In the worst cases a doctor may face a criminal conviction and erasure from the register.
Most practitioners and Trusts would not be too shocked to learn that a number of doctors take locum shifts in addition to and outside their regular employed hours. The locum work is undertaken without compromising the regular work and only infrequently is any issue taken by an employer.
A problem does arise however when, with improper purpose, a doctor takes sick leave and undertakes locum work during the time they are supposed to be in ill health. Dr M took a little under a month off purporting to be sick. He self-certified at first then obtained a sick note from his GP for the remaining weeks. During this time he carried out 2 days work at one hospital, 2 days work at another and then undertook 13 shifts at a third hospital. A doctor at one of the hospitals reported Dr M to the GMC, it seems this may have been as a consequence of representations made by Dr M to another doctor.
Prior to the GMC investigation Dr M was convicted of committing fraud contrary to sections 1 and 2 of the Fraud Act 2006, he had dishonestly made a false representation and gained sick pay he was not entitled to. He pleaded guilty and was sentenced to a community order of 100 hours unpaid work, a victim surcharge of £85 and a collection order – by which he paid all the money back.
In the later MPTS proceedings there was evidence of a degree of pre-planning by Dr M in arranging the shifts. During the investigation he had sent a chronology to the GMC where he had omitted mentioning some of the locum work he had carried out. The explanation he worked lots of shifts in lots of places and the omission was accidental was not accepted by the Tribunal, they took it as another attempt to mislead and they reasoned some note of shifts would have been kept to ensure payment was made.
The Tribunal found that the dishonesty was varied, persistent and over a period of time. There was the initial misleading of the Trust, there was an inaccurate chronology sent to the GMC and additionally Dr M had not disclosed on an employment application form that he was being investigated and subject to conditions.
There were numerous mitigating factors considered by the Tribunal: Dr M was remorseful, admitted the facts relating to dishonesty, apologised, paid all the money back, never repeated the misconduct, his patients and colleagues provided positive feedback, he was a safe clinician and there was a degree of insight. Despite this, and the fact that it was pleaded erasure would be financially catastrophic to Dr M who had a family which would be rendered destitute, the Tribunal erased Dr M from the register. They decided erasure was necessary to uphold proper standards of the profession.
Dr M’s case is at the more serious end of the spectrum and so he faced the serious legal consequences. There will be those lesser cases, with an isolated act or mitigating factors when such serious proceedings are unwarranted. Seeking early advice on how to deal with these issues can be crucial. Not only will there be regulatory and potential criminal consequences but employment issues can also arise. If you have any queries on these and locum issues please do contact us for advice directly, these general points are fact specific to Dr M’s case, we will be pleased to speak with you about any specific concerns.