Trustees Annual Report and Accounts 2013

Transcription

1 21 May 2014 Council 5 To consider Trustees Annual Report and Accounts 2013 Issue 1 To consider the Trustees Annual Report and Accounts for Recommendations 2 Council is asked to: a Approve the Trustees Annual Report and Accounts for b Approve the Letter of Representation. c Authorise the Chair of Council to sign the Annual Report and Accounts for 2013, and the Letter of Representation, on its behalf.

2 Trustees Annual Report and Accounts 2013 Issue 3 We are required to produce an Annual Report and Accounts that complies with the Statement of Recommended Practice (SORP) approved by the Charity Commission in The Annual Report and Accounts must be submitted to the Charity Commission and the Office of the Scottish Charity Regulator within ten months of the year end. 5 The Annual Report and Accounts was considered by the Performance and Resources Board at its meeting on 10 April 2014, and by the Audit and Risk Committee on 29 April The Report, at Annex A, reflects the changes requested by the Committee. 6 The external auditor Crowe Clark Whitehill requires us to provide a Letter of Representation, at Annex B, covering the Trustees responsibilities in producing the financial statements. Through discussions with the external auditor, the Director of Resources and Quality Assurance, and the Assistant Director for Finance and Procurement, the Audit and Risk Committee satisfied itself that the accounts were properly prepared and were in accordance with applicable law, regulations and accounting standards. The Committee considered the Audit Findings Report from Crowe Clark Whitehill which confirmed that the external auditor was satisfied in respect of audit and accounting matters, and that no significant weaknesses in financial systems and controls were identified. 7 The Annual Report and Accounts, and the Letter of Representation, must be signed and dated by one or more Trustees authorised to do so Annual Report 8 The Annual Report begins by highlighting the most significant activities undertaken and the outcomes achieved in It then sets out in more detail what we have delivered against the objectives outlined in our 2013 Business Plan. It focuses on outcomes and highlights operational performance, achievements and developments against each of the strategic aims from the Corporate Strategy The Report also sets out: a A summary of our priorities for 2014, against the new strategic aims from our Corporate Strategy b A review of our financial performance, including our reserves policy and investment policy. 2

3 c Our approach to risk management. d Structure, governance and management arrangements. e The 2013 accounts, principal accounting policies and notes to the accounts. 10 At its meeting on 29 April 2014, the Audit and Risk Committee asked that a number of changes be made, and these are now incorporated in the Report Annex A. In particular, we have: a Added a summary at the start of the document, capturing a year in numbers for 2013 b Expanded the narrative on our public accountability. 11 We also undertook to consider opportunities to present some of the content in a more graphical format to improve the readability of the document. Our design team have reviewed how best to make the changes and implemented as much as possible in the time available. The most up to date version of the Annual Report is attached at Annex A and any outstanding graphical content will be included at final formatting stage. 12 The Annual Report and Accounts will be subject to final proof-reading and formatting before being finalised for publication. Draft 2013 Accounts 13 We continued our programme to improve our performance and achieved new efficiency gains of 2.2 million in In addition, we generated continuing efficiency gains of 15.4 million from major projects started before 2013 which deliver gains over several years. We have therefore achieved total annualised efficiency gains of 17.6 million in Of this, around 15 million is cashable savings, which helped us to freeze the registration fees and annual retention fee at the current level. 14 In 2013, we generated total income of 95.4 million, and our operational expenditure was 91.7 million. Further details are set out in Annex A. 15 Based on our analysis of cash flows and the risks facing the organisation, our policy is to maintain free reserves within the range of 25 million to 45 million. However, we recognise that level of reserves will inevitably fluctuate year on year, reflecting variations in actual levels of income and expenditure compared with budget. Our policy is to maintain actual free reserves in line with the target level over the medium term. 16 Our free reserves on 31 December 2013 were 42.3 million, which is within the target range. 3

4 17 At its meeting on 10 December 2013, Council agreed to freeze the registration fees and annual retention fee at the current level. We estimate that our free reserves at the end of 2014 will be around 40.3 million. 4

5 Supporting information How this issue relates to the corporate strategy and business plan 18 The Annual Report and Accounts summarises our performance, achievements and developments under each of our strategic aims. 19 Specifically, the publication of the Annual Report and Accounts demonstrates our commitment to make best use of our resources. Other relevant background information 20 Following Council s approval of the Annual Report and Accounts, we will submit them to the Privy Council, the Charity Commission, and the Office of the Scottish Charity Regulator. They will also be published on our website. 21 The Annual Returns and Summary Information Returns will be submitted to the Charity Commission and the Office of the Scottish Charity Regulator. If you have any questions about this paper please contact: Jane Malcolm, Assistant Director Office of the Chair and Chief Executive, jmalcolm@gmc-uk.org, ; or Steve Downs, Assistant Director Finance and Procurement, sdowns@gmc-uk.org,

6 5 Trustees Annual Report and Accounts 2013 Annex A Annual Report and Accounts 2013 A1

7 Annual report 2013 Trustees annual report and accounts for the year ended 31 December 2013

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9 Contents Our purpose 02 Review of Some highlights of the year 04 The year in numbers 06 Delivery against our business plan for Protecting the public 07 Strategic aim 1 07 Strategic aim 2 09 Helping doctors 13 Strategic aim 3 13 Strategic aim 4 15 Working with partners 16 Strategic aim 5 16 Strategic aim 6 18 Delivering value for money 21 Strategic aim 7 21 Strategic aim 8 22 Looking forward to financial review 28 Our total income and expenditure 29 for 2013 Trustees responsibilities for the 30 financial statements Reserves policy 31 Investment policy 32 Audit and Risk Committee s report 33 Risk management statement 34 Structure, governance and management 35 Organisational structure 36 Learning from our Reference 37 Community Induction and training of new trustees 38 Our governance model in Audit and Risk Committee 38 Remuneration Committee 38 Strategy and Policy Board 39 Performance and Resources Board 39 Board of Trustees of the GMC s 39 Superannuation Scheme Education and Training Advisory Board 40 UK Advisory Forums 40 Medical Practitioners Tribunal Service 40 Member attendance at Council, 41 Boards and Committees in 2013 Management 43 Professional advisers 44 Independent auditors report to the 45 trustees of the General Medical Council Accounts Acronyms 69 1 General Medical Council

10 Our purpose The General Medical Council (GMC) is the independent regulator for doctors in the UK. Our statutory purpose is to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine. Our current powers and duties are set out in the Medical Act 1983 (as amended) and in our statutory rules and regulations.

11 1 We help to keep patients safe in the UK by making sure that doctors practise medicine safely and effectively. We do this by: a setting standards for medical education and training and for medical practice b making sure only those doctors who ve shown they can meet our standards can practise medicine in the UK and by keeping a publicly searchable register of these doctors c making sure doctors continue to meet these standards throughout their careers and helping them to do so d taking action when we receive information that a doctor isn t meeting these standards for example, by removing their right to practise medicine in the UK. 2 Every patient should receive a high standard of care. Our role is to help achieve that by working closely with doctors, their employers and patients, making sure that the trust patients have in their doctors is fully justified. 3 As a registered charity (number with the Charity Commission for England and Wales, and number SC with the Office of the Scottish Charity Regulator), we have to show that our aims are for public benefit. Our trustees follow the Charity Commission s guidance and confirm that our aims and objectives, as set out in our Corporate strategy , are for public benefit. The trustees have complied with their duty to have regard to the Charity Commission guidance on public benefit in exercising their powers and duties. 4 Our corporate strategy sets out how we will improve the quality of healthcare and enhance patient safety through effective medical regulation was the final year of our Corporate strategy , and the culmination of our work towards the strategic aims included within it. We launched our new Corporate strategy on 30 January It sets out how we ll continue to adapt to remain relevant to patients and doctors over the next four years in an increasingly challenging external environment. 3 General Medical Council

12 5 We are also accountable to the Parliamentary Health Select Committee for our performance and work with the Professional Standards Authority, the independent body accountable to Parliament which scrutinises and oversees our work, together with other health and care professional regulatory bodies in the UK. 6 More information on our Corporate strategy , our Equality and diversity strategy and our Business plan 2014 can be found at paragraphs and are available at 7 This report looks at how we delivered in 2013 against the strategic aims from the Corporate strategy This strategy has eight strategic aims set across four themes, which reflect the integrated approach we take to delivering our statutory functions, and the importance we place on engaging and working with others in the interests of patient safety. 8 Our trustees regularly monitor and review our success in meeting these strategic aims. The trustees confirm that these aims fully meet the public benefit test and that all the activities described in this report are undertaken in pursuit of these aims. In this report, we set out the activities we undertook in 2013 to benefit the public. General Medical Council 4

13 Strategic aim 1: To continue to register only those doctors that are properly qualified and fit to practise and to increase the utility of the medical register. 01 Strategic aim 2: To give all our key interest groups confidence that doctors are fit to practise. 02 PROTECTING THE PUBLIC Strategic aim 4: To provide 03 doctors with relevant up-todate guidance on professional HELPING standards DOCTORS and ethics. Strategic aim 6: To help shape the local, 04 UK, European and international regulatory environment through effective engagement WORKING with decision makers, other regulators and key WITH interest groups. PARTNERS Strategic aim 8: To deliver evidence-based policies that demonstrate better regulation principles, and promote and DELIVERING support diversityḍraft equality and VALUE FOR MONEY Strategic aim 3: To provide an integrated approach to the regulation of medical education and training through all stages of a doctor s career. Strategic aim 5: To develop more effective relationships with delivery partners in order to achieve an integrated approach to medical regulation in the UK. Strategic aim 7: To continue to use our resources efficiently and effectively. 5 General Medical Council

14 Review of 2013

15 Some highlights of the year A successful first year for revalidation 9 Revalidation was introduced in December 2012, to improve patient safety and the quality of care provided by doctors through a system of regular checks. By continuing to work with our key partners, including the NHS and four UK health departments, revalidation had a successful first year. In 2013, we processed revalidation recommendations for 33,047 doctors; 99.78% of the number we d anticipated to receive for this period. We expect to cover the majority of licensed doctors in the UK for the first time by March It s important that we understand the impact of the introduction of revalidation during 2013, we worked with others on the Revalidation Implementation Advisory Board to gather views and experiences from doctors, employers and patients. We also developed a framework for evaluating the longer term impact of revalidation on medical practice and the quality of care provided to patients. Our response to the Mid Staffordshire report 11 In February 2013, we welcomed the publication of the final report of the public inquiry into failures of care at Mid Staffordshire NHS Foundation Trust, led by Robert Francis QC. The Francis report recognised many of the steps we have already taken to help make healthcare safe for patients, including revalidation. But it also made clear that there is more work for us to do with others in the healthcare system to reduce risks to patients. Preparing doctors for changing healthcare needs 12 Challenges in today s healthcare environment, including an ageing population and increasingly complex conditions, mean that doctors need to be able to deliver care in a range of different settings. In October 2013, the final report of an independent review into potential reforms to the structure of postgraduate medical education training, the Shape of Training review, was published. The review was overseen by a joint sponsoring board, which included the GMC. The final report sets out an approach to make sure doctors are prepared for changing patient and service needs. We will take this approach forward, with other key partners, across the UK over the next few years. 7 General Medical Council

