GMC fitness to practise advice changed to factor in COVID-19 pandemic

GMC guidance for staff investigating complaints against doctors has been updated to fit the 'extraordinary circumstances' of the COVID-19 pandemic.

Problems caused by shortages of staff or PPE, or by doctors being forced to work 'outside of normal routines' will now be taken into account under guidance updated to reflect 'the context of the pandemic'.

‘Distress and emotional trauma’ suffered by doctors will also be considered in assessing complaints against doctors, while the disproportionate impact of disease and mortality rates for individuals from black, Asian and minority ethnic (BAME) groups will also be recognised.

Guidelines to be used by GMC assessors from 14 September consider ‘the environment created by the pandemic’ in which doctors are working and take into account ‘relevant information about resources, guidelines or protocols in place at the time’.

Fitness to practise

However, despite assurances that some concerns about doctors may not - in the current circumstances - put into question their fitness to practise, the GMC has stressed that doctors still have a duty ‘to provide the best and safest care they can’.

An eight-page guidance document published by the regulator comes after an announcement by health officials in March that context would be taken into account for doctors facing complaints during the pandemic.

The GMC recgonised that doctors could be forced to work 'outside their normal scope of practice to support the COVID-19 effort', and wanted to ‘reassure colleagues’ that complaints would be handled in a way that reflected this.

The new GMC guidance says ‘the availability and distribution of resources to provide healthcare’ and ‘the change in healthcare provision due to social distancing guidance’ should be considered following a complaint.

COVID-19 pandemic

Wearing PPE for extended periods will also be taken into account, with the regulator accepting it ‘can create discomfort and impede communication with patients and colleagues’. A ‘rapidly evolving evidence-base’ around coronavirus is also highlighted.

The guidelines state that a fitness to practise challenge may be less likely in cases where a doctors was ‘unable to see a patient in the usual way, for example, undertaking remote consultations using video rather than face-to-face.’

Investigation may also not be opened ‘if care for non COVID-19 related treatment was delayed’ or where a doctors’ actions are reasonable in the event that guidance ‘was lacking, inconsistent’ or ‘unclear’.

GMC chief executive Charlie Massey said: ‘Our new guidance considers the environment, created by the pandemic, in which doctors were working, along with any relevant information about resources, guidelines or protocols in place at the time.

Risk to patients

‘During this challenging time, doctors of course still have a duty to provide the best and safest care they can in the circumstances. When we consider concerns raised about doctors, we always review the circumstances and context of the case to decide whether they pose a future risk to patients and whether their fitness to practise is impaired.’

Medical Protection Society (MPS) medical director Dr Rob Hendry said: 'This GMC staff guidance setting out how to take the COVID-19 context into account when considering complaints will be welcomed by doctors, many of whom have had the stress of the pandemic compounded by the prospect of a regulatory investigation.

'The GMC guidance must however stand the test of time. It could be some time – potentially years - before such investigations are handled and we remain concerned that by this point memories of this difficult time may have faded.'

Head of advisory services at the Medical Defence Union Dr Caroline Fryar, said: ‘While the GMC’s recognition of the impact of the pandemic is reassuring, some of the complaints facing our members also have the potential to become clinical negligence claims which is why it is vital that the government acts to ensure all NHS healthcare professionals are exempt from COVID-19 related litigation, and the additional distress and anxiety it inevitably causes.’

Medico-legal experts have argued that emergency laws should be introduced to protect doctors making difficult decisions during the pandemic and for doctors who refuse to treat COVID-19 patients because of inadequate PPE not to face investigation.

MPs have called on the government to set up an independent expert committee to provide guidance on how medico-legal issues should be dealt with as a result of the COVID-19 pandemic.

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