2016 53,076 477 15 – – 53,568

Resources deferred during the year 54,593 1,162 16 26 328 56,125

Amounts released from previous years (53,076) (477) (15) – – (53,568)

Deferred income at 31 December 2016

54,593 1,162 16 26 328 56,125

ACCOUNTS 2016


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12. Provisions2016 2015

£’000 £’000

Dilapidations 519 509

Legal claims 420 397

Change programme 570 2,500

1,509 3,406

Dilapidations – each year we review our property leases and make provision for dilapidations, where the cost can be reasonably estimated.

Legal claims – each year the GMC makes a provision for potential costs related to ongoing legal cases.

Change programme – on 10 December 2015 the GMC decided to embark on a major change programme to reduce costs and increase income

over the medium term. A provision has been created in 2016 for the remaining restructuring costs associated with this change programme.

Dilapidations Legal claims

Change programme

total

£’000 £’000 £’000 £’000

Provisions at 1 January 2016 509 397 2,500 3,406

Provisions created during the year 519 420 570 1,509

Amounts released from previous years (509) (397) (2,500) (3,406)

Provisions at 31 December 2016 519 420 570 1,509

13. Fund movements in the year

Unrestricted funds

Pension fund

2016 total

2015 total

£’000 £’000 £’000 £’000

At 1 January 2016 47,902 21,504 69,406 67,670

Net incoming/(outgoing) resources 4,069 (7,993) (3,924) 1,736

At 31 December 2016 51,971 13,511 65,482 69,406

14. Capital commitments

Capital expenditure contracted but unspent at 31 December 2016 amounted to £265,306. The equivalent figure for 2015 was £269,928.

ACCOUNTS 2016


15. Operating lease commitments

Land and buildings Equipment

2016 2015 2016 2015

£’000 £’000 £’000 £’000

Expiry date

Within one year 4,252 4,333 31 57

In years two to five 16,843 16,758 – –

After more than five years 9,540 13,599 – –

30,635 34,690 31 57

16. Superannuation schemes

The GMC has three staff pension schemes.

GMC Group Personal Pension Plan

This is a defined contribution pension scheme, which was set up on 1 July 2013. We started auto enrolment on 1 November 2013. At the end of 2016 there were 528 members of staff contributing to the scheme. It meets the government’s requirements following the introduction of auto enrolment. Individuals can choose to make additional contributions by deduction from salary to the scheme. Under the terms of FRS102, contributions are accounted for as a defined contribution scheme based on actual contributions paid through the year.

NHS Multi-Employer Scheme

We have three members of staff who contribute to the NHS Multi-Employer Scheme, which is a defined benefit scheme. These staff transferred to the GMC on the merger with PMETB. The scheme operates as a pooled arrangement, with contributions paid at a centrally agreed rate. The trustees are unable to confirm the GMC's share of the underlying assets and liabilities of the NHS scheme and so, under the

terms of FRS102, contributions are accounted for as if the scheme were a defined contribution scheme based on actual contributions paid through the year.

GMC Staff Superannuation Scheme

This is a funded scheme of the defined benefit type, providing retirement benefits based on final salary. The top-up arrangement is an unfunded scheme.

This scheme was closed to new members on 30 June 2013, and replaced by the GMC Group Personal Pension Plan. At the end of 2016, there were 543 members of staff contributing to this scheme.

The FRS 102 valuation has been based on a full assessment of the liabilities for the scheme as at 31 December 2015. The present values of the defined benefit obligation, the related current service cost and any past service costs were measured using the projected unit credit method.

Actuarial gains and losses have been recognised in the period in which they occur (but outside the profit and loss account) through the Other Comprehensive Income.

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The GMC recognises surpluses in accordance with the requirements of International Financial Reporting Interpretations Committee (IFRIC) 14. The trustees of the scheme do not have the unilateral right to commence wind-up of the scheme. Thus, the GMC assumes that the scheme continues in existence until the last benefit payments are made to members, at which point any residual assets are returned to the GMC in line with the rules of the scheme. The GMC is not yet clear on whether the International Accounting Standards Board proposed amendments to IFRIC 14 will affect its ability to receive a refund of surplus. Once the amendments have been finalised, the GMC will review the likely impact.

Regular employer contributions to the scheme in 2017 are estimated to be £5,381,000.

The GMC made an additional top-up payment to the scheme of £2.4m in 2016 and will contribute a top up payment to the scheme of £0.5m in each of the next 5 years.