16 Improving fitness to practise procedures 13 Fitness to practise investigations can be highly stressful, both for the people raising a concern the complainants - and the doctors involved. In 2013, we continued to pilot meetings with individuals from both groups. The aim of the meetings is to promote information sharing with complainants and doctors earlier in the process, and to make sure that everyone understands how an investigation works. An independent evaluation report will be published in In 2013, we also made a number of improvements to our adjudication processes so that in some cases, the length of hearings can be shortened, to reduce stress involved. For example, witnesses don t always need to attend hearings in person. These improvements were made possible by changes on which we consulted in 2012 to the General Medical Council (Fitness to Practise Rules) 2004, which govern fitness to practise hearings and investigations. New events to support doctors new to the UK 15 We want to increase the support we give to doctors who are new to practice in the UK. In 2013, we piloted a series of events called Welcome to UK Practice. These aim to increase attendees awareness of our core guidance for doctors, Good medical practice, and the cultural context of the UK healthcare system. Doctors from more than 20 countries attended these events, which took place across the UK. We had positive feedback from the events, so will roll out a programme to support doctors who are new to practising in the UK in General Medical Council 8

17 924 calls Our Employer Liaison Service held 1,400 meetings with responsible officers and their teams. 73 % were made to our confidential helpline for doctors to raise concerns about patient safety of doctors who gave feedback said they would change their practice following our professional standards sessions we registered 20,878 new doctors 97.7 % of doctors in training completed our annual national training survey We made 2.2 million of new efficiency gains 9 General Medical Council

18 Delivery against our business plan for 2013

19 Protecting the public Strategic aim 1: To continue to register only those doctors that are properly qualified and fit to practise and to increase the utility of the medical register. 16 In 2013, we granted 20,878 registration applications, 6,636 certification applications and 681 licence restorations. We responded to 100% of registration applications within five working days. We also completed 99% of Certificate of Eligibility for Specialist Registration (CESR) and Certificate of Eligibility for GP Registration (CEGPR) applications within three months. Our performance in relation to CESR and CEGPR applications in 2013 is a significant improvement on our performance in In 2013, our Specialist Applications team delivered ten sessions of training to over 150 medical royal college and faculty CESR evaluators. These are senior clinicians who evaluate applications and make recommendations for entry to the Specialist Register on our behalf, through a contractual arrangement with the medical royal college and faculties. This training contributed to the improved quality of recommendations, and allowed us to issue decisions on 99% of applications within the three month legal deadline throughout An award for our customer service 18 Our Manchester-based contact centre responded to 197,217 calls and 87,493 s and letters. The implementation of revalidation signalled a change in our engagement with doctors and this was reflected in the enquiries we received through our contact centre. In response to campaigns through the year, enquiries have become increasingly lengthy and complex. This extended the average call length and the volume and complexity of s, which had an impact on our ability to consistently meet our service targets. Despite this, our commitment to providing excellent customer service was recognised in a national award scheme, the Top 50 Companies for Customer Service. We were placed sixth overall in the call enquiry category. 11 General Medical Council

20 19 We received 503 subject access requests made under the Data Protection Act 1998, and 856 information requests made under the Freedom of Information Act Registration performance against targets in % 99 % To respond to 95% of applications within five working days. 86 % Despite a significant increase in the number of subject access requests we received, we met the targets we set ourselves to deliver timely responses. To complete 95% of Certificate of Eligibility for Specialist Registration (CESR) and Certificate of Eligibility for GP Registration (CEGPR) applications within three months. Information access performance against targets in % To respond to 80% of subject access requests within 40 calendar days. To respond to 87.5% of freedom of information requests within 20 working days. General Medical Council 12

21 Contact Centre performance against targets in % To answer 90% of calls within 15 seconds. 71 % To answer 95% of s and letters within five working days. 98 % To see 95% of doctors visiting reception within ten minutes of their arrival. 98 % To see 95% of doctors visiting reception 13 General Medical Council

22 Strategic aim 2: To give all our key interest groups confidence that doctors are fit to practise. Fitness to practise 20 In 2013, we processed 9,895 concerns that we received about doctors fitness to practise. While this reflected a 4% decrease on 2012, we opened 9% more stream 1 (more serious) cases and 26% fewer stream 2 (less serious) enquiries. 21 We responded to the increase in serious cases by recruiting more staff, improving the management of individual cases, and improving the training and support for new and existing members of staff. These measures have made sure that, despite the overall rise in volumes, we continue to meet our service targets to maintain the timeliness of our decisions. An independent audit by the Professional Standards Authority (PSA) confirmed that the quality of our decisions remains high. 22 We acted on the recommendation of the House of Commons Health Select Committee in December 2012 to set a target to conclude 90% of all complaints received within 12 months. This replaced the previous 15-month target. We have met this new target consistently since it was introduced in September During 2013, we completed two projects to improve the speed and efficiency of our fitness to practise processes, using the Lean process review methodology. The first of these focused on our initial complaints handling process known as triage. The second focused on streamlining and removing duplicated effort within our case review process. General Medical Council 14

23 New ways to raise concerns 24 At the end of 2012, we launched our confidential helpline for doctors to raise concerns about patient safety, especially when they feel unable to do this at a local level. During 2013, its first year, the helpline received 924 calls. These calls led to 132 fitness to practise enquiries and 65 investigations. 25 We ve also made it easier for patients and the public to raise concerns. In October, we launched a new, easier-to-use, online complaints form, which lets complainants give more-detailed information. This means we re less likely to have to ask them for further information, and will be able to process their complaint quicker. We ve also introduced three downloadable versions of the form, so that people can access the complaints form in easy read and Word formats, to complete and submit by post. 26 We continued to pilot face-to-face meetings with doctors who are the subject of a fitness to practise investigation to see if this can improve our understanding of cases. We also wanted to see whether, in some instances, the meetings could reduce the time taken to conclude cases. 27 The pilots involved meeting with a sample of doctors at the end of our initial investigation. The aim was to encourage doctors to share information at this stage, and determine where it would be appropriate to issue a sanction to protect the public, instead of a public hearing. We have commissioned an independent evaluation of the pilot and will analyse the results in summer In September 2013, we also began a pilot of meetings with individual members of the public who have raised a concern. These are designed to allow us to increase the support we offer at what can be a very stressful time, by making sure we fully understand complainants concerns. It also gives us an opportunity to explain our role, the investigation process and, later, the outcome of the case. So far, feedback indicates that the meetings can reduce the isolation that people can feel within the fitness to practise process. A report of an independent evaluation of the pilot will be published in General Medical Council

24 Fitness to practise performance against targets in % 90 % To conclude 90% of fitness to practise cases within 12 months * 95 % To conclude or refer 95% of cases at the investigation stage within 12 months 93 % To conclude or refer 90% of cases at the investigation stage within six months 100 % To review 100% of doctors with conditions or undertakings attached to their registration before being returned to unrestricted registration To start 100% of Investigation Committee hearings within two months of referral * From September 2013 (our target for January August 2013 was to conclude 90% of fitness to practise cases within 15 months, against which we achieved 96%). Two out of 29 cases missed the target. General Medical Council 16

25 Medical Practitioners Tribunal Service (MPTS) 29 We launched the independently chaired and operated MPTS in June In 2013 its first full year, it made independent decisions in more than 2,000 interim orders panel hearings and more than 330 fitness to practise panel hearings. 30 The MPTS has continued its programme of reform, with the intention of creating a modern and efficient adjudication service. In 2012, we consulted on changes to the General Medical Council (Fitness to Practise Rules) 2004, which govern fitness to practise hearings and investigations. In May 2013, these changes were brought in, which has let us make a number of improvements to how MPTS hearings are run. MPTS performance against targets in The rule changes include a number of improvements which can reduce the length of hearings and stress involved for witnesses. Signed witness statements can now be accepted as evidence-in-chief, when a case is disclosed at the outset. In some cases, this removes the need for witnesses to attend hearings in person. Where witnesses do need to attend, we can now tell them so in advance, which reduces the amount of time they have to spend on call. 32 The rule changes have also let us make use of telephone and video evidence where parties agree. This has increased the range of options for witnesses, potentially reducing travel time and anxiety. 96 % 100 % To start 90% of panel hearings within nine months of referral To start 100% of interim orders panel hearings within three weeks of referral 17 General Medical Council

26 33 In December 2013, we completed a project to improve our use of hearing resources, using the Lean process review methodology. Once the changes to our case management procedures become business as usual, we expect to reduce the amount of time it takes to schedule a hearing by up to three weeks. Revalidation 34 Revalidation is the process by which all licensed doctors are required to demonstrate on a regular basis that they are up to date and fit to practise. It was introduced in December During 2013, the first full year of revalidation, we received 33,047 revalidation recommendations for doctors from a variety of backgrounds and practices across the UK, and are on track to cover the majority of UK doctors by March We processed 98% of revalidation recommendations within five working days, which exceeded the 95% target we set ourselves. 36 The introduction of revalidation was a shared responsibility involving the four UK health departments, the NHS and other healthcare providers, the medical royal colleges and faculties, responsible officers and doctors. We continued to work closely with our key partners during 2013 to make sure the process was introduced smoothly. Assessing the progress of revalidation 37 We established the Revalidation Implementation Advisory Board (RIAB) in March 2013 to provide oversight of the implementation of this new process and to give us insight and advice on how well revalidation is working. Membership includes representatives from patient groups, doctors, responsible officers, the medical royal colleges and faculties and the four UK health departments. 38 We continued to hold meetings of our Responsible Officer Reference Group, which was launched in Bringing together responsible officers from across the UK, this group lets us share our thinking and draw on the experiences of medical leaders to support revalidation. In 2013, we launched the Medical Staffing Reference Group, to focus on the crucial role employers have in supporting revalidation. General Medical Council 18

27 39 We re committed to understanding the longer-term impact of revalidation. As such, we commissioned the development of an evaluation framework in 2013 to help shape our future evaluation. We also continue to work with patient organisations to raise awareness of revalidation and the role patients can play in giving feedback. 40 We continued to work with doctors throughout 2013 to understand their practice circumstances and their plans for their revalidation. The Health and Social Care Act 2012 came into effect on 1 April 2013, introducing substantial changes to the way the NHS in England is organised with consequent changes to how doctors are connected to a responsible officer to support their revalidation. 41 We worked with the Department of Health (England), Health Education England, employers and doctors to manage the transition to make sure that our systems accurately reflected the changes. We ve also carried out a series of targeted campaigns with doctors who do not have a connection to a responsible officer, to outline their options for revalidation and to ask them to choose the option best suited to their circumstances. 19 General Medical Council

28 Helping doctors Strategic aim 3: To provide an integrated approach to the regulation of medical education and training through all stages of a doctor s career. Shape of Training review 42 In October 2013, the final report of an independent review into potential reforms to the structure of postgraduate medical education and training, Shape of Training: Securing the future of excellent patient care, was published. 43 The review was overseen by a joint sponsoring board, consisting of the Academy of Medical Royal Colleges, the Conference of Postgraduate Medical Education Deans of the UK, Health Education England, the Medical Schools Council, NHS Education Scotland, Wales Deanery and the Northern Ireland Medical and Dental Training Agency and the GMC. 44 The Shape of Training review began in March The purpose of the review was to make sure that we continue to train doctors who are fit to practise in the UK, are able to meet patient and service needs, and provide safe and high quality care. The report s recommendations will help doctors to continue to meet patient and service demands now and in the future. Findings from the final report 45 The Shape of Training review found that challenges in today s healthcare environment, such as an ageing population and increasingly complex conditions, mean that doctors need to be capable of providing general care in broad specialities, across a range of different settings. General Medical Council 20

