This report, in response to the 2001 inquiry into the murders and clinical practice of Hyde general practioner Dr Harold Shipman and the six reports produced thereafter by Dame Janet Smith recommending greater medical regulation, identified problems with medical regulation as it stood and set out recommendations for reform. These focused on lower standards of proof in serious cases against doctors headed by independent tribunals, improvements to fitness to practise procedures to ensure fairness, assurance and improvement to the quality of medical practice through standardisation and a more effective process of revalidation for doctors. Among these recommendations were proposals for changes to the structure and governance of the General Medical Council.