Responsibility for investing pension scheme assets rests with pension trustees. The Pensions Act 1995 requires trustees to draw up a Statement of Investment Principles, setting out the scheme’s investment strategy. Pension trustees are required to consult the employer (GMC) when drawing up the strategy, but do not require the employer’s formal agreement. Following consultation with the GMC, in 2014 the pension trustees adopted a fiduciary management approach to the investment of the scheme’s assets

The principal assumptions used by the independent qualified actuaries to calculate the liabilities under FRS102 are set out below.

Main financial assumptions

31 December 2016 31 December 2015 31 December 2014

% pa % pa % pa

Retail Prices Index inflation 3.5 3.4 3.3

Consumer Price Index inflation 2.6 2.5 2.4

Rate of general long-term increase in salaries 5.0 4.9 4.8

Pension increases (excess over guaranteed minimum pension)

2.6 2.5 2.4

Discount rate for scheme liabilities 2.7 3.8 3.6

Mortality assumptions

The mortality assumptions are based on standard mortality tables which allow for expected future mortality improvements. The assumptions are that a member currently aged 65 will live on average for a further 22.6 years if they are male and for a further 23.7 years if they are female.

For a member who retires in 2036 at age 65 the assumptions are that they will live on average for a further 24.2 years after retirement if they are male and for a further 26.5 years after retirement if they are female.

ACCOUNTS 2016


Scheme asset allocation

31 December 2016 31 December 2015

£’000 % £’000 %

Delegated Consulting Service 209,586 98 162,329 98

Other 3,974 2 2,821 2

Total 213,560 100 165,150 100

Reconciliation of funded status to balance sheet

31 December 2016 31 December 2015 31 December 2014

£’000 £’000 £’000

Fair value of assets 213,560 165,150 152,061

Present value of funded defined benefit obligations

(198,851) (142,670) (134,255)

Funded status 14,709 22,480 17,806

Present value of unfunded defined benefit obligation

(1,198) (976) (683)

Asset/(liability) recognised on the balance sheet

13,511 21,504 17,123

Amounts recognised in income statement

Year ending 31 December 2016


Operating cost: £’000 £’000

Current service cost 8,319 9,049

Past service cost – –

Financing cost:

Interest on net defined benefit liability/(asset) (951) (752)

Pension expense recognised in profit and loss 7,368 8,297

The delegated consulting service is a fiduciary management solution that invests in a wide range of underlying assets to meet the scheme's specific investment objectives. The underlying asset allocation changes over time, based on the views of the fiduciary manager within the overall bounds set by the trustees. Under this approach the majority of scheme assets are invested in pooled funds. The managers of the

pooled funds are required to have in place a policy on social, environmental and ethical considerations.

None of the scheme assets are invested in financial instruments or in property occupied by, or other assets used by, the GMC.

ACCOUNTS 2016


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Amounts recognised in Other Comprehensive Income



£’000 £’000

Asset gains/(losses) arising during the year 33,929 224

Liability gains/(losses) arising during the year (44,068) 3,446

Pension expense recognised in profit and loss (10,139) 3,670

Changes to the present value of the defined benefit obligation during the year



£’000 £’000

Opening defined benefit obligation (DBO) 143,646 134,938

Current service cost 8,319 9,049

Interest expense on DBO 5,432 4,826

Actuarial (gains)/losses on liabilities 44,068 (3,446)

Net benefits paid out (1,416) (1,721)

Past service cost – –

Closing defined benefit obligation 200,049 143,646

Changes to the fair value of scheme assets during the year



£’000 £’000

Opening fair value of scheme assets 165,150 152,061

Interest income on scheme assets 6,383 5,578

Gain/(loss) on scheme assets 33,929 224

Contributions made 9,514 9,008

Net benefits paid out (1,416) (1,721)

Closing fair value of scheme assets 213,560 165,150

ACCOUNTS 2016


Actual return on scheme assets



£’000 £’000

Interest income on scheme assets 6,383 5,578

Gain/(loss) on scheme assets 33,929 224

Actual return on scheme assets 40,312 5,802

17. Honoraria 2016 2015

Trustees £ £

Professor Terence Stephenson (Chair) 110,000 110,000

Dr Shree Datta 18,000 18,000

Lady Christine Eames 18,000 18,000

Professor Michael Farthing 18,000 18,000

Baroness Helene Hayman 18,000 18,000

Professor The Lord Ajay Kakkar* 13,500 18,000

Professor Deirdre Kelly 18,000 18,000

Dame Suzi Leather 18,000 18,000

Professor Jim McKillop 18,000 18,000

Dame Denise Platt 18,000 18,000

Mrs Enid Rowlands 18,000 18,000

Mr Julian Lee† 7,500 18,000 * Professor The Lord Ajay Kakkar demitted as a Council member on 30 September 2016.† Mr Julian Lee demitted as a Council member on 31 May 2016.