29 46 The final report sets out an approach to make sure doctors are trained to the highest standards and are prepared to meet changing patient and service needs. We are committed to taking forward the recommendations with other key partners across the UK in a carefully planned implementation phase. 47 The final report identified the concept of credentialing as a potential way for doctors to enhance their careers and demonstrate additional expertise in areas of sub-specialty practice. The process of credentialing would involve formal accreditation of attainment of competence in a defined area of practice. Credentialing offers a way to enhance patient protection in areas of medical practice, such as cosmetic surgery and forensic medicine, which are currently underregulated. During 2013, we continued our work to develop a regulatory framework to support credentialing. Following a successful workshop in January 2013 to explore ways forward, we established a credentialing working group, which met for the first time in July 2013 and which will report in Our quality assurance processes 48 As part of our quality assurance processes, we make sure that medical schools, postgraduate deaneries, Local Education and Training Boards and local education providers comply with the standards we set for training. One of the ways we do this is through a programme of regional reviews, which includes visits to local education providers. 49 A key part of how we assure the quality of education and training is through a programme of regional visits. In May 2013, we published the report of our review of the London region which we carried out in In December 2013, we completed visits for the review of North West England, which was published in April We also review training themes within specific specialities. During 2013, we carried out thematic reviews of academic training and oral and maxillofacial surgery. 50 Between December 2012 and February 2013, we completed checks on seven local education providers in England and Jersey to review the delivery of training in emergency medicine. Our checks were prompted after we received an increasing number of concerns about education and training in emergency medicine particularly about very junior doctors in training working unsupervised at night. Our report, Medical education s front line, identified seven ways for those involved in training in emergency medicine to improve the quality of training and therefore provide safer care for patients. 51 Throughout 2013, our review of quality assurance continued. We also published a number of position papers and engaged with our key interests groups as our policy developed. We held seminars with the medical royal colleges to discuss their role in quality assurance. We reported on the outcomes of the review of quality assurance of medical education and training in February General Medical Council

30 National training survey 52 Our annual national training survey is a core part of our work to monitor the quality of medical education and training in the UK. We ask every doctor in postgraduate training what they think about the quality of their training. 53 In 2013, we had a particularly high response rate of 97.7%. For the first time, we asked the 39,000 doctors in training who completed both their secondary education and medical degree in the UK five questions about their socioeconomic status. The research and findings will help our work as part of the Selecting for Excellence Executive Group, set up by the Medical Schools Council in March The group is working to make sure a career in medicine is accessible to everyone who has the ability and aptitude to be a good doctor. Tomorrow s Doctors 54 We continued our review of the impact Tomorrow s Doctors (2009), which sets out the outcomes and standards we expect of undergraduate medical education. We published the interim report in August 2013, which identified some key themes, including professionalism and addressing changing healthcare needs. Our final report is due in In 2013, we established the Education and Training Advisory Board to advise on the delivery of undergraduate and postgraduate medical education and training, and career progression. It met twice in 2013, and will meet three times a year from 2014 onwards. More about the governance of the Board can be found at paragraphs General Medical Council 22

31 Strategic aim 4: To provide doctors with relevant up-to-date guidance on professional standards and ethics. New core guidance for doctors and patients 56 In March 2013, we published the fifth edition of our core guidance, Good medical practice, which sets out the standards for every doctor on our register. 57 The guidance took effect in April, when we also launched for the first time, guidance for patients on what they can expect from their doctor. What to expect from your doctor: a guide for patients is available on our website and also in accessible formats. It explains how patients can help create a partnership with their doctor to enhance the standard of their care. This reflects the ambition of the Francis report, which called for patients to be put at the heart of healthcare. 58 Alongside the updated Good medical practice we also published updated versions of several of our explanatory guidance including: n Good practice in prescribing and managing medicines and devices n Doctors use of social media and n When a patient seeks advice or information about assistance to die. 59 During 2013, we reviewed our work on professional standards and ethics. Informed by internal and external engagement, it looked at how we can make sure our guidance remains relevant to doctors at every stage of their career, now and in the future. The final report will be published in summer General Medical Council

32 Working with partners Strategic aim 5: To develop more effective relationships with delivery partners in order to achieve an integrated approach to medical regulation in the UK. 60 Our extensive engagement and communication during 2013 sought to build and maintain relationships with the organisations and individuals who influence our work. Here are some of the key ways we did this. n We held a GMC conference in December 2013, which brought together around 300 people from across healthcare to consider and debate the future of medical professionalism. n We attended and promoted our work at a broad range of events including: n Healthwatch England s first national conference n the Royal College of General Practitioners Annual Primary Care Conference n the NHS Confederation Annual Conference and the British Medical Association s Annual Representative Meeting n The King s Fund Annual Conference n the Patient Safety Congress n National Voices Annual Members Conference and AGM n and two Policy Forum for Wales events: Next steps for end of life and palliative care in Wales; and Integration, primary care and the changing role of the GP. General Medical Council 24

33 n We promoted our new guide for patients, What to expect from your doctor, which we launched in April. n We hosted stands at fresher s fair events at every medical school across the UK and distributed our student news , which now has a circulation of over 15,000 students. n We promoted our messages and built relationships using our online profile, including webinars, online videos and our social media presence. This helped us reach out to doctors, medical students, organisations, and the public through a range of targeted messages and materials. In 2013, we hosted Twitter chats (using the hashtag #GMCchat) and launched our blog on medical professionalism and regulation in the UK. n We participated in the main UK party political conferences. How we ve developed relationships across the UK 61 Our Employer Liaison Service, Regional Liaison Service, and offices in Northern Ireland, Scotland (which has now been open for ten years) and Wales continue to help us develop effective local relationships that foster a better understanding of our role and support intelligence sharing. Through these services we have engaged with employers, patient groups and every UK medical school. 62 We have also developed relationships with the new structures that have emerged from the formation of NHS England, including Healthwatch England, Local Education and Training Boards and Health Education England. 63 Our Regional Liaison Service and offices in Northern Ireland, Scotland and Wales give valuable feedback from doctors and help to embed our work with those who have to implement our standards. They support many aspects of our work, but in 2013 they focused on: n the introduction of revalidation for doctors n helping doctors improve their understanding of our guidance and how it works in the context of their role n engaging with students on professionalism. 25 General Medical Council

34 64 During 2013, we engaged with more than 16,000 doctors on our professional standards through our Regional Liaison Service. Our offices in Northern Ireland, Scotland and Wales have engaged with over 9,000 stakeholders, including more than 1,250 patients and members of the public. 65 Feedback collected by the Regional Liaison Service during 2013 revealed that 73% of doctors who gave feedback said they would change their practice as a result of the session. And 88% of doctors who gave feedback said their knowledge of the GMC had improved. 66 Fully staffed and operational across all four countries since mid-2012, our Employer Liaison Service allows us to have closer working relationships with employers. In 2013, the Employer Liaison Service held 1,400 meetings with responsible officers and their teams, providing support and advice. 67 Feedback from responsible officers collected as part of the Post Implementation Review and Evaluation of the Employer Liaison Service has been overwhelmingly positive 95% of responsible officers said that the Employer Liaison Service enabled good links to responsible officers and supported two-way exchanges of information about underperforming doctors. 68 The Employer Liaison Service also delivered around 30 presentations and events a month. This helped us raise awareness and understanding of fitness to practise and revalidation processes and thresholds, share fitness to practise case-specific information and give updates on the wider work of the GMC. General Medical Council 26

35 Strategic aim 6: To help shape the local, UK, European and international regulatory environment through effective engagement with decision makers, other regulators and key interest groups. 69 The Francis report into the failures at the Mid Staffordshire NHS Foundation Trust was published in February Themes from the public inquiry have influenced our work for some years now and we continued with our programme of reform in In our response to the Francis report, we identified 24 recommendations with specific impact on our work, 17 of which name us directly. In April 2013, we set out our initial response to these recommendations under the themes identified in the report, including how we will take them forward in the context of our programme of reform. In November, we published the first of a series of six-month updates on our progress. 71 During 2013, the government also commissioned six further reviews to inform its response to the Francis report. We worked with the Department of Health (England) and the other regulators to make sure we play our part in helping to promote a more open, patient-focused culture in health and regulation throughout the UK. 72 We have embedded this work through meetings with our Chief Operating Officer and directors, to connect the recommendations with key activities in our business plan. For example, we have made sure that our review of the quality assurance of medical education and training reflects the recommendations. 73 Our new corporate strategy, developed during 2013, also reflects our commitment to taking forward work to improve professional regulation in the light of the Francis report and associated reviews. We have also monitored the progress of the Vale of Leven Hospital and Penrose Inquiries in Scotland and the Hyponatraemia Inquiry in Northern Ireland, all three of which are expected to report in General Medical Council

36 Working closely with other professional bodies 74 The GMC, other professional regulators, systems regulators, medical royal colleges, employers and educators are all part of a wider system committed to improving the quality and safety of care. The Francis report set a clear challenge that we should work more closely together and we are determined to do so. 75 In August 2013, we launched a joint operational protocol with the Care Quality Commission (CQC), as part of a joint working framework to help staff in both organisations work more closely, share information quickly and efficiently, and safeguard patients. The protocol includes six main ways of achieving this. n Routine information sharing. n Local liaison meetings. n Coordination of on-going activities. n Risk summits. n Strategic collaboration n Sharing information on urgent concerns In 2014, we will develop similar agreements with the other systems regulators across the UK. In 2013, we also sat on the CQC s NHS General Practice Advisory Group and Acute Advisory Group. 76 Some further ways in which we collaborated with other professional regulators in 2013 include: n sitting on NHS England s National Quality Board, along with other regulators, and working with the new Regional Quality Surveillance Groups to share intelligence and agree how we can best work together where we believe patient safety may be at risk n providing the secretariat for a forum for education staff at the health professional regulatory bodies to discuss areas of common interest and to share best practice particularly in the development of quality assurance processes and educational standards; General Medical Council 28

37 n hosting quality assurance and operational excellence benchmarking visits from other regulators, including the Nursing and Midwifery Council, General Dental Council and Irish Medical Council n attending quarterly meetings of the Customer Service Network which includes representatives from each of the medical regulators n regular involvement with the Welsh Concordat, which brings together all healthcare regulators that operated in Wales to share good practice. Sharing best practice in European and international medical regulation 77 We continued to engage in the review of Directive 2005/36/EC on the recognition of professional qualifications to make sure the amendments we secured in the early drafts of the proposal were included in the final text. We achieved this through extensive and targeted briefing of key Members of the European Parliament ahead of debates and votes in the relevant European Parliament committees, both directly and with our counterparts in the Alliance of UK Health Regulators on Europe and the Network of Medical Competent Authorities. 78 The new Directive 2013/55/EC has now been adopted and through our engagement with the European Parliament, the European Commission, the Council of Ministers and the UK government, we have secured key safeguards for patient safety in the text on a number of issues, including: n clear provisions that would allow us to check the language skills of doctors who have qualified in the European Economic Area n strengthening the alert mechanism about healthcare professionals who have been removed from practice in other jurisdictions n clarity about the duration of basic medical training. 29 General Medical Council

