MPTS acknowledges ‘stress and workload’ in decision to suspend GP who drank on the job

An MPTS tribunal has taken into account stress and workload as mitigating factors in the decision to suspend a GP who consumed alcohol at work.

Dr Catherine Aspinall consumed alcohol in February last year while she was working as a GP at Westway Medical Centre, near Liverpool, and treated ‘one or more patients’ while under the influence of alcohol, the tribunal heard.

She was suspended for three months as the tribunal noted that at the time of the incident she was stressed and working long hours while sleep deprived.  

As the hearing took place, Dr Aspinall’s patients started a petition asking the GMC to consider ‘the excessive level of stress’ that GPs face when dealing with misconduct cases and implement ‘a more compassionate and supportive approach’ that takes into account the underlying stressors faced by GPs.

The tribunal’s record of determination said: ‘Following a concern raised with reception staff by a patient who had just come out of a consultation with her, the practice manager entered Dr Aspinall’s room to find Dr Aspinall intoxicated and unable to stand.

‘Dr Aspinall was noted to smell strongly of alcohol and was unable to have a coherent conversation.

‘She was asked whether she had drunk any wine and she indicated that she had drunk a few sips that morning.

‘As a result of this Dr Aspinall was suspended from all duties at the medical centre for four weeks, in order to allow for an internal investigation.’

Dr Aspinall provided her own witness statement during the hearing and gave oral evidence, where she detailed ‘the stress she was under at the time of the events’ and that she ‘intends to remain abstinent from alcohol’.

When considering the appropriate period of suspension, the tribunal noted ‘the significant mitigating factors’ and that no further remediation would need to be demonstrated during the period of suspension.

It bore in mind ‘the evidence of good insight’ and ‘extensive remediation provided by Dr Aspinall’, that there was a low risk of repetition and as such she did not present a risk to patient safety.  

The tribunal also considered that Dr Aspinall has remained abstinent from alcohol and ‘has been employed without issue since then’.

The record added: ‘The tribunal also noted the personal circumstances of Dr Aspinall at the time which included struggling to manage her workload and working long hours whilst being sleep deprived.

‘The tribunal considered that Dr Aspinall has good insight and appears to have coped by working part-time at a supportive practice.

‘Due to her significant insight, remediation, change in personal circumstances and employment of better coping mechanisms, the tribunal was satisfied that she can now pick up signs of stress at an earlier stage and take remedial action, meaning the risk of repetition is low.’

When considering aggravating factors, the tribunal took into account that Dr Aspinall had received a warning from the GMC in 2016 for a drink driving conviction, and that this was not the first time therefore that Dr Aspinall ‘had come to the attention of the GMC for reckless behaviour that endangered the public following consumption of alcohol’.

The tribunal also bore in mind that Dr Aspinall ‘did not raise concerns about her lack of ability to work in a manner that kept patients safe, and that her misconduct involved intoxication in the workplace’.

‘This demonstrated a reckless approach to patient safety which undermines public confidence in the medical profession,’ the record added.

Suzanne Gordon, who started the petition, said that patients who have benefited from Dr Aspinall’s ‘dedicated care and expertise’ understand that being a GP is ‘an incredibly demanding profession’.

The petition said: ‘By providing GPs with access to confidential counselling services, stress management programs, and other support mechanisms, we can help them navigate the challenges they face without resorting to harmful coping strategies.

‘This approach will not only benefit doctors but also ensure the continued provision of high-quality healthcare services to our community.

‘We implore the GMC to review its current practices and policies regarding misconduct cases involving alcohol use by GPs.

‘We urge you to consider implementing a more compassionate and supportive approach that takes into account the underlying stressors faced by these professionals.’

Dr Lizzie Toberty, GP chair for the Doctors’ Association UK, told Pulse: ‘It’s really moving that even our patients can see the stress GPs are under. There is of course help available via the NHS Practitioner Health programme but this is not addressing the cause of these problems.

‘We agree with these patients – the GMC must recognise the context within which transgressions take place.

‘Doctors’ Association UK believe the problems with clinician mental health issues are deeply linked to the underfunding of primary care.

‘Whenever unfunded work is pushed into primary care, there is no one to do it but the GP. The cost is not financial, the cost is the GP’s mental health when the strain of providing for too many patients in a broken health service gets too much.

‘We need a properly funded primary care service where GPs are valued health care professionals. This would go a long way to help prevent such cases.’

Dr Zaid Al-Najjar, medical director at NHS Practitioner Health told Pulse: ‘We have become aware of the recent case where the MPTS have suspended a GP who was found to have been under the influence of alcohol whilst at work.

‘We were heartened to hear of the warm support she has since received from her patients following the MPTS determination.

‘We always advocate for a supportive rather than punitive approach by regulatory bodies in such cases.

‘Sadly, we are all too familiar with the health impact that periods of prolonged stress in demanding roles like primary care can have on practitioners and it is important that services like NHS Practitioner Health continue to be able to provide support and treatment when needed.’

In January, Pulse reported that a growing number of GPs were seeking support from NHS Practitioner Health for the first time because of ‘ongoing pressures’ on the NHS. 

Meanwhile, in 2017 a Pulse survey suggested that one in nine GPs has turned to alcohol because of work pressures, while 6% have turned to prescription drugs.

The GMC declined to comment.