GMC ‘Good Medical Practice’ 2013 edition
The 2013 edition of ‘Good Medical Practice’, which comes into effect on 22nd April, is significantly shorter than the previous 2006 edition – 27 pages instead of 42. However, this does not represent a diminution of its guidance – it is just that much of the detailed guidance on specific issues headlined in ‘Good Medical Practice’ (which was previously included in GMP itself) can now be found in separate guidance documentation, some of it also recently issued.
As a result, ‘Good Medical Practice’ is now more of a headline summary rather than a compendium of the duties of a doctor, and direct comparison between old GMP and new GMP is made difficult by a change in format. However the following is a summary of the more significant changes between the old and new guidance which it contains:
Preamble 1& para.25 – Doctors must now take prompt action not just where patient safety is being compromised, but also where this is the case as regards the patient’s ‘dignity and comfort’.
Preamble 2 – Adds a requirement for doctors to demonstrate through the revalidation process that they ‘work in line with the principles and values set out in this guidance’ in order to maintain their licence to practise.
10 – Doctors must find and participate in structured support opportunities offered by their employer/contractor when they join an organisation or their role in it changes. Mentoring is given as a specific example, and para 42 provides that doctors should be prepared to take on a mentoring role for more junior doctors and other healthcare professionals- not just to contribute to their training.
15a – Doctors must now take account of ‘spiritual and cultural’ factors, as well as psychological and social ones, when assessing patients.
15c – The test for referring a patient to another doctor is no longer when this is in the patient’s best interests, but ‘when this serves the patient’s needs’ – presumably reflecting an objective test rather than the previous subjective one.
16c – Doctors must now take ‘all possible steps’ to alleviate a patient’s pain and distress – previously obligation was ‘to take steps’
16f – Doctors must check the treatment they provide is compatible with any other treatment the patient is receiving, including over-the-counter medications obtained direct by the patient.
19 – All documents which a doctor makes must be clear, accurateand legible – not just clinical records as before.
21e – Clinical records must now include details of ‘who is making the record and when’, and ‘who is making the decisions and actions agreed’.
23c – There is now a specific obligation for doctors to report ‘adverse incidents involving medical devices that put or have the potential to put the safety of a patient or another person at risk’.
24 – Doctors must ‘promote and encourage a culture that allows all staff to raise concerns openly and safely’
31 – A specific obligation is now placed on doctors to answer patients’ questions honestly.
43 – Doctors must support colleagues who have problems with their performance or health.
44b – Doctors must check, where practical, that a named clinician or team has taken over responsibility for a patient’s care when their role in it has ended.
49b – Doctors must provide information regarding their role and responsibilities within a team to patients.
52 – Doctors must inform patients of any conscientious objection to a particular procedure without expressing or implying any disapproval of the patient’s lifestyle, choices or beliefs.
60 – Doctors must consider and respond to the needs of disabled patients and make reasonable adjustments (physical and organisational) to meet their needs.
61 – In addition to responding promptly and honestly to complaints, doctors must now do so ‘fully’.
62 – Doctors should only end their professional relationship with a patient because of a breakdown of trust if this means that they can no longer provide the patient with good care.
72 – The obligation not deliberately to omit relevant information is extended to evidence given by doctors in Court, not just in reports for Court proceedings.
73D – Doctors must co-operate with formal inquiries and complaints procedures generally – not just those relating to the treatment of patients and must ‘offer all relevant information’ in relation to them
The previous edition of ‘Good Medical Practice’ specifically referred to its contents being ‘guidance, not a statutory code’. This does not appear in the new version, paragraph 12 of which sets out a specific obligation to keep up to date with and to follow GMC guidance – thus indicating that ignorance of such guidance can in itself be the basis of an allegation of impaired fitness to practise.
The further detailed guidance on different practice areas issued by the GMC and contained on its website now comprises a total of some 360 pages. Not all of it is relevant to all doctors, but much of it is relevant to most doctors. As a result, and bearing in mind the specific obligation referred to above, all doctors would be well-advised to study the list of specific guidance set out on the ‘Guidance on Good Practice’ field of the website, and then select those titles relevant to them for further study.
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