The GMC is advising doctors during the swine flu pandemic to prioritise patient care on the basis of clinical need and the patient’s likely capacity to benefit rather than factors such as age.
In updated guidance for doctors working in a pandemic, the GMC this week outlines the standards of practice expected if their work is affected.
The guidance, which forms part of Good Medical Practice, acknowledges that a pandemic can break out regionally and so while some doctors may be working normally, others may be struggling to cope with the additional workload. The guidance allows those most affected to work flexibly to provide assistance where it is most needed.
In addition to offering guidance on making decisions about which patients receive treatment where resources are scarce, the GMC document makes allowance for doctors to work outside their normal field of practice so long as they are able to do so safely. An orthopaedic surgeon may be asked to support A&E admissions or administer vaccines for example.
While key responsibilities such as acting with honesty and making patient safety a priority remain unchanged, the guidance recognises the constraints on time and resources likely in a pandemic.
There is no formal duty to report concerns about resources, equipment or insufficient patient services, other than in exceptional circumstances – because managers will already be aware of the pressures involved working in a pandemic.
And doctors running research programmes are asked to consider whether to interrupt them during a pandemic.
Jane O’Brien, GMC head of standards and ethics, said: “If services and resources come under real strain because of a pandemic, it is right that doctors should have some flexibility to ensure their efforts are directed towards treating patients and maintaining patient safety.
“Whilst the GMC expects doctors to provide a good standard of care, even in difficult circumstances, we do recognise that in a pandemic, some will have to make difficult decisions due to additional pressures. Should a complaint be made against a doctor working under the strain of a pandemic, the GMC will take into account the circumstances under which they were working. However, it is important to note that all doctors should be ready to explain how and why they altered their practice if called upon to do so.”
Good Medical Practice, responsibilities of doctors in a national pandemic, was first made available in March 2009. It has since been amended to be consistent with the varying and regional impact of the pandemic on health services so far. Read the updated guidance online.
It can be used immediately, if necessary, by doctors working under strain because of the pandemic. It no longer requires a UK alert level 3 to be announced before it is effective.
Meanwhile, cases of swine flu have risen again with an estimated 78,000 new infections last week. The latest official figures for England also show that the number of people needing critical care has jumped to 157 patients – the highest number since swine flu emerged.
Read a blog on doctors’ responsibilities during swine flu.