38 79 We continued to lead the Healthcare Professionals Crossing Borders initiative and held a successful meeting on 31 October 2013, hosted by the Health and Care Professions Council, which attracted over 80 participants to discuss the agreement reached on the Directive at the time. 80 We continued to make progress working with the Department of Health (England) toward making sure that doctors who work in the UK can speak English safely. Both the Department of Health (England) and the GMC consulted on the legal changes we are proposing for new language requirements for EEA doctors to come into force in the summer of We continued to participate actively in the work of the International Association of Medical Regulatory Authorities. As Chair of the Physician Information Exchange Working Group, we are encouraging members to: n endorse a statement of intent on proactive information sharing, which was agreed by the General Assembly at the tenth international conference on medical regulation held in Ottawa, Canada, in October 2012 n enter into memoranda of understanding with each other to make the exchange of information between regulators more effective and efficient. 82 To share our experiences of implementing revalidation with other regulators we: n participated in a round table discussion organised by the Centre d Analyse Stratégique, in Paris on 5 June 2013 n jointly hosted the second International Revalidation Symposium with the Federation of State Medical Boards, in Washington, DC on 7 8 October 2013 n held a workshop on revalidation at the Healthcare Professionals Crossing Borders conference, in London on 31 October 2013 n informed the European Commission Health Directorate General s decision to commission a study into Continuous Professional Development practices across Europe to get a better understanding of the regulatory processes that allow doctors to keep their skills and knowledge up to date. We will contribute to the study in General Medical Council 30

39 Delivering value for money Strategic aim 7: To continue to use our resources efficiently and effectively. 83 We continued our programme to improve our performance and achieved new efficiency gains of 2.2 million in Additionally, we generated continuing efficiency gains of 15.4 million from major projects started before 2013, which will deliver gains over several years. We have therefore achieved total annualised efficiency gains of 17.6 million. Of this, around 15 million is cashable savings, which helped us to freeze the registration fees and annual retention fee at the current level. You can find further information on this in paragraphs Alongside our efficiency programme, we met with regulators of other health professionals through a variety of forums to discuss common issues with our operations to help increase efficiency and effectiveness. Improving benefits for our staff members 85 We implemented significant changes to our pension arrangements. This involved setting up a defined contribution arrangement for new joiners in July 2013 and meeting our auto-enrolment obligations from 1 November The triennial valuation process for the defined benefit scheme was successfully concluded and we supported trustees as they reviewed their investment strategy. 86 We also reviewed our staff benefits provision. We will introduce options to buy and sell leave from April This, alongside our existing policies and the expansion of scheduled homeworking, will further enhance the overall package we offer employees. 31 General Medical Council

40 Strategic aim 8: To deliver evidence-based policies that demonstrate better regulation principles, and promote and support equality and diversity. Research and analysis 87 We published our third State of medical education and practice in the UK report in September The report is part of our continued commitment to share the insights we learn from our own and others data. We use it to engage with the profession and the wider health system. 88 Our 2013 edition focuses on complaints about doctors made to the GMC. By exploring the relationship of these complaints with other datasets, the report improves our understanding of the areas of risk within medical practice. 89 In November, we developed our Research implementation plan for , which signals our areas of research interest for the next four years and establishes a framework for the identification, prioritisation, delivery and evaluation of research. We will publish the key themes from this plan during We use research to inform our strategic direction, foster transparency and confidence in medical regulation, and to support policy making and regulatory development. General Medical Council 32

41 Highlights from our research programme in To inform the development of our registration processes, we completed two studies to review entry points to the profession for international medical graduates. A review of the International English Language Testing System (IELTS) concluded that although the test continues to provide an adequate measure of English language ability, our current requirements should be reviewed with a view to increase the scores needed to pass. 92 In promoting equality and diversity more widely, we know that there are significant differences in the pass rates between different groups of doctor in some specialty examinations (such as the Clinical Skills Assessment examination), and we will commission research to explore this further in Understanding what people think about us can help to inform our policy making and give us evidence to understand its impact. During 2013, we commissioned several studies to help us understand how we are perceived by our key interest groups. This includes a report, delivered in February 2014, which looked at how fair doctors think our processes are for all groups of doctors, including black and minority ethic doctors. We ll use this information to help review our policies and processes to make sure that they are fair and objective for all groups of doctors. 94 Despite our public profile increasing considerably in recent years, research suggests that this has not necessarily translated into a clear public understanding of our function and role. It has been suggested that this may be one factor in the significant rise in complaints we have recently received from the public, and in particular, the rise in complaints that are beyond our remit. This may suggest the need to reconsider how we engage with the public in the context of explaining our role. 33 General Medical Council

42 95 As part of our wider review of health and disability in medical education and training, in 2013 we looked at how medical schools can best support students with mental health concerns. In July 2013, we worked with the Medical Schools Council to jointly launch new guidance to help medical schools provide advice and support to medical students who experience mental health difficulties. We also tested a survey tool to help medical schools better understand their students needs and concerns with regard to key risk factors, helping them to provide more tailored support to their students. We held roundtable meetings with medical students in London, Manchester and Edinburgh to hear their views directly on mental health issues in medical schools. 96 We are committed to understanding the longer-term impact of revalidation and have commissioned a team from Peninsula Schools of Medicine and Dentistry at Plymouth University to develop an evaluation framework. We intend to use the framework to evaluate revalidation from spring Equality and diversity 97 There were six themes for our work on equality and diversity during n Compliance. n Accessibility. n Mainstreaming. n Training. n Research and data. n Developing a diverse workforce. 98 We continued our work to make sure we comply with equality and human rights legislation. For example, we considered the aims of the public sector equality in making decisions and carrying out our main activities, including the review of the Professional and Linguistic Assessments Board (PLAB) test, in developing our proposals to assess the language capability of all doctors, and the review of registration and certification appeals. 99 We also took steps to meet our legal obligations on accessibility. We provided guidance on our approach to making reasonable adjustments when raising a concern. And we launched a more accessible version of our online complaints form. General Medical Council 34

43 100 Each directorate implemented plans to support our corporate commitment to being fair and evidence-based in our approach. These action plans also show how equality and diversity issues are considered throughout our core activities, such as the roll out of revalidation and the review of our guidance for decision makers in our fitness to practise procedures. We commissioned a number of pieces of research, including a survey of 6,000 doctors to understand their views of the professional regulator, and the extent to which they regard us as a fair regulator. 101 Equality and diversity training is mandatory for all of our staff members. In 2013, we relaunched our face-to-face training with a new provider. We continue to provide bespoke training for panellists, education visitors, and other groups of GMC associates. This training focuses on helping them to understand their role in making sure that our activities are fair. 102 We also continued our engagement with a range of networks that represent doctors and patients with protected characteristics. This includes our work with the BME Doctors Forum, the Gender Identity Research and Education Society, the Medical Women s Federation, and groups of refugee doctors. 103 One of our organisational values is We treat everyone fairly. We continue to analyse workforce data in line with our local employment markets and develop steps to address the gaps. Other examples of our work in this area during 2013 include reviewing data on staff members who request flexible working, and quality assuring our pay award to make sure there are no disproportionate outcomes for any group of staff. 104 We are committed to making sure that our website and the guidance we produce are accessible to everyone. All our publications can be made available in alternative formats or languages. We have had a Welsh language scheme since June 2005 and offer services to doctors and the public in Wales in either English or Welsh. 35 General Medical Council

44 Looking forward to 2014

45 105 On 30 January 2014, we launched two new strategies for : our new corporate strategy and our equality and diversity strategy. The Corporate Strategy includes five strategic aims, which will shape our direction over the next few years. These are: n Strategic aim 1: Make the best use of intelligence about doctors and the healthcare environment to ensure good standards and identify risks to patients. n Strategic aim 2: Help raise standards in medical education and practice. n Strategic aim 3: Improve the level of engagement and efficiency in the handling of complaints and concerns about patient safety. n Strategic aim 4: Work more closely with doctors, medical students and patients on the frontline of care. n Strategic aim 5: Work better together to improve our overall effectiveness, our responsiveness and the delivery of our regulatory functions. 106 Our Business Plan 2014 sets out the activities we will do in 2014 to achieve these strategic aims, in addition to our core regulatory functions. 107 Our Equality and Diversity Strategy was developed alongside our corporate strategy. It gives a framework for our work in this area as a regulator and employer, and sets out the key equality and diversity issues for patients and doctors which arise from our activities. 108 Our approach is to make equality and diversity a day-to-day part of the way our core activities are run. We are working towards our ambition of being recognised as a fair regulator and employer, and for our interest groups to be confident that we treat everyone fairly. 37 General Medical Council

46 Continuing our robust checks on doctors 109 We ll continue to support the development of revalidation within the healthcare system, processing revalidation recommendations for nearly 70,000 doctors in An important focus will be supporting doctors to make their prescribed connection to enable them to revalidate, or to tell us when they don t have one. We ll finalise our approach for revalidation for doctors who don t have a connection, so that the system is accessible to all. 110 We expect new legislation to be introduced in summer 2014, which will allow us to ask doctors from the European Economic Area to provide us with evidence that they have the necessary knowledge of English to practise in the UK. This will involve making changes to our registration and licensing processes to make sure they re as robust as possible. General Medical Council 38

47 Changes in the external environment 111 In 2014 we re likely to see progress towards major change in the legal framework that underpins our work. We ll make sure we re ready for the changes, and will work with others so that our new ways of working serve to improve patient safety. 112 We ll continue to take forward the recommendations in the Francis report which affect our work. This will involve working with the Department of Health (England) and other key external organisations to explore the best ways to help enhance patient safety. In April and November 2014, we ll publish updates on our progress. 113 In October 2013, the Shape of Training review set out an approach to make sure that medical education and training in the UK continues to deliver to a high quality and meets the changing needs of patients and the service over the coming years. Some of the recommendations would bring significant change. 114 We will work with partners involved in the review, including the four UK health departments, to develop plans to implement the recommendations carefully. The aim will be to minimise any disruption to trainees and to make sure patient safety remains the priority. Improving the way we deal with patient safety concerns 115 In 2014, we ll make some changes to how we handle complaints and concerns about patient safety. This will include developing our internal processes and our work with others, including responsible officers, to make sure complaints are dealt with by the most appropriate people, and are resolved earlier where this is in the interests of patient safety. 116 We ll also continue to pilot meetings with doctors and patients who are involved in a fitness to practise investigation, with the aim of reducing the stress associated with the process. 39 General Medical Council

48 Working with others and sharing our guidance 117 In 2014, we ll continue to develop our understanding of our key interest groups, and how they perceive us. We ll pilot a trainer survey to complement our annual national training survey, to find out more about the experiences and perceptions of the senior doctors who support doctors in postgraduate training. 118 In summer 2014 we ll also launch an annual tracking survey of doctors, doctors in training, patient representative bodies, patients and the public, which will show us how we and our services are perceived. Insights drawn from our data and intelligence will continue to be published through development of our State of medical education and practice and other reports. General Medical Council 40

49 119 Helping doctors, patients, employers and others understand our guidance and the standards expected of a doctor is a key part of our work. Our liaison services will continue to help achieve this through engagement across the UK. We ll also develop new ways to communicate our guidance, such as smartphone applications. 120 Of course, to achieve all of this we ll need to work well as an organisation and continue to develop new ways of working together effectively. During 2014, we ll develop a people strategy as part of our continued investment in our staff members, their learning and development, their working environment and the information systems and infrastructure that support them. 41 General Medical Council

50 2013 financial review

51 121 We continued our programme to improve our performance and achieved new efficiency gains of 2.2 million in Savings came from a range of initiatives. For example, we: n reduced the costs and volume of hearing transcripts, through a tender process and change of policy n reduced our fitness to practise investigation and hearing costs through a pilot scheme to meet doctors to share information earlier and better this gave us more information, so that cases are not unnecessarily referred for a hearing n reduced our research costs by bringing some project work in-house n minimised our accommodation costs, by introducing scheduled homeworking arrangements. 122 Additionally, we have generated ongoing efficiency gains of 15.4 million from major projects started before 2013 that deliver gains over several years. For example, we: n relocated our adjudication and certification functions, and moved to a single adjudication hearing centre in Manchester n expanded our in-house legal team n introduced digital recording in place of written transcripts at adjudication hearings n reduced the number of panellists who sit on panels n successfully negotiated a rent review on our premises n increased the use of e-communications and reducing the use of paper copy. 123 We therefore achieved a total annual efficiency gain of 17.6 million in Of this, around 15 million is cashable savings, which helped us to freeze the registration fees and annual retention fee at the current level. 43 General Medical Council

