Second, delays in the investigation of complex GNM cases could be mitigated by the formation of a national police unit or regional specialist units to investigate GNM allegations which could develop expertise in complex medical cases. Again, there needs to be clearer guidance on current law, as well as input from properly instructed experts (medical and non-medical) to help the police establish if cases will meet the threshold for GNM.

And there should be training for those involved in the prosecution process to help them assess whether there is real criminal culpability by a doctor, as well as understanding other factors at work such as poorly functioning systems.

But while swift and decisive action is needed to address failings in the way that GNM is investigated and prosecuted, the best way to achieve a safer environment for patients lies in promoting a culture of fairness, transparency and learning from mistakes. To this end, we have also recommended that NHS Improvement reviews its guidance on dealing with and learning from sudden unexpected deaths to emphasise the importance of treating clinical staff supportively and avoiding any early apportionment of blame. Doctors should be accountable but not without fair process.

As you would expect, the MDU's contribution to the review draws on our detailed knowledge and understanding of the law surrounding GNM and its practical effect on doctors. As the only medical defence organisation with an in-house legal team dedicated to assisting members with criminal investigations arising from their clinical practice, we are in a unique position to suggest workable solutions thanks to the team's collective expertise and more than 70 years' combined experience.

It is largely thanks to their specialist and tenacious representation that MDU has a strong track record in defending members who are unfortunate enough to be the subject of a police investigation, which should offer some reassurance to members who find themselves under investigation following the death of a patient.

On behalf of our members, the MDU is ready and able to make a positive stand on this issue which has understandably become so emotive for the profession.

Specialist support

Dr Christine Tomkins

Specialist support