Doctors who refuse to treat patients due to poor PPE 'should not face investigation'

Doctors who refuse to treat COVID-19 patients because of inadequate personal protective equipment (PPE) should not face investigation if a patient comes to harm, medico-legal experts have warned.

A demonstrator protests about the lack of PPE for NHS staff earlier this month (Photo: Isabel Infantes/Getty Images)
A demonstrator protests about the lack of PPE for NHS staff earlier this month (Photo: Isabel Infantes/Getty Images)

The Medical Protection Society (MPS) has called for ‘urgent reassurance’ that doctors will not be subjected to regulatory action or disciplinary procedures by employers following a decision or outcome which stems from poor PPE provision.

The call comes after BMA representative body chair Dr Helena McKeown warned earlier this month that PPE shortages were forcing GPs to choose between patient care and personal safety.

Ministers have already been urged to introduce emergency laws to protect doctors who make difficult decisions about patient care during the COVID-19 outbreak. The MPS had previously warned that doctors and other healthcare workers were vulnerable to criminal and regulatory investigations due to a lack of legal protection during the coronavirus crisis.

The GMC has said it will continue to consider the context within which doctors are working when conducting its investigations.

PPE shortages

Last week GPs hit out at the 'shambolic' provision of PPE as practices continue to experience shortages of vital equipment. An open letter published by Kent LMC warned that no practice in the county had received adequate PPE through standard NHS supply channels and practices were 'having to rely on donations and personal innovation' to protect doctors and other staff.

GPonline has previously reported on GPs who have partnered with local businesses or schools to 3D print visors, because many practices have been unable to secure eye protection, despite Public Health England recommending its use. Meanwhile, others have been forced to crowdfund to pay for PPE or buy supplies from DIY stores.

The national shortage of PPE has forced Public Health England to issue guidance on reusing certain pieces of equipment.

MPS medical director Dr Rob Hendry said: ‘It is appalling enough that doctors are placed in the position of having to choose between treating patients and keeping themselves and their other patients safe – this stress should not be compounded by the prospect of being brought before a regulatory or disciplinary tribunal.

Immunity from investigation

‘Considering the daily challenge doctors continue to face on the supply and adequacy of PPE, through no fault of their own, it seems right and just that they are afforded immunity from investigations by their employer, or the GMC if the patient came to harm. Of course, this does not apply to wilful or intentional criminal harm or reckless misconduct.

‘We hope to see a statement of reassurance from the GMC and employers as a matter of urgency. Now more than ever, doctors need to know they are supported.’

A GMC spokesperson said the watchdog would continue to trust doctors to use their professional judgment to apply the principles in its guidance. They said: ‘If a concern was raised with us about a doctor’s actions we would need to look at the specifics, as we would any other concern referred to us. We'd also consider the context within which the doctor was working, including information about resources, guidelines or protocols in place at the time.’

Earlier this month Dr McKeown told GPonline that GPs could be justified in their decisions not to carry out face-to-face consultations where they had no PPE. She said: 'If you heroically see patients who may have COVID-19 with or without symptoms without proper PPE, you may get infected - and ultimately you may die.

'It's nuanced and it's not natural to say "no", but as a GP I want to know I am seeing patients knowing I am protected and am not going to be infected and bring that home to my family. If you get infected you are a doctor who cannot see many hundreds of other patients.'

At least 100 NHS staff and healthcare workers have now died from COVID-19, including seven GPs.

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