52 Our total income and expenditure for In 2013, we generated total income of 95.4 million, and our operational expenditure was 91.7 million. Our income in 2013 reduced by 2.5 million compared to 2012, largely as a result of our decision to freeze the annual retention fee and reduce registration fees for new doctors joining the register. Our expenditure in 2013 increased by 3.3 million compared to 2012, largely as a result of a significant increase in the number of fitness to practise complaints being referred to us for investigation. 125 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 in paragraphs of this report, and our financial performance against budget is summarised below. 126 Our overall income in 2013 was in line with our budget. The introduction of licensing in 2009, and revalidation in 2012, has made accurate forecasting of our income difficult. While the number of registered doctors increased over the year, the timing of doctors joining and leaving the medical register over the year differed from our budget assumptions, and so our income from annual retention fees was around 1.3% less than budgeted. However, this was offset by additional income from other sources, including improved returns on our investment income. 127 Our total operational expenditure in 2013 was 4.7 million under budget. 128 Our fitness to practise costs are a significant proportion of our total expenditure. Our expenditure in 2013 was 0.4 million lower than budgeted, mainly due to staff vacancies in the first half of the year. Also, there were fewer adjudication hearings than planned, so the costs incurred by the MPTS were 1 million under budget. General Medical Council 44

53 129 Registration and revalidation costs were 0.9 million under budget, mainly due to staff vacancies during the year, and some project work being deferred. 130 Our strategy and communication costs were 1.9 million under budget because of staff vacancies during the year and research projects being deferred. 131 Education and standards costs were 0.8 million under budget, due to staff vacancies, lower activity levels on medical school visits and lower than anticipated costs on the Shape of Training review. 132 Resources costs were 0.9 million higher than budgeted. Our actuarial advice costs were higher than budgeted, and we commissioned external advice to help introduce a new defined contribution pension scheme. Staff training costs were higher than budgeted, as we introduced new senior management development programmes and updated and relaunched our existing staff development programmes. Costs were also higher than budgeted due to increased demand for information systems support across the organisation. 133 Accommodation costs were 0.2 million under budget, due to savings secured on rented office space in Manchester, plus negotiated reductions in our electricity charges. 134 Depreciation charges were 0.4 million under budget, reflecting the nature and timing of our capital expenditure during the year. 135 During 2012, we continued our programme of capital investment to improve our accommodation and information systems infrastructure. We spent 7 million on major projects, including the roll-out of scheduled homeworking across the organisation. 136 The triennial valuation of the defined benefit pension scheme at the end of 2012 showed a deficit of 4.7 million, so we made a one-off contribution of 5.85 million at the end of 2013 to the scheme to eliminate this deficit. Following a better than expected return on assets, the scheme ended the year with a surplus of 9.3 million, with assets of million and liabilities of million, valued in accordance with the accounting standard FRS 17: Retirement Benefits. This is set out in more detail in note 14 to the accounts. The defined benefit pension scheme was closed to new joiners and a new defined contribution scheme was introduced on 1 July General Medical Council

54 Trustees responsibilities for the financial statements 137 The 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 UK Generally Accepted Accounting Practice (UK Accounting Standards) 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 Statement of Recommended Practice: Accounting and Reporting by Charities (revised March 2005). 138 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 ensuring that 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 The trustees are responsible for safeguarding the assets of the charity and for taking reasonable steps to prevent and detect fraud and other irregularities. General Medical Council 46

55 Reserves policy 139 Our level of reserves and our reserves policy are reviewed annually, and any financial implications are addressed as part of the budget-setting process. 140 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 period between a decision to increase income and it taking full effect. 141 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. 142 We operate a defined benefit pension scheme. In line with the accounting standard FRS 17: Retirement Benefits, 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 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. 143 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. 144 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 45 million. However, we recognise that the level of reserves will inevitably fluctuate year on year, 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. 47 General Medical Council

56 145 Our free reserves at the end of 2012 stood at 45.5 million, which was marginally above the target range. We therefore took the decision to freeze the annual retention fee in 2013, and to reduce registration fees for new doctors joining the register. 146 Our free reserves on 31 December 2013 reduced to 42.3 million, which is within the target range. Total reserves at the end of the year were 64.9 million, made up of free reserves, plus 13.3 million of reserves represented by fixed assets, and a pension reserve of 9.3 million valued in accordance with FRS 17: Retirement Benefits. 147 On 10 December 2013, we decided to freeze the registration fees and annual retention fee at the current level. Also, a proportion of doctors facing revalidation for example, those not in clinical practice might choose to relinquish their licence to practise or seek voluntary erasure from the register, which would impact on our future income. We estimate that our free reserves at the end of 2014 will reduce to around 40.3 million. Investment policy 148 During 2013 our investment 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. We have undertaken a review of the policy and agreed the outline of a new policy to improve yield while maintaining an appropriate degree of security and liquidity. We have appointed external advisers to help develop that policy, which Council will consider in Cash required for normal day-to-day working capital is shown on our balance sheet within current assets, whereas cash held for the longer term is shown as investments. 150 In 2013, our investments generated interest of 0.8 million, equivalent to an average annual rate of return of 0.9%. The Performance and Resources Board regularly reviewed investment income, as part of the overall monitoring of our financial performance in General Medical Council 48

57 Audit and Risk Committee s report 151 The Audit and Risk Committee is an important part of our governance structure. The committee was reconstituted in January 2013, and now consists of six members of Council, and two external members, one of whom was appointed on 24 July The committee bases its advice and decisions on guidance issued by the Financial Reporting Council. Its responsibilities include: n confirming whether the accounting policies used in preparing the annual report and accounts are appropriate n appointing the external auditors and reviewing their work n monitoring internal control and risk management n monitoring internal audit work and the implementation of actions arising from it. 153 The committee reports its activities and any significant matters to Council at least twice a year. 154 Following a tender process, the current external auditors were appointed in September 2011 for an initial period of three years. Internal audit is provided separately, and the head of the internal audit service has a direct reporting line to the chair of the committee. The internal auditors carried out an approved programme of internal control reviews, reporting to the committee on the effectiveness of controls in managing the risks associated with our activities. 49 General Medical Council

58 155 The committee met four times in 2013, in addition to its induction meeting, and among other things: n monitored the non-audit services that the external auditors provided, to make sure they are independent and objective n approved the external audit letter of engagement, and reviewed how the audit for the year ending 31 December 2013 would be done to make sure that it set out what would be produced, identified key areas of risk, and reflected changes in circumstances since the previous year n approved a programme of internal audit work for the first two quarters of 2014 n oversaw our risk management activities, as outlined in the risk management statement in paragraphs Risk management statement 156 Our Council is ultimately responsible for making sure the organisation operates an appropriate system of risk management. Council has made sure that formal structures and processes are in place to identify, evaluate, mitigate and monitor risks effectively. It has delegated responsibility for routine oversight of risk management arrangements to the Audit and Risk Committee. 157 Our approach to risk management is set out in our risk management framework. The Audit and Risk Committee has reviewed and endorsed the framework, and has been assured by the internal auditors that the arrangements in place are sufficient to make sure that risks are identified, mitigated and monitored. 158 During 2013, we completed a review of the risk management framework to find ways to make sure our risk management is robust as possible. This resulted in a number of improvements, including clarification of roles and responsibilities in relation to risk management. We also developed new tools to help those responsible for managing corporate level risks to identify trends in relation to the strategic aims from our new corporate strategy. General Medical Council 50

59 159 The revised risk assessment framework was considered by Council in February A plan has been developed to roll out the revised framework to all staff during 2014, with the aim of making sure that there is awareness at all levels of the organisation of how to raise risks and how they are escalated and managed. 160 A performance report, including emerging risks, was monitored monthly by the Performance and Resources Board and the Senior Management Team. Additionally, the Performance and Resources Board and the Senior Management Team reviewed the corporate risk register quarterly. The Audit and Risk Committee received reports on risk management arrangements in April and November, and had a seminar session on risk management on 5 September as part of the review of the risk management framework. Council received reports on risk management arrangements in February and September Risk management needs to permeate all levels and operational functions of the organisation, and sound risk management needs to be embedded in business planning and project management. To achieve this, we keep three types of risk register to assist in the strategic and operational management of the organization. n Local risk registers embedded in the operational plan of each directorate. These capture the risk which could affect delivery for each individual activity within the operational plan. n Project risk registers maintained for specific projects, where a separate register is needed for more regular monitoring of the risks which could affect delivery of the project. n A corporate risk register where organisational risks which could potentially threaten the achievement of our strategic aims are recorded and monitored. The Audit and Risk Committee and Council focus on the corporate risk register. 162 Our risk registers are structured around the eight strategic aims from our Corporate Strategy , and any cross-cutting strategic or political risks. We know there are inherent risks associated with our core functions and we have systems and procedures in place to mitigate these. For example, there is a risk that we register or revalidate an individual who is not properly qualified and/or fit to practise. We mitigate this risk by having registration and revalidation systems and procedures in place that are specifically designed to prevent this. 163 Broadly, our corporate risk register focuses on potential threats or opportunities to both specific aspects of our operational, day-to-day work (such as registering doctors) and those which would have an impact on our direction as an organisation, such as major legislative change. 51 General Medical Council

60 Structure, governance and management

61 164 The GMC is registered with the Charity Commission for England and Wales under number , and with the Office of the Scottish Charity Regulator under number SC Our trustees are responsible for making sure that we fulfil our charitable purposes and role of protecting the public. They confirm that our aims and objectives, as set out in our Corporate Strategy , are for public benefit. The trustees present their report and financial statements for the year ended 31 December In preparing this report, the trustees have complied with the Charities Act 2011, Charity Commission guidance on public benefit in exercising their powers and duties, and applicable accounting standards. The statements are in the format required by the Statement of Recommended Practice: Accounting and Reporting by Charities (revised March 2005). 166 The trustees have a duty to act impartially and objectively, and 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 have published a register of members interests on our website. 53 General Medical Council

62 COUNCIL GOVERNANCE EXECUTIVE GOVERNANCE FORMAL GOVERNANCE Remuneration Committee Council MPTS Advisory Committee Audit and Risk GMC/MPTS Committee Liaison Group Board of Pension Trustees Strategy and Policy Performance Board and Resources Board Directorate work plans Advisory forums Advisory boards Scotland Education and Training Wales Revalidation Implementation Northern Ireland Task and Laison groups groups finish External input to programme or project boards General Medical Council 54

