Dr Zaid Al-Najjar, medicolegal adviser at Medical Protection advises:
A common query we receive at Medical Protection relates to what GPs should do when they have concerns about a colleague. This may be in regards to the colleague’s performance, conduct or even their health, such as alcohol dependency.
In this particular scenario, the risk of alcohol dependency coupled with the daily demands of a GP role could lead to a significant deterioration in your colleague’s health. This could lead to errors/lapses in their clinical judgement and performance issues which could seriously jeopardise patient safety.
With regards to your professional obligations, the GMC released guidance in 2012 on 'Raising and acting on concerns about patient safety', which states:
'All doctors have a duty to raise concerns where they believe that patient safety or care is being compromised by the practice of colleagues or the systems, policies, and procedures in the organisations in which they work. They must also encourage and support a culture in which staff can raise concerns openly and safely.'
However, we often find that GPs in this situation can feel torn between wanting to ensure that patients are safe, and getting a colleague into trouble. While the GMC recognises that doctors may be reluctant to report a concern because of the negative effect it may have on working relationships, they also make it clear that doctors have a duty to put patients’ best interests first, and that this overrides personal and professional loyalties.
As your colleague has asked you to not report them, you may, out of courtesy, choose to discuss your concerns with them so they are aware that you intend to act on them. However, whether or not this is appropriate will depend on the specific circumstances of the case and your relationship with your colleague.
In terms of how to raise your concern, it is best to speak with the partnership or a senior partner. GMC guidance also states that:
'If your concern is about a partner, it may be appropriate to raise it [the concern] outside the practice – for example with the medical director or clinical governance lead responsible for your organisation. You must be clear, honest and objective about the reason for your concern. You should acknowledge any personal grievance that may arise from the situation, but focus on the issue of patient safety. You should also keep a record of your concern and any steps that you have taken to deal with it.'
If you feel that you are unable to raise your concern with an appropriate person/body for any reason, or if you do raise it but feel as though it has not been acted on appropriately, you can consider contacting the GMC directly. You should also consider doing this if you feel that there is an imminent risk of serious harm to patients.
If you are still unsure of your professional obligations or how to approach the situation, it would be a good idea to seek advice from your medical defence organisation or to contact your local clinical governance lead or medical director.