Quality assuring GPs and their practices

The greatest driver for quality and protection of patients has always been doctors' desire to live up to the expectations of themselves, their colleagues, and their patients. This internal responsibility is at work in every clinical encounter. It is particularly significant in general practice where most of our clinical work is in one-to-one consultations. Yet inevitably we all at times fall short of our own expectations and those of our colleagues and patients. Mostly these lapses are temporary and forgivable. For the past 154 years, the General Medical Council (GMC) has been a regulator of the more egregious deviations in our behaviour; and in the past three decades it has also been concerned about our health and our competency as doctors.1 A third traditional accountability for doctors has been to wider society. This includes accountability through legislation concerning everything from prescribing to health and safety; in the courts through litigation and coroners; and to the NHS or other employers through contracts and complaints processes. GPs have, additionally, sought voluntary markers of merit and quality. Prior to it becoming compulsory in 2007, the MRCGP examination was taken by the majority of young doctors wishing to enter general practice. Later in their careers, many wish to be recognised as a trainer and to acquire FRCGP. Fellowship by Assessment …