63 Organisational structure Council 167 The trustees between 1 January 2013 and 31 December 2013 were: Dr Shree Datta, MBBS BSc (Hons) MRCOG LLM Lady Christine Eames, OBE LLB MPhil Professor Michael Farthing, MD DSc(Med) FRCP FMedSci Baroness Helene Hayman, GBE MA PC Professor The Lord Ajay Kakkar, BSc (Hons) MBBS (Hons) Phd FRCS FRCPE Professor Deirdre Kelly, MD FRCP FRCPI FRCPCH Dame Suzi Leather, DBE MBE MA BA BPhil CQSW DL Professor Jim McKillop, BSc MB ChB PhD FRCP FRCR Dame Denise Platt, DBE CBE BSc Econ Mrs Enid Rowlands, BSc CCMI Professor Sir Peter Rubin, BM BCh MA DM FRCP Dr Hamish Wilson, CBE MA PhD FHSM FRCGP 168 The trustees of the GMC (the 12 Council members listed above), were all independently appointed by the Privy Council, through a process which followed the Professional Standards Authority s guidance for making appointments to healthcare regulatory bodies. No changes in membership occurred between the end of the year and the date that the accounts were formally approved by Council. 169 The Chair, Professor Sir Peter Rubin, and Dr Hamish Wilson, will be demitting office at the end of An appointments campaign will take place during 2014 to fill the vacancies. This will be managed in accordance with the Professional Standards Authority s guidance for making appointments to the healthcare regulatory bodies, and the Privy Council will make the appointments. 170 Council, which was reconstituted from 1 January 2013, has 12 members (six doctors and six lay members), including an appointed Chair. Supporting the Council, a new governance model was implemented in This comprises: n two governance committees: Audit and Riskand Remuneration n a Board of Trustees, which oversees the GMC s Staff Superannuation Scheme n an advisory Management Committee, which monitors and reviews the GMC s Staff Defined Contribution Pension Scheme n the MPTS Advisory Committee, and GMC/MPTS Liaison Group n advisory forums in Scotland, Wales and Northern Ireland 55 General Medical Council

64 n two advisory boards: Education and Training, and Revalidation Implementation n two executive boards to support the work of the Chief Executive and the Chief Operating Officer respectively: Strategy and Policy Board, and Performance and Resources Board, which both report to Council. Learning from our Reference Community 171 In 2013, we continued to draw on the insight of our Reference Community, composed of 27 members of the public and 27 doctors, as a sounding board to help us develop policy and improve our approach for communicating with doctors and the public. In January 2013, members agreed to remain in the group in its current form until further notice. 172 During 2013, we conducted 14 exercises with the Reference Community. These exercises included the testing of a new online form to help patients make a complaint about a doctor and a new way of presenting education concerns more transparently on our website. 173 In 2014, we will aim to refresh membership of the forum, and look for other opportunities to involve the current Reference Community members in other forms of engagement. Inducting and training new trustees 174 In 2013, we continued with the induction programme to make sure our new Council members have the information they need to support them in their role. This has included briefings and information relevant to our work, including: n seminars and updates as part of Council s forward work programme, including a strategic away day n visits to the GMC and MPTS offices to see our operations n one-to-one meetings with the Chair, including the first round of individual appraisal meetings n meetings with the executive management team n bespoke induction and training sessions on the work associated with the boards and committees they are part of n opportunities to attend advisory forum and other external group meetings, including our conference and staff awards event. General Medical Council 56

65 Our governance model in Council approved the new governance framework in February 2013, and a revised Governance handbook was developed and agreed in April The new model comprises a range of governance, executive and engagement groups which support Council in its role. Council also reviewed the system for member appraisal and a revised process was agreed in September An early review of the governance arrangements, and a review of the competency framework which underpins member appraisal, is being undertaken in Approach to equality and diversity in the new governance model 177 Council agrees our strategic aims on issues of equality and diversity and then holds the executive accountable for their delivery. The former Chief Operating Officer and from 2014, the Chief Executive, act as our senior sponsor for work in this area. They lead on articulating our commitment on equality and diversity issues and raise their profile with staff and interest groups, as well as providing assurance to Council on behalf of the executive. 178 The Strategy and Policy Board is responsible for developing our equality and diversity strategy, and for making sure that the relevant equality and diversity issues are taken into account in our core activities. The Performance and Resources Board is responsible for monitoring progress in implementing our equality and diversity strategy, and for reviewing the action plans for each directorate. 179 Work has begun to develop our engagement strategy following a review in This will include our approach to engaging with groups covered by equality legislation, and to continuing to involve them in our work. 57 General Medical Council

66 Audit and Risk Committee 180 The Audit and Risk Committee is chaired by Dr Hamish Wilson. Its purpose is to monitor the integrity of the financial statements, to review the internal control, governance, and risk management systems and to monitor and review the internal and external audit services. There are two external, co-opted members, Mr John Morley and Ms Elizabeth Butler. The Audit and Risk Committee s report can be found at paragraphs Remuneration Committee 181 The Remuneration Committee is chaired by Dame Denise Platt. It advises Council on the remuneration, 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 Advisory Committee members. Strategy and Policy Board 182 The Strategy and Policy Board has been established as a new executive Board, and is chaired by Mr Niall Dickson, our Chief Executive, and includes members of the 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 is also responsible for overseeing the work of the Professional and Linguistic Assessments Board. The Strategy and Policy Board reports its work through the Chief Executive s reports and an annual report to Council. General Medical Council 58

67 Performance and Resources Board 183 The Performance and Resources Board has been established as a new executive Board and was chaired by Mr Paul Philip, our Chief Operating Officer (until he left the GMC in January 2014), and includes members of the senior management team. The board is an advisory forum for the Chief Operating Officer, which 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 is integrated into our core activities, including monitoring action plans and compliance with the equality duty. It also oversees the advisory Management Committee, set up in 2013, 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. Board of Trustees of the GMC s Superannuation Scheme 184 The GMC s Staff Superannuation Scheme is managed and administered by a Board of Trustees, chaired by Lord Kirkwood of Kirkhope, in accordance with the Scheme s Trust Deed and Rules. Education and Training Advisory Board 185 The Education and Training Advisory Board has been established as a new advisory board and is chaired by Professor John Connell. It provides advice to the GMC on matters concerned with the delivery of undergraduate and postgraduate medical education and training, and career progression. 186 Its advice will be crucial in developing GMC policy and in making sure that Council is fully briefed before major decisions are made. The board s invited membership reflects the range of those who have a key interest in medical education and training across the UK. The board s work is reported to the Strategy and Policy Board. 59 General Medical Council

68 Revalidation Implementation Advisory Board 187 The Revalidation Implementation Advisory Board has been established as a new advisory board and is chaired by Sir Keith Pearson. It provides advice to the GMC about how effectively revalidation has been operating during the first year since implementation in December It 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, and is an important part of how we monitor implementation and issues relating to evaluation, and whether it is being delivered as envisaged. The board s work is reported to the Strategy and Policy Board. UK Advisory Forums 189 Advisory forums have been newly established in Scotland, Wales and Northern Ireland in 2013, and are chaired by Professor Sir Peter Rubin, Chair of Council. The forums support Council s role in making sure that we have effective engagement with interest groups, and that our policies are suited to the context in all parts of the UK. 190 The forums are in addition to our existing arrangements for engagement and are intended to provide 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. Medical Practitioners Tribunal Service 191 The MPTS was launched in 2012 with responsibility for overseeing the adjudication of fitness to practice cases, and is 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. In 2013, the role of the MPTS Committee was refocused on providing advice to the Chair of the MPTS, with an expanded membership, and is now called the MPTS Advisory Committee. The GMC/MPTS Liaison Group, chaired by Professor Sir Peter Rubin, Chair of Council, oversees the working relationship between the MPTS and the functions of the GMC with which it interacts. General Medical Council 60

69 Member attendance at Council, Boards and Committees in 2013 Number of meetings attended Dr Shree Datta Council 7/8 Audit and Risk Committee 4/4 Lady Christine Eames Council 7/8 Audit and Risk Committee 3/4 UK Advisory Forum Northern Ireland** 1/1 Professor Michael Farthing Council 7/8 Audit and Risk Committee 4/4 Baroness Helene Hayman Council 8/8 Remuneration Committee 3/3 Professor the Lord Ajay Kakkar Council 6/8 Remuneration Committee 2/3 Professor Deirdre Kelly Council 6/8 Audit and Risk Committee 4/4 UK Advisory Forum Scotland 1/1 Dame Suzi Leather Council 8/8 Audit and Risk Committee 4/4 61 General Medical Council

70 Number of meetings attended Professor Jim McKillop Council 7/8 Remuneration Committee 2/3 Board of Trustees of the GMC s Superannuation Scheme 7/7 UK Advisory Forum Scotland** 1/1 Dame Denise Platt Council 7/8 Remuneration Committee 3/3 UK Advisory Forum Wales** 1/1 Mrs Enid Rowlands Council 8/8 Remuneration Committee 2/3 Board of Trustees of the GMC s Superannuation Scheme 4/7 UK Advisory Forum Wales** 1/1 Professor Sir Peter Rubin Council* 8/8 GMC/MPTS Liaison Group 3/3 UK Advisory Forum Northern Ireland 1/1 UK Advisory Forum Scotland 1/1 UK Advisory Forum Wales 1/1 Dr Hamish Wilson Council 8/8 Audit and Risk Committee 4/4 Board of Trustees of the GMC s Superannuation Scheme 7/7 UK Advisory Forum Scotland** 1/1 * Includes Council seminars, closed session/open meetings and strategic away day. ** Council member attendance at the Forum meetings is on a voluntary basis on the invitation of the Chair of Council. General Medical Council 62

71 Management 192 In 2013, the GMC s staff was under the direction of Chief Executive Niall Dickson. The Chief Operating Officer and Deputy Chief Executive was Paul Philip, until he left the GMC in January As at 31 December 2013, the Directors were: n Paul Buckley, Director of Education and Standards n Ben Jones, Director of Strategy and Communication n Una Lane, Director of Registration and Revalidation n Anthony Omo, Director of Fitness to Practise n Neil Roberts, Director of Resources and Quality Assurance. 193 In January 2014, Ben Jones left the GMC, and Paul Buckley was appointed Director of Strategy and Communication. Judith Hulf took up the post of Director of Education and Standards on an interim basis. 194 Our principal places of business are Regent s Place, 350 Euston Road, London NW1 3JN and 3 Hardman Street, Manchester M3 3AW. 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. 63 General Medical Council

72 Professional advisers Bankers National Westminster Bank Plc Rubin Regent Street Branch PO Box 4RY Regent Street London W1A 4RY 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 scheme adviser Aon Hewitt Parkside House Ashley Road Epsom Surrey KT18 5BS Approved by the trustees on 21 May 2014, and signed on their behalf by: Professor Sir Peter General Medical Council 64

73 Independent auditors report to the trustees of the General Medical Council 195 We have audited the financial statements of the General Medical Council (GMC) for the year ended 31 December 2013, which comprise the statement of financial activities, the balance sheet, the cash flow statement and the related notes numbered The financial reporting framework that has been applied in their preparation is applicable law and UK Accounting Standards (UK Generally Accepted Accounting Practice). 197 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 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 auditors 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 198 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. 199 We have been appointed as auditors under section 144 of the Charities Act 2011 and section 44(1c) of the Charities and Trustee Investment (Scotland) Act 2005, and we report in accordance with those Acts. 200 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. 65 General Medical Council

74 Scope of the audit of the financial statements 201 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: whether the accounting policies are appropriate to the charity s circumstances and have been consistently applied and adequately disclosed; the reasonableness of significant accounting estimates made by the trustees; and the overall presentation of the financial statements. 202 In addition, we read all the financial and nonfinancial information in the trustees annual report to identify material inconsistencies with the audited financial statements. If we become aware of any apparent material misstatements or inconsistencies, we consider the implications for our report. Opinion on financial statements 203 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 2013 and of its incoming resources and application of resources, for the year then ended n have been properly prepared in accordance with UK Generally Accepted Accounting Practice n have been prepared in accordance with the requirements of the Charities Act 2011, the Charities and Trustee Investment (Scotland) Act 2005, Regulation 8 of the Charities Accounts (Scotland) Regulations 2006 and the Medical Act 1983 and the Privy Council Directions issued thereunder. General Medical Council 66