Honoraria payments are permitted by the governing document of the General Medical Council, the Medical Act 1983, paragraph 17, schedule 1.

ACCOUNTS 2016


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2016 2015

Medical Practitioners Tribunal Service Advisory Committee members

£ £

His Honour David Pearl* – –

Mr Richard Davies 3,720 3,720

Dr Tim Howard† 1,240 3,720

Dr Patricia Moultrie 3,720 3,720

Professor Jacky Hayden‡ 1,240 –

Mrs Judith Worthington 3,720 3,720

* His Honour David Pearl is the Chair of the MPTS and is paid as an employee. His remuneration is included in note 6 of these accounts.

He stepped down on 31 December 2016 and has been replaced by Dame Caroline Swift who took up the role on 1 January 2017.† Mr Tim Howard demitted as a member on 29 April 2016.‡ Professor Jacky Hayden was appointed on 1 September 2016.

2016 2015

Audit and Risk Committee co-opted members £ £

Ms Elizabeth Butler 1,705 1,395

Mr John Morley 2,170 1,240

2016 2015

Investment Sub-Committee co-opted members £ £

Mr Tim Scholefield 1,395 2,480

Mr Jason Britton* – 2,480

Mr Keith Mackay† 620 –

Mr Jeremy Beckwith† 310 –

* Mr Jason Britton demitted as a member on 1 November 2015.† Mr Keith Mackay and Mr Jeremy Beckwith were appointed on 1 September 2016.

ACCOUNTS 2016


18. Travel and subsistence expenses claimed in 2016

2016 2015

Trustees £ £

Professor Terence Stephenson (Chair) 16,080 12,008

Dr Shree Datta 621 808

Lady Christine Eames 6,791 5,689

Professor Michael Farthing 296 113

Baroness Helene Hayman 300 265

Professor The Lord Ajay Kakkar* – –

Professor Deirdre Kelly 3,027 1,657

Dame Suzi Leather 3,727 4,153

Professor Jim McKillop 6,769 5,937

Dame Denise Platt 157 610

Mrs Enid Rowlands 1,493 311

Mr Julian Lee† 595 2,469 Total 39,856 34,020

* Professor The Lord Ajay Kakkar demitted as a Council member on 30 September 2016.† Mr Julian Lee demitted as a Council member on 31 May 2016.

Medical Practitioners Tribunal ServiceAdvisory Committee members

2016 £

2015 £

His Honour David Pearl* 5,050 679

Mr Richard Davies 539 543

Dr Tim Howard† 403 890

Dr Patricia Moultrie 1,586 382

Professor Jacky Hayden‡ – –

Mrs Judith Worthington 731 581 * His Honour David Pearl stepped down as Chair of the MPTS on 31 December 2016 and has been replaced by Dame Caroline Swift who took

up the role on 1 January 2017.

† Mr Tim Howard demitted as a member on 29 April 2016.

‡ Professor Jacky Hayden was appointed on 1 September 2016.

ACCOUNTS 2016


ABOU

T US

DELIV

ERING

OU

R CO

RPORATE STRATEG

Y 2014–17

DELIV

ERING

OU

R ROLE

OUR STRUCTURE,

GO

VERNAN

CE AND

M

ANAG

EMEN

T

AUDIT AND RISK

COM

MITTEE REPO

RT

REFERENCE AN

D

ADM

INISTRATIV

E IN

FORM

ATION

ACCOU

NTS 2016

2016 FINAN

CIAL REVIEW

Audit and Risk Committee co-opted members2016

£2015

£

Ms Elizabeth Butler 221 37

Mr John Morley 209 14

Investment Sub-Committee co-opted members

Mr Tim Scholefield – 182

Mr Jason Britton* – 936

Mr Keith Mackay† 68 –

Mr Jeremy Beckwith† 9 –

* Mr Jason Britton demitted as a member on 1 November 2015.† Mr Keith Mackay and Mr Jeremy Beckwith were appointed on 1 September 2016.

