Context will count if doctors face complaints in coronavirus outbreak, say officials

Doctors forced to work 'outside their normal scope of practice' during the coronavirus outbreak will have that context taken into account if they face complaints, health officials have said.

A joint statement from the GMC, NHS England and the UK's chief medical officers, says NHS services will face 'extreme pressure' if COVID-19 becomes 'an established significant pandemic in the UK'.

The statement makes clear that while doctors are always expected to adhere to GMC principles and guidance, the difficult context in which they are working will be factored in if complaints arise - and that for junior doctors or students stepping up, 'we are determined to ensure the long-term prospects...are not compromised'.

The statement adds: 'Pressure will inevitably be exacerbated by staff shortages due to sickness or caring responsibilities. It will be a challenge for our profession. We are confident doctors will respond rapidly and professionally and want to assure colleagues that we recognise this will require temporary changes to practice, and that regulators and others will take this into account.'

GMC investigation

The latest statement comes just over a week after the GMC and other UK health regulators told doctors: 'We recognise that the individuals on our registers may feel anxious about how context is taken into account when concerns are raised about their decisions and actions in very challenging circumstances.

'Where a concern is raised about a registered professional, it will always be considered on the specific facts of the case, taking into account the factors relevant to the environment in which the professional is working. We would also take account of any relevant information about resource, guidelines or protocols in place at the time.'

The statements from regulators and health officials seeking to reassure doctors over handling of complaints during the coronavirus outbreak come just 18 months after the GMC set out plans to overhaul its investigation methods in the wake of the high-profile case of Dr Hadiza Bawa-Garba - in which the context in which she was working was a key factor.

Dr Bawa-Garba was struck off by the GMC after it challenged a medical tribunal ruling that said she should face a 12-month suspension, but later reinstated when High Court judges ruled that the medical tribunal had correctly taken account of the context in which she was working - including systematic failures at the hospital and by other staff where she worked - when imposing the lesser penalty.

Coronavirus

In the latest message to doctors, health officials said they recognised that an epidemic would require doctors to be 'flexible in what they do', and may 'entail working in unfamiliar circumstances or surroundings, or working in clinical areas outside of their usual practice for the benefit of patients and the population as a whole'.

The statement makes clear that doctors will always be expected to follow GMC guidance and 'stick to the basic principles of being a good doctor'. It adds: 'We want doctors, in partnership with patients, always to use their professional judgment to assess risk and to make sure people receive safe care, informed by the values and principles set out in their professional standards. A rational approach to varying practice in an emergency is part of that professional response.

'It is the responsibility of GP practices, hospitals, trusts and health boards to ensure that clinicians working in their organisations are supported to do this. They must bear in mind that clinicians may need to depart, possibly significantly, from established procedures in order to care for patients in the highly challenging but time-bound circumstances of the peak of an epidemic.'

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