GMC - Good Medical Practice 2013

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The General Medical Council (“GMC”) registers doctors to practise medicine in the UK. Their purpose is to protect, promote and maintain health and safety by ensuring proper standards in the practice of medicine.

Good Medical Practice 2006

The previous guidance on Good Medical Practice for doctors came into effect on 13 November 2006. It sets out the principles and values on which good practice is founded. The guidance was addressed to doctors and described the medical profession in action. However, the practice was also intended to let the public know what they could expect from doctors. The GMC also provided links to other guidance and information which illustrated how the principles in Good Medical Practice apply in practice and how they may be interpreted in other contexts.

Good Medical Practice 2013

The new guidance on Good Medical Practice was published on 25 March 2013. The guidance comes into effect on 22 April 2013. A copy of the new guidance can be found on the General Medical Council website. This is the new core guidance for doctors and sets out high level principles of good practice expected of all doctors. The guidance is split into a total of 80 paragraphs. On 22 April 2013, the GMC will also launch a range of supporting materials including online versions of the guidance and new interactive case studies. The GMC have also published explanatory guidance alongside the Good Medical Practice, particularly relevant, considering the popularity of websites such as Facebook and Twitter, is the introduction of guidance on doctor’s use of social media. The explanatory guidance provides more detail on various topics that doctors and others ask the GMC. The new explanatory guidance includes:

  • Acting as a witness in legal proceedings
  • Delegation and referral
  • Doctors’ use of social media
  • Ending your professional relationship with a patient
  • Financial and commercial interests and conflicts of interest
  • Intimate examinations and chaperones
  • Maintaining your professional boundary with a patient
  • Personal beliefs and medical practice
  • Reporting regulatory and criminal proceedings within and outside the UK
  • Sexual behaviour and your duty to report colleagues

The duties of a doctor registered with the GMC

At the beginning of the guidance are the duties of a doctor registered with the General Medical Council. The content of these duties is largely the same as in the 2006 guidance and provide a summary of the guidance and what is expected from a doctor. It states that “Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and make sure your practice meets the standard expected of you in four domains”. The duties differ from 2006 in that they have been split into four domains, which are:

  • Knowledge, skills and performance
  • Safety and quality
  • Communication, partnership and teamwork
  • Maintaining trust

Professionalism in action

Paragraphs 1 to 6 of the guidance covers professionalism in action. This provides an outline of how doctors are expected to act professionally. For example, doctors should make the care of patients their first concern, respect patient’s privacy and dignity, take responsibility for being familiar with Good Medical Practice and use their judgement in applying the principles.

The guidance also sets out in paragraph 6 that in order to retain their licence, doctors must demonstrate through the revalidation process that they work in line with the principles and vales set out in the guidance. The aim of the process is to give extra confidence to patients that their doctor is being regularly checked by their employer and the GMC. The process of revalidation started on 3 December 2012. The GMC expect to revalidate the majority of licensed doctors in the UK for the first time by March 2016. Revalidation is a process by which licensed doctors are required to demonstrate on a regular basis that they are up to date and fit to practise. Licensed doctors will have to revalidate every five years. This is done through regular appraisals with their employer based on the core guidance, Good Medical practice 2013.

The four domains

The first domain is “Knowledge, skills and performance” and is covered in paragraphs 7 – 21. Within this domain doctors must demonstrate the expected standard by making the care of patients their first concern, provide a good standard of practice and care, keep their professional knowledge and skills up to date, recognise and work within the limits of their competence. The domain provides doctors with guidance on developing and maintaining their professional performance; applying knowledge and experience to practice; and recording work clearly, accurately and legibly

The second domain is “Safety and quality” and is covered in paragraphs 22 – 30. Doctors must demonstrate the standard expected within this domain by taking prompt action if they think that patient safety, dignity or comfort is being compromised. Doctors are also required to protect and promote the health of patients and the public. The domain provides guidance on contributing to and complying with systems to protect patients; responding to risks to safety; and protecting patients and colleagues from any risk posed by a doctor’s health.

The third domain is “Communication, partnership and teamwork” which is covered in paragraphs 31 – 52. Doctors are expected to demonstrate the expected standard by treating patients as individuals and respecting their dignity; treating patients politely and considerately and respecting patients’ right to confidentiality. Also doctors should work in partnership with patients; listen to and respond to their concerns and preference, give patients the information they want or need in a way they can understand, respect patients’ right to reach decision with doctors about their treatment and care, support patients in caring for themselves to improve and maintain their health. Doctors should work with colleagues in the ways that best serve patients’ interests. The guidance states that colleagues includes anyone a doctor works with, whether or not they are also doctors. Within the third domain there is guidance on communicating effectively, working collaboratively with colleagues to maintain or improve patient care; teaching, training, supporting and assessing; continuity and coordination of care; and establishing and maintaining partnerships with patients.

The fourth domain is “Maintaining trust” and is covered in paragraphs 53 – 80. Doctors must demonstrate the expected standard by being honest and open and acting with integrity; never discriminate unfairly against patients or colleagues; and never abuse patient’s trust in them or the public’s trust in the profession. This domain gives guidance in that doctors should show respect for patients; treat patients and colleagues fairly and without discrimination; and act with honesty and integrity.