2016 2015

Senior Management Team £ £

Charlie Massey – Chief Executive* 1,915 –

Niall Dickson – Chief Executive* 22,013 29,061

Susan Goldsmith – Chief Operating Officer and Deputy Chief Executive 12,048 6,109

Paul Buckley – Director of Strategy and Communication 5,322 2,805

Judith Hulf – Senior Medical Advisor and Responsible Officer† 5,542 2,675

Vicky Osgood – Director of Education and Standards† – 4,814

Neil Roberts – Director of Resources and Quality Assurance 13,792 14,002

Una Lane – Director of Registration and Revalidation 10,647 8,768

Anthony Omo – Director of Fitness to Practise 11,941 9,884

* Niall Dickson stepped down as Chief Executive and Registrar on 31 October 2016. Charlie Massey took up the role on 1 November 2016. † Judith Hulf, in her capacity as Senior Medical Advisor and Responsible Officer, covered Vicky Osgood's absence, who left the GMC on 30

June 2016.

Colin Melville has been appointed as Director of Education and Standards and started on 1 January 2017.

Variations in expenses reflect that the trustees, committee members and the Senior Management Team live in different parts of the UK and

are required to travel around the UK on GMC business, including to our offices in London, Manchester, Edinburgh, Belfast and Cardiff, and

occasionally outside the UK.

Adjustments are also made for those with disabilities, which may mean that additional expenses are incurred for travel and accommodation

according to specific needs.


REFERENCE AND ADMINISTRATIVE INFORMATION

We are independent of UK government and the medical profession and accountable to Parliament. Our powers are given to us by Parliament through the Medical Act 1983.

We are registered with the Charity Commission for England and Wales (1089278), and with the Office of the Scottish Charity Regulator (SC037750). We are not currently required to be registered separately with the Northern Ireland Charity Commission.

Our principal places of business are 3 Hardman Street, Manchester M3 3AW and Regent’s Place, 350 Euston Road, London NW1 3JN. We also have offices in Belfast, Cardiff and Edinburgh and a centre for hearings, where the MPTS is based, at St James’s Buildings, 79 Oxford Street, Manchester M1 6FQ.

Council is our governing body. Our Council members are also the trustees of the organisation. You can read more about our Council members on page 20.

Our trustees have a duty to act impartially and objectively, and to take steps to avoid any conflict of interest arising as a result of their membership of, or association with, other organisations or individuals. As trustees, members have a duty to avoid putting themselves in a position where their personal interests conflict with their duty to act in the interests of the charity, unless authorised to do so. To make this fully transparent, we publish a register of members’ interests on our website.

Day-to-day management of the organisation is delegated to the Chief Executive and Chief Operating Officer and Deputy Chief Executive. You can read more about our governance and management arrangements on page 20.

We work with the Professional Standards Authority (PSA), an independent body, which is accountable to Parliament and scrutinises and oversees our work, together with other health and social care professional

regulatory bodies in the UK. The PSA concluded that we had met all of their 24 Standards of Good Regulation for 2015–16, as set out in their Performance Review Report.

Information requests

In 2016, we received 394 subject access requests under the Data Protection Act 1998. This was a decrease of 9.4% from 2015. The number of information requests that we received under the Freedom of Information Act 2000 in 2016 was 757. This was a 0.4% decrease from 2015.

n We achieved 84.9% against our target of responding to 80% of subject access requests within 40 days.

n We achieved 92.2% against our target of responding to 87.5% of freedom of information requests within 20 working days.

Paying for goods and services

We paid 94% of valid and undisputed invoices within 30 days and did not pay any interest to suppliers due to late payment in excess of 30 days.

Professional advisers

Bankers Royal Bank of Scotland 250 Bishopsgate London EC2M 4AA

Solicitors The majority of our legal work is carried out by our in-house legal team.

Auditors Crowe Clark Whitehill LLP St Bride’s House 10 Salisbury Square London EC4Y 8EH

Actuary and pension Aon Hewitt scheme adviser Parkside House, Ashley Road

Epsom, Surrey KT18 5BS

Email: [email protected]: www.gmc-uk.orgTelephone: 0161 923 6602General Medical Council, 3 Hardman Street, Manchester M3 3AW

Textphone: please dial the prefix 18001 then 0161 923 6602 to use the Text Relay service

Join the conversation @gmcuk facebook.com/gmcuk

linkd.in/gmcuk youtube.com/gmcuktv

To ask for this publication in Welsh, or in another format or language, please call us on 0161 923 6602 or email us at [email protected].

Published July 2017

© 2017 General Medical Council

ISBN: 978-0-901458-95-7

The text of this document may be reproduced free of charge in any format

or medium providing it is reproduced accurately and not in a misleading context.

The material must be acknowledged as GMC copyright and the document

title specified.

The GMC is a charity registered in England and Wales (1089278)

and Scotland (SC037750).

Code: GMC/AR2016/0717

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