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On Tuesday 14th December 2016 the Professional Conduct Committee of the GCC brought a case which had lasted for 18 months to a timely end. They found all of the allegations against our client not proved.   One of those allegations was of proposing a treatment plan which was excessive. The GCC’s expert referred to the NICE guidance published in 2009 for the treatment of low back pain and opined to the PCC in support of the charge that the first two phases of treatment (symptomatic relief and rehabilitation) would require no more than 10 treatments before the start of maintenance treatment. However, he accepted that the maintenance stage could incorporate treatment for life.

Two experts for the defence disagreed. The first referred to the serious long term complaint the patient presented with which included various complications. The second expressed the view It is not possible to dictate a definitive number of visits that an individual patient may require, however it is important to give the patient a clear indication of what to expect so that they can be informed when making choices about their care and giving consent. There are differing opinions in the profession as to how many visits are required for any given condition and some of this is due to the differing approaches and techniques utilised and the outcomes desired. The Committee found that the number of treatments planned at the initial consultation was very much patient-dependent and was a clinical decision made by the treating chiropractor with the advantage of seeing the patient. The Committee noted that Patient A had indicated that she wanted to keep healthy once right and that this equated to all three phases of care. The Committee accepted Dr B’s explanation for why he considered at the plan stage why it was appropriate to allow for the potential number of treatments that he did and the Committee did not consider this number of treatments to be excessive. What Dr B had formulated in his treatment plan was entirely consistent with his findings and Patient A’s indication that she wanted all three stages of care. The Committee noted that the plan had built into it a review at week 6 and a re-examination on the 12th visit. The Committee therefore foundthis Particular not proved.

John Williams commented “I was very pleased for our client and grateful to the PCC for coming to the correct decision and finding all of the allegations against him not proved. They expressly stated about our chiropractor client that they “held him to be to be honest, straightforward, passionate about chiropractic, and caring. The Committee had no reason to doubt his credibility.” These are findings I would wholeheartedly echo and endorse. However, this is not the first allegation of excessive treatments which has recently come before a PCC and been dispatched into the long grass. The GCC and the experts they choose to instruct have appeared to take no heed of previous PCC findings on recommending excessive treatments and they have continued to waste the professions resources on prosecuting such allegations. Now that the NICE guidance on treatment for lower back pain has been replaced so that the old maximum of 12 has gone and the new guidance does not specify any minimum or maximum there is perhaps even less justification for putting honest, straightforward and caring chiropractors who are passionate about chiropractic through the trauma of an 18 month ordeal of GCC proceedings. Given that the costs of regulation and insurance just seem to keep on increasing there must come a time when the GCC should look at its policies on which allegations should be pursued and whether decisions on the commencement of proceedings and indeed whether an interim suspension hearing should take place are appropriate and consistent with the thinking of the PCC, health professionals and now NICE.

By way of example one of the GOsC’s criteria in their guidance as to the Threshhold Criteria for Unacceptable Professional Conduct as a criteria which would not merit a referral to a PCC is

h. Complaints that amount to a difference of professional opinion - provided that the opinion is: i. accepted as proper and responsible by a responsible body of osteopaths who are skilled in that particular area of practice and acting responsibly; and ii. reasonably held and capable of withstanding logical analysis

Isn’t it about time the GCC (in particular the Investigating Committee) adopted a more practical and consistent approach and stopped bringing cases which are unlikely to be found proved? Our success rate in defending all cases is 91%. Whilst we are rightly proud of this we also recognise that there are too many cases which are being referred to the PCC by the IC which are lacking in merit. The consequences of this is that the profession pays a high price, registration and insurance premiums rise and it does nothing to protect the public if innocent chiropractors are facing unnecessary proceedings. If anything it brings the system of regulation into disrepute as Patients will not relish attending hearings in which the allegations are found to be not proved."

Our client commented “I would like to thank Bankside's John Williams and Jonathan Goldring, my barrister, for their upmost professional expertise and experience which has proved invaluable to me. The support and confidence that is gained from having the most experienced team behind you has helped to carry me through the mental stress of one of toughest years in my life. It is very clear that these guys care passionately about the people they represent."