As a result of the rapid spread of Covid-19, the UK's healthcare system is currently under significant strain. The pressure caused by this burden has led to thousands of elective procedures being cancelled, healthcare professionals being redeployed away from their normal work, and retired doctors and nurses being contacted by their regulator asking them to return to the front line.
In this unprecedented situation, it is inevitable that healthcare and facilities will not meet the usual standards, and the normal way of delivering healthcare will dramatically change. To date there has been tremendous public goodwill and support shown to NHS staff, who will continue to work tirelessly in the weeks and likely months ahead. However, human nature dictates that in some cases there will inevitably be issue taken with some of the care provided and doctors, many of whom will work round the clock, will be called to account for their actions, potentially by the GMC. Keeping a few key principles in mind will help protect you in the weeks and months ahead.
In a statement (issued jointly with other professional healthcare regulators across the UK) the GMC has already acknowledged that doctors may have concerns about decisions they need to make in order to provide the best care in challenging circumstances. https://www.gmc-uk.org/news/news-archive/how-we-will-continue-to-regulate-in-light-of-novel-coronavirus. There is a recognition that "in highly challenging circumstances, professionals may need to depart from established procedures in order to care for patients and people using health and social care services," and that healthcare professionals "may feel anxious about how context is taken into account when concerns are raised about their decisions and actions in very challenging circumstances." In terms of guidance and reassurance the GMC's position (absent any specific further specific guidance at this stage), is that any concern "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." The joint statement adds, "...We would also take account of any relevant information about resource, guidelines or protocols in place at the time."
Whilst the GMC (and other healthcare regulators) have committed to take into account factors relevant to the environment in which a doctor is working, inevitably this guidance is very general. In practical terms you should bear in mind the following:
- If you have concerns about system failures and risk of harm to patients it remains important that you escalate those concerns with colleagues/management, and in writing where possible
- In addition to the GMC's own guidance as set out in Good Medical Practice, ensure you are aware of the guidelines and protocols issued by your NHS Trust/organisation;
- Make sure you understand your own level of clinical competence – this is particularly true for those professionals returning to practice following retirement;
- Be clear with your colleagues, patients and others about your level of competence and expertise;
- Discuss patient's expectations with them, and be clear about what can and cannot be achieved. Ensure all options discussed with the patient and/or their family are clearly recorded;
- As always, make sure all the relevant information, your decision making and discussions with patient are noted clearly in the patient records;
- Be aware of your own health - make sure you self-isolate if required
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.