75 Matters on which we are required to report by exception 204 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 n the financial statements are not in agreement with the accounting records and returns n we have not received all the information and explanations we require for our audit. Crowe Clark Whitehill LLP Statutory Auditors London 21 May 2014 Crowe Clark Whitehill LLP is eligible to act as an auditor in terms of section 1212 of the Companies Act General Medical Council

76 Accounts 2013

77 Statement of financial activities for the year ended 31 December 2013 Total Total Note Incoming resources From charitable activities Registration 2 90,651 93,452 Certification 2 3,022 3,089 From generated funds Sales and other income Investment income and interest 3 1,302 1,057 Total incoming resources 95,437 97,975 Resources expended Charitable activities Fitness to practise 40,912 41,296 MPTS 12,538 8,150 Registration and revalidation 18,028 18,069 Standards 1,270 1,729 Education 5,610 5,035 Communications 2,862 4,135 External relationships 4,678 3,948 Governance 5,815 6,060 Total resources expended 4 91,713 88,422 Net incoming resources before recognised gains and losses 3,724 9,553 Other recognised gains and losses on investments Actuarial (loss)/gain on defined benefit pension scheme 14 (485) (958) Net movement in funds 3,239 8,595 Total funds brought forward 61,648 53,053 Total funds carried forward 64,887 61,648 The results above are derived from continuing activities. All gains and losses recognised in the year are included in the statement of financial activities above. 69 General Medical Council

78 Balance sheet as at 31 December Note Fixed assets Tangible fixed assets 6 13,257 11,936 Investments 7 60,000 60,000 73,257 71,936 Current assets Debtors and prepayments 8 17,934 18,328 Cash and bank balances Short-term deposits 28,750 30,232 46,787 48,798 Liabilities Creditors: amounts falling due within one year 9 (63,567) (62,759) Net current liabilities (16,780) (13,961) Total assets less current liabilities 56,477 57,975 Provisions for liabilities and charges 10 (912) (534) Net assets excluding pension scheme asset 55,565 57,441 Defined benefit pension scheme asset 14 9,322 4,207 Net assets including pension scheme asset 64,887 61,648 The funds of the charity Unrestricted income funds 55,565 57,441 Pension reserve 9,322 4,207 Total charity funds 11 64,887 61,648 The financial statements were approved by the trustees and authorised for issue on 21 May They were signed on behalf of the trustees by: Professor Sir Peter Rubin Chair of Council General Medical Council 70

79 Cash flow statement for the year ended 31 December Net cash inflow from operating activities (Note 1 below) 4,657 7,733 Returns on investments and servicing of finance Interest received Net cash inflow from returns on investments and servicing of finance Capital expenditure (7,068) (4,819) Net cash inflow/(outflow) from investing activities (7,068) (4,819) Net increase/(decrease) in cash and cash equivalents (Note 2 below) (1,617) 3,495 Note 1 Cash flow from operating activities Net incoming resources 3,724 9,553 Investment income and interest (1,302) (1,057) Non-cash items depreciation 5,645 6,363 Non-cash items assets written off Pension past service cost and curtailment Pension scheme current service cost 7,425 4,873 Pension scheme contribution (12,527) (4,529) (Increase)/decrease in debtors 394 (294) Increase/(decrease) in creditors and provisions 1,186 (7,518) 4,657 7,733 Note 2 Cash and equivalents Short-term Cash at bank Total deposits and in hand Balances at 1 January , ,470 Net increase/(decrease) in cash and cash equivalents (1,482) (135) (1,617) Balances at 31 December , , General Medical Council

80 Notes to the accounts 1. Principal accounting policies Accounting convention Our financial statements have been prepared on a going concern basis and under the historical cost convention as modified by the inclusion of investments at market value in accordance with the Charities and Trustee Investment (Scotland) Act 2005 and Charities Accounts (Scotland) Regulations 2006, the Statement of Recommended Practice: Accounting and Reporting by Charities (Statement of Recommended Practice 2005), applicable accounting standards in the UK, and the Charities Act 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 the GMC is legally entitled to the income and the amount can be quantified with reasonable accuracy. The following specific policies apply. n n n 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. Registration fees, including provisional registration fees, are recognised when registration is granted. Professional Linguistic Assessment Board (PLAB) fees are recognised when the examinations are sat. All income is recognised gross. 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. Other resources are expended on governance of the charity and are identified as such in the statement of financial activities. Accommodation 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. General Medical Council 72

81 Provisions for liabilities 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. 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. 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. 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 (where the assets meet the FRS 15 definition of grouped assets ) 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. Asset Leasehold buildings and leasehold improvements Furniture, fixtures, and office fittings Estimated useful life Period of lease or useful economic life of assets The lesser of five years or remaining term of the lease IT equipment and software Three years Other office equipment Three to five years 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. Finance leases Rental payments under finance leases are apportioned between the finance charge and the reduction of the outstanding obligation. The finance charge is charged to thestatement of financial activities over the period of the lease. Investments General reserves are held as cash on short or medium-term deposits. Cash required for normal day to day working capital is shown on the GMC s balance sheet within current assets, while cash held for the longer term is shown as investments. 73 General Medical Council

82 Pensions We have a defined benefit pension scheme for permanent employees. However, 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 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. The interest cost and the expected return on assets are shown as a net amount of other finance costs or as an incoming resource alongside investment income and interest. Actuarial gains and losses are recognised immediately in other recognised gains and losses on investments. 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 note 14 (Superannuation schemes). Our defined contribution pension scheme was set up on 1 July Under FRS 17, contributions to the scheme are charged to the statement of financial activities in the year in which they are payable to the scheme. A number of staff who transferred to the GMC on the merger with 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. General Medical Council 74

83 2. Income from charitable activities Total Total Registration Annual retention fees 85,401 88,090 Registration fees 3,218 3,255 Provisional registration fees PLAB fees 1,191 1,232 Other fees ,651 93,452 Certification CCT fees 2,357 2,413 CESR/CEGPR fees Income from generated funds 3,022 3, Activities for generating funds Sales and other income Investment income Other finance income pension scheme (note 14) Bank interest ,302 1, General Medical Council

84 4. Total resources expended Direct staffing Direct Allocated Total Total costs costs costs Fitness to practise 16,552 13,692 10,668 40,912 41,296 MPTS * 2,632 7,581 2,325 12,538 8,150 Registration and revalidation 8,238 2,944 6,846 18,028 18,069 Communications 1, ,862 4,135 Education 3, ,695 5,610 5,035 External relationships 2, ,507 4,678 3,948 Standards ,270 1,729 Charitable activities 35,190 26,590 24,118 85,898 82,362 Governance 2,714 1,661 1,440 5,815 6,060 Total resources expended 37,904 28,251 25,558 91,713 88,422 * In June 2012, we launched the Medical Practitioners Tribunal Service (MPTS) as an impartial adjudication function. Before this, adjudication costs were included within our fitness to practise costs. External relationships includes the work carried out by our Regional Liaison Service, strategic relationships, our devolved offices, and our European and international development activities. Governance includes the costs of our strategy and planning functions, the Chair, Council and Chief Executive costs, research and development, consultancy and review, and equality and diversity. Support costs allocated to charitable activities Management IT HR Finance Procure- Facilities Total Total ment Fitness to practise 210 3,230 1, ,515 10,668 9,573 MPTS ,325 1,691 Registration and revalidation 135 2,072 1, ,899 6,846 7,171 Communications Education ,695 1,623 External relationships ,507 1,319 Standards Charitable activities 476 7,301 3,724 2, ,209 24,118 22,595 Governance ,440 1,759 Total 506 7,739 3,947 2, ,805 25,558 24,354 Support costs are managed within our Resources and Quality Assurance directorate, and then allocated to charitable activities on the basis of staff head count across the organisation. General Medical Council 76

85 4. Total resources expended (continued) Staffing costs 45,574 39,656 Office costs 5,826 6,741 Council and committee costs Panel and assessment costs 14,364 15,184 Legal costs 6,930 6,472 Accommodation costs 6,345 5,823 Financial, actuarial and professional costs 4,645 5,004 Purchase of assets charged to revenue 1,885 2,302 Assets written off Depreciation 5,645 6,363 91,713 88,422 Total resources expended include: Operating lease costs: leasehold property and equipment 3,224 3,685 Audit fees General Medical Council

86 5. Staff Total costs of all staff: Salaries 34,626 30,241 Social security costs 2,648 2,325 Superannuation costs 6,113 4,981 Redundancy costs Other staffing costs 2,072 1,881 45,574 39,656 Average staff numbers (full-time equivalents) in the year by category: Fitness to practise MPTS Registration and revalidation Standards Education Communications External relations Governance Resources The number of staff whose taxable emoluments (excluding redundancy payments) fell into higher salary bands was: GMC 60,000 70, ,001 80, ,001 90, , , , , , , , , , , , , , , , , , , , , General Medical Council 78

87 5. Staff (continued) MPTS ,000 70, ,001 80, , , , , Number of staff whose taxable emoluments fell into higher salary bands for whom retirement benefits are accruing: GMC defined benefit pension scheme Defined contribution scheme * 2 3 Not in scheme * These staff transferred to the GMC on the merger with PMETB, and contribute to the NHS multi-employer scheme. Contributions to the scheme are charged to the statement of financial activities in the year in which they are payable to the scheme. 6. Fixed assets Buildings Fixtures, furniture IT equipment Total and equipment and software Cost Balance at 1 January ,059 9,919 14,144 36,122 Additions 188 2,011 4,869 7,068 Disposals (564) 0 (1,222) (1,786) Balance at 31 December ,683 11,930 17,791 41,404 Depreciation financial activities in Balance at 1 January ,932 4,100 10,154 24,186 Depreciation charge for year 162 1,211 4,272 5,645 Disposals (465) 0 (1,219) (1,684) Balance at 31 December ,629 5,311 13,207 28,147 Net book value at 1 January ,127 5,819 3,990 11,936 Net book value at 31 December ,054 6,619 4,584 13,257 All fixed assets are owned by the GMC, except for buildings and building improvements which are all leasehold.asset disposals include 1.7m of assets that have reached the end of their useful life. These assets have been fully depreciated, and their disposal has no financial impact. In addition, following the reconfiguration of some of our office space to meet operational requirements, we disposed of 0.1m of assets before the end of their useful life and these costs have been charged to the statement of 79 General Medical Council

88 7. Investments The valuation at the end of the year consisted of: Cash deposits 60,000 60, Debtors Amounts falling due within one year Registration debtors 14,910 14,591 Prepayments and accrued income 2,680 2,356 Other debtors 344 1, Creditors 17,934 18, Amounts falling due within one year Trade creditors Other creditors including tax and social security 893 1,894 Accruals 12,641 11,360 Deferred income 49,291 48,826 63,567 62,759 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 fee PLAB Certification Total Deferred income at 1 Jan , ,826 Resources deferred during the year 48, ,291 Amounts released from previous years (48,428) (260) (138) (48,826) Deferred income at 31 Dec , ,291 General Medical Council 80

