My work on racial discrimination in the medical profession has covered the discrimination faced by ethnic minority doctors from entry into medical school, job applications, differences in remuneration, and assessment in complaints. I am recognized internationally for my research on discrimination in the medical profession. Much of the work that I have carried out in this area has resulted in significant changes in recruitment, selection and monitoring of the medical profession. I have provided advice to ministers, senior civil servants and other professional bodies on matters related to race and diversity. In 2013, I completed a major piece of work on unfairness in postgraduate medical examinations. I helped set up the Workforce Race Equality Standard for the NHS in 2015 and was a member of its strategic advisory board till 2017.
My research on accountability of the medical profession is based on the premise that the medical profession remains largely unaccountable for its practices in relation to how it controls entry into the profession, the way that it allows career progression, handles complaints and rewards its members. Through the exemplar of racism my work has shown that there is a lack of mechanisms for monitoring, a culture of denial and a lack of clearly defined pathways of accountability in the NHS, the professional bodies in medicine, universities and the General Medical Council. The work has a direct bearing on the current debate on how to make the profession more accountable, revalidation and governance. This work has directly led to processes to improve accountability and transparency in the GMC, resulted in my appointment as the Medical Advisor to the Shipman Inquiry which itself produced far-reaching recommendations designed to improve patient safety in the UK.
My research on patient safety started from the premise that issues related to patient safety in primary care are distinct from and require different interventions from those devised for secondary care. We carried out the first study on reporting errors in general practice as part of the Linneaus collaboration and established the principle that general practitioners were willing to report errors and that errors in general practice were significant in relation to the harm that they caused. Our work on the utility of medico-legal databases resulted in changes in the way the medical defence organisations and the NHS Litigation authority handled and processed litigation claims and ensured that systems were developed to encourage learning from the claims databases. Our analysis of these databases highlighted the role that delayed and missed diagnoses play in the genesis of errors in primary care. Our work on safety culture led to the development of the Manchester Patient Safety Framework (MaPSaF), which is widely used in the NHS to improve safety culture and has been translated into five languages. I have worked widely in Europe helping to develop capacity and engagement from clinicians in relation to improving patient safety in primary care. My research on patient safety and on the accountability of doctors was featured in a major Channel 4 documentary Can you Trust your doctor? (Broadcast November 2011). In 2012 we were awarded the £6.5 million NIHR Translational Research Centre for Patient Safety in Primary Care. I was its inaugural Director having successfully led the bid and remained Director till 2017.