Issues and incidents involving team dynamics arise in all workplace settings. This sheet sets out roles and responsibilities when doctors are involved, to support an efficient response, effective learning and proper accountability.

The designated body has primary responsibility to manage the team. The responsible officer and GMC have statutory responsibilities towards doctors involved. The GMC Employer Liaison Adviser has a role in supporting the responsible officer. The NHS England and Improvement higher-level responsible officer has statutory responsibility towards the responsible officer in the external designated body. Other regulators have statutory or other responsibilities, whether towards individuals (e.g. NMC, HEE) or the organisation (e.g. CQC).

While the higher-level responsible officer and GMC have no statutory function in relation to team dynamics within an external designated body, they do support the responsible officer. All parties have an interest in fair outcomes supporting good care to patients and a responsibility to role-model constructive behaviours.

Actions consistent with these roles and responsibilities are:

Designated body should:

• have robust policies and procedures to address matters consistently and objectively, with compassion and cultural awareness.

Medical Director/Responsible Officer should:

• support/lead investigation as appropriate when doctors are involved.
• contribute to a plan to manage and support the team, working with colleagues such as Human Resources and the director of nursing (and the university, if academic staff are involved) signed off by CEO and ideally Board (or equivalent). The plan should consider culture, behavioural code, and whether disciplinary action is required. It should also be SMART.
• begin a separate process if the investigation of the team indicates a concern about a doctor’s individual professional behaviour.

GMC Employer Liaison Advisers can:

• offer advice to the responsible officer about the actions of doctors involved.
• support sessions for doctors about good medical practice.

Higher level Responsible Officers can, as appropriate:

• advise and support the designated body’s responsible officer.
• advise on the designated body’s plan.
• convene a Single Item Quality Support Group to oversee progress of the designated body’s plan with other regulators as appropriate.

NHS Resolution’s Practitioner Performance Advice Service can:

• Offer advice to the responsible officer
• Offer a team review

This information sheet is relevant primarily to NHS England responsible officers but may be of interest to other designated bodies in England.

Released November 2021.