89 10. Provisions Dilapidations Legal claims A provision of 424,358 has been recognised for a potential liability for dilapidations at the next lease break. The level of provision is reviewed annually. A provision of 488,000 has been recognised for the potential settlement of legal claims made against the GMC. 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. Further details of provisions are not disclosed as this would be prejudicial to the GMC. 11. Fund movements in the year Unrestricted fund Pension fund 2013 Total 2012 Total At 1 January ,441 4,207 61,648 53,053 Net incoming/(outgoing) resources (1,876) 5,115 3,239 8,595 At 31 December ,565 9,322 64,887 61, Capital commitments Capital expenditure contracted but unspent at 31 December 2013 amounted to 292,720. The equivalent figure for 2012 was 184, Operating lease commitments At 31 December 2013 the GMC had annual commitments under non-cancellable operating leases as follows: Land and buildings Equipment Expiry date: Within one year In years two to five After more than five years 2,839 2, ,988 3, General Medical Council

90 14. 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 The GMC started autoenrolment on 1 November At the end of 2013 there were 78 members of staff contributing to this scheme. It meets the government s requirements following the introduction of automatic enrolment. Individuals can choose to make additional contributions by deduction from salary to the scheme. Under the terms of FRS 17, contributions are accounted for as a defined contribution scheme based on actual contributions paid through the year. NHS Multi-Employer Scheme We have 21 members of staff who contribute to the NHS Pension Scheme, which is a defined benefit scheme. It is an unfunded multi-employer occupational scheme backed by the Exchequer which is open to all NHS staff and staff of other approved organisations. 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. As a consequence, no share of the underlying assets and liabilities can be directly attributed to the GMC. In these circumstances, under the terms of FRS 17, 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 2013 there were 775 members of staff contributing to this scheme. The FRS 17 valuation has been based on a full assessment of the liabilities of the scheme as at 31 December 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 Statement of Recognised Gains and Losses. Regular contributions to the scheme in 2014 are estimated to be 7,771,000. The principal assumptions used by the independent qualified actuaries to calculate the liabilities under FRS 17 are set out below. Main financial assumptions 31 December December December 2011 % p.a. % p.a. % p.a. Retail Prices Index inflation Consumer Prices Index inflation Rate of general long-term increase in salaries Pension increases (excess over guaranteed minimum pension) Discount rate for scheme liabilities General Medical Council 82

91 14. Superannuation scheme (continued) 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 23.5 years if they are male and for a further 25.5 years if they are female. For a member who retires in 2033 at age 65, the assumptions are that they will live on average for a further 24.8 years after retirement if they are male and for a further 26.8 years after retirement if they are female. Expected return on assets Long-term Long-term Long-term rate of return Value at rate of return Value at rate of return Value at expected at 31 Dec expected at 31 Dec expected at 31 Dec 31 Dec Dec Dec % p.a. 000 % p.a. 000 % p.a. 000 Equities , , ,538 Fixed interest gilts , , ,752 Index-linked gilts , , ,669 Property , , ,298 Other , , Combined , , ,779 We employ a building block approach in determining the long-term rate of return on pension plan assets. Historical markets are studied and assets with higher volatility are assumed to generate higher returns consistent with widely accepted capital market principles. The assumed long-term rate of return on each asset class is set out within this note. The overall expected rate of return on assets is then derived by aggregating the expected return for each asset class over the actual asset allocation for the scheme at 31 December Reconciliation of funded status to balance sheet Value at Value at Value at 31 December December December Fair value of scheme assets 125, ,681 88,779 Present value of funded defined benefit obligations (115,489) (96,884) (83,111) 10,002 4,797 5,668 Present value of unfunded defined benefit obligations (680) (590) (584) Asset/(liability) recognised on the balance sheet 9,322 4,207 5, General Medical Council

92 14. Superannuation scheme (continued) Analysis of profit and loss charge Year ending Year ending 31 December December Current service cost 7,425 5,975 Past service cost Interest cost 4,636 4,059 Expected return on scheme assets (5,144) (4,533) Curtailment cost 0 0 Settlement cost 0 0 Expense recognised in profit and loss 6,927 5,550 Changes to the present value of the defined benefit obligation during the year Year ending Year ending 31 December December Opening defined benefit obligation 97,474 83,695 Current service cost 7,425 5,975 Interest cost 4,636 4,059 Actuarial (gains)/losses on scheme liabilities 7,308 4,251 Net benefits paid out (684) (555) Past service cost Net increase in liabilities from disposals/acquisitions 0 0 Curtailments 0 0 Settlements 0 0 Closing defined benefit obligation 116,169 97,474 Changes to the fair value of scheme assets during the year Year ending Year ending 31 December December Opening fair value of scheme assets 101,681 88,779 Expected return on scheme assets 5,144 4,533 Actuarial gains/(losses) on scheme assets 6,823 3,293 Contributions by the employer 12,527 5,631 Net benefits paid out (684) (555) Net increase in assets from disposals/acquisitions 0 0 Settlements 0 0 Closing fair value of scheme assets 125, ,681 General Medical Council 84

93 14. Superannuation scheme (continued) Actual return on scheme assets Year ending Year ending used. 31 December December Expected return on scheme assets 5,144 4,533 Actuarial gain/(loss) on scheme assets 6,823 3,293 Actual return on scheme assets 11,967 7,826 Analysis of amounts recognised in the Statement of Recognised Gains and Losses Year ending Year ending 31 December December Total actuarial gains/(losses) (485) (958) Cumulative amount of gains/(losses) recognised in the STRGL (7,671) (7,186) History of asset values, defined benefit obligation and surplus/deficit in scheme 31 Dec Dec Dec Dec Dec Fair value of scheme assets 125, ,681 88,779 79,984 67,541 Defined benefit obligation (116,169) (97,474) (83,695) (74,748) (73,273) Surplus/(deficit) in scheme 9,322 4,207 5,084 5,236 (5,732) History of experience gains and losses changes to the actuarial assumptions Year ending Year ending Year ending Year ending Year ending 31 Dec Dec Dec Dec Dec Experience gains/(losses) on scheme assets 6,823 3,293 (1,016) 3,972 6,569 Experience gains/(losses) on scheme liabilities * 3,941 (635) 113 2,896 (405) * This item consists of gains/(losses) in respect of liability experience only, and excludes any change in liabilities in respect of 85 General Medical Council

94 15. Honoraria Trustees Professor Sir Peter Rubin (Chair) * 110,000 95,433 Dr Shree Datta 18,000 0 Lady Christine Eames 18,000 0 Professor Michael Farthing 18,000 0 Baroness Helene Hayman 18,000 0 Professor The Lord Ajay Kakkar 18,000 0 Professor Deirdre Kelly 18,000 0 Dame Suzi Leather 18,000 0 Professor Jim McKillop 18,000 15,225 Dame Denise Platt 18,000 0 Mrs Enid Rowlands 18,000 15,225 Dr Hamish Wilson 18,000 12,000 Professor Jane Dacre 0 15,225 Dr Suzanne Davison 0 12,000 Dr Sam Everington 0 12,000 Ms Sally Hawkins 0 12,000 Dr John Jenkins 0 15,225 Lord Kirkwood of Kirkhope 0 15,225 Ms Ros Levenson 0 15,225 Professor Malcolm Lewis 0 15,225 Mr Robin MacLeod 0 15,225 Professor Rajan Madhok 0 12,000 Dr Johann Malawana 0 12,000 Dr Joan Martin 0 15,225 Mrs Suzanne McCarthy 0 12,000 Professor Trudie Roberts 0 12,000 Mrs Ann Robinson 0 15,225 Dr Mairi Scott 0 12,000 Professor Iqbal Singh 0 15,225 Professor Terence Stephenson 0 12,000 Ms Anne Weyman 0 12,000 Mr Stephen Whittle 0 12,000 * Honorarium paid to employer. Council was reconstituted from 1 January 2013, and the number of trustees reduced from 24 to 12. A number of trustees demitted office on 31 December Travel and subsistence expenses of 36,430 were paid to the 12 council members in Travel and subsistence expenses of 122,199 were paid to the 24 council members in General Medical Council 86

95 Medical Practitioners Tribunal Service Advisory Committee members His Honour David Pearl * 0 0 Dr Tim Howard 6,835 4,960 Ms Alison White 1,078 4,960 Mr Richard Davies Dr Patricia Moultrie Mrs Judith Worthington * His Honour David Pearl is the Chair of the MPTS and is paid as an employee. His remuneration is included in note 5 of these accounts. Ms Alison White demitted office on 22 February Mr Richard Davies, Dr Patricia Moultrie and Mrs Judith Worthington became MPTS Advisory Committee members on 4 November Audit and Risk Committee co-opted members Mr John Morley 1,085 1,240 Ms Elizabeth Butler Mr Michael Jeans ** 0 1,240 Ms Elizabeth Butler became an external, co-opted member of the Audit and Risk Committee on 24 July ** Mr Michael Jeans demitted office as an external, co-opted member of the Audit and Risk Committee on 28 February General Medical Council

96 16. Travel and subsistence expenses claimed in Trustees Professor Sir Peter Rubin (Chair) 10,375 9,906 Dr Shree Datta Lady Christine Eames 5,692 0 Professor Michael Farthing Baroness Helene Hayman Professor The Lord Ajay Kakkar 0 0 Professor Deirdre Kelly 2,337 0 Dame Suzi Leather 3,265 0 Professor Jim McKillop 5,272 12,540 Dame Denise Platt Mrs Enid Rowlands 988 1,032 Dr Hamish Wilson 6,535 6,357 Professor Jane Dacre * Dr Suzanne Davison * 0 2,396 Dr Sam Everington * 0 0 Ms Sally Hawkins * Dr John Jenkins * 0 26,002 Lord Kirkwood of Kirkhope * 0 1,348 Ms Ros Levenson * Professor Malcolm Lewis * 0 13,173 Mr Robin MacLeod * 0 6,204 Professor Rajan Madhok * 0 3,583 Dr Johann Malawana * Dr Joan Martin * 0 22,024 Mrs Suzanne McCarthy * 0 0 Professor Trudie Roberts * 0 3,375 Mrs Ann Robinson * Dr Mairi Scott * 0 4,265 Professor Iqbal Singh * 0 7,908 Professor Terence Stephenson * Ms Anne Weyman * Mr Stephen Whittle * * Demitted office on 31 December General Medical Council 88

97 16. Travel and subsistence expenses claimed in 2013 (continued) Medical Practitioners Tribunal Service Advisory Committee Members His Honour David Pearl Dr Tim Howard 3,201 3,161 Ms Alison White 24 1,123 Mr Richard Davies Dr Patricia Moultrie Mrs Judith Worthington Audit and Risk Committee co-opted members Mr John Morley 0 0 Ms Elizabeth Butler 41 0 Mr Michael Jeans Senior Management Team Niall Dickson Chief Executive 25,055 18,119 Paul Philip Chief Operating Officer 6,936 8,550 Paul Buckley Director of Education and Standards 5,533 5,047 Ben Jones Director of Strategy and Communication 9,109 6,211 Neil Roberts Director of Resources and Quality Assurance 9,895 16,666 Una Lane Director of Registration and Revalidation 9,191 6,669 Anthony Omo Director of Fitness to Practice 4,339 0 Variations in expenses incurred by individuals reflect their different roles and responsibilities. Variations also reflect that trustees and members of the Senior Management Team live in different parts of the UK and are required to travel around the UK on GMC needs. accommodation according to specific 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 89 General Medical Council

98 Acronyms

99 CCT CEGPR CESR FRS GMC MPTS NHS PLAB PMETB Certificate of Completion of Training Certificate of Eligibility for GP Registration Certificate of Eligibility for Specialist Registration Financial Reporting Standards General Medical Council Medical Practitioners Tribunal Service National Health Service Professional and Linguistic Assessments Board Postgraduate Medical Education and Training Board 91 General Medical Council