Posts Tagged ‘GMC’

Hold the front page Katie’s got married again

By Mike Broad - 8th February 2010 10:38 pm

Why do some medical stories get covered in the media and others don’t?

It’s a pertinent question this week as debate rages in the blogosphere about Dr Jane Barton. For the uninitiated, she’s a GP in Gosport who has just been found guilty of serious professional misconduct by the GMC.

Dr Barton prescribed “potentially hazardous” levels of sedatives and painkillers to patients at the Gosport War Memorial Hospital in the 1990s. But, despite being found guilty of putting her patients at risk of premature death during that time, she has not been struck off. Instead she can continue to work under certain conditions, which includes a ban on injecting opiates for three years.

There’s been widespread criticism of the decision. The GMC case followed an inquest last year into 10 deaths that concluded that prescribed drugs had been a factor in five. Furthermore, a number of commentators have questioned why Dr Barton didn’t receive the same level of media attention as Dr Andrew Wakefield or Dr Daniel Ubani, the German GP at the centre of the out-of-hours storm.  

It being the web, conspiracy theories abound. Barton ‘survived’ and received less coverage because she’s white and from the right background. Others, like Ubani, haven’t fared so well because of prejudice and racism. The media is only interested in exposing minorities or outsiders because that’s what their small minded readerships want.

If you don’t like that one, there’s another. Barton ‘got off’ because she has friends and family in high places within the medical establishment. Conversations were held behind closed doors, strings were pulled. The media were scared off by the threat of libel.

Like most conspiracy theories, they’re nonsense. There is a more prosaic explanation. Let’s start with the GMC. The fitness to practise panel was clearly swayed by the outpouring of local support for Dr Barton. Supportive comments from current patients have even appeared on comment boards beneath the case’s coverage in the nationals. Despite her serious failings at the Memorial Hospital in the 90s, she’s clearly a popular GP now.  

The GMC’s adjudication powers are being moved to the totally independent Office of the Health Professions Adjudicator next year, effectively signalling the end of self-regulation. It will be interesting to see whether the OHPA would be similarly influenced - I doubt it.  

Fitness to practise panels make their own decisions, and the GMC itself is clearly not happy about this one. New chief executive Niall Dickson suggested she should have been struck off and has instigated a review. Furthermore, the Council for Healthcare Regulatory Excellence (CHRE), a supra-regulator if you like, is also having a look. Many forget that doctors now face double jeopardy. The CHRE has the power to refer the case to the High Court if it considers the decision to be unduly lenient.

In short, this case isn’t over yet. Norman Lamb, shadow health secretary for the Lib Dems, is calling for a public inquiry into the matter, though I doubt that will be required.

So, on to the next point, why haven’t the media covered it? Or, to be more accurate (because it has been covered by most of the nationals), why hasn’t it been on TV?

It’s simple - it just hasn’t sufficiently interested their journalists. While many health specialists might think it is an important story about competence, supervision and public protection, when you move into the mainstream media there is only so much ‘space’ for health stories. We’ve had a series of big health stories and if journalists, or more importantly their editors, decide that the Wakefield and Ubani cases have stronger news values (such as scope, relevance and topicality for their audiences) then every other health story gets squeezed. In the wider news agenda, the Iraq Inquiry has been squeezing everything.

Journalism is also a dying profession. Numbers have been slashed in recent years, which results in fewer specialists. Most reporters are now generalists, there’s a lot of churnalism, and effective PR has more sway than ever. ‘Good’ stories get missed. Partly because of this the media acts like a pack, if one credible publication or outlet runs a story, the others dive in. It helps to manage their risk.

So, it really doesn’t take a clandestine conspiracy for meaningful stories get pushed to the back of the queue, sadly just the England football captain getting caught with his pants down or Katie Price getting re-married will be enough.

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Review into the regulation of education and training

By Mike Broad - 12:29 pm

The GMC is going through an enormous period of change, with the introduction of revalidation, the merger with PMETB and the shift in responsibility for adjudication in fitness to practise cases to the Office of the Health Professions Adjudicator.

In September 2007, as part of the inquiry into Modernising Medical Careers, Sir John Tooke recommended that: “PMETB should be assimilated in a regulatory structure with the GMC that oversees the continuum of undergraduate and postgraduate medical education and training, continuing professional development, quality assurance and enhancement.”

This was accepted by the government and PMETB is due to merge with the GMC in April.

Although the merger will bring regulatory responsibility for the whole of medical education and training under one roof, this consolidation of functions will not, in itself, achieve the full benefits envisaged by Sir John Tooke’s report.

To ensure that those benefits are realised the GMC invited Lord Naren Patel to lead a review of the current arrangements for the regulation of medical education and training and make recommendations that would inform future policy developments by the GMC.

The review’s draft report makes 27 recommendations to the GMC and they are currently out to consultation. Here is a summary:

1. All those involved in developing the skills and commitment of doctors must fulfil their responsibilities if the UK is to provide world class training. The GMC was urged to enhance links with other key interests, such as training providers and regulators.

2. Regulation has to reach across the different stages of doctors’ education and learning and support their transitions. Effective systems need to be developed for the transfer of information across all different stages. 

3. Medicine is both a profession and a vocation. One of the goals of undergraduate medical education is to instil a culture of professionalism, and to begin the process of induction into the profession, that will inform doctors’ practice throughout their careers. It has been argued that the current undergraduate experience does not always achieve this and that student registration could be one way of fostering professionalism and a sense of professional identity. However, the review panel was not convinced. Instead it called on the GMC to evaluate the effectiveness of its existing arrangements for engaging with students and how professionalism is fostered by medical schools.

4. Newly qualified doctors need to be able to deliver the same standard of care regardless of where they qualified. Until now the GMC has set high level standards and allowed medical schools considerable flexibility in the way those standards are met. It must evaluate the effectiveness of the new requirements in delivering outcomes that are consistent and reliable to determine whether further measures are needed to achieve these ends.

5. Anomalies with the regulation of the Foundation Programme need to be addressed. Doctors in the first year of their foundation training may be working many miles from the medical school which is formally responsible for their training. This leads to an unsatisfactory lack of clarity over responsibilities. Equally unsatisfactory is the lack of any clear regulatory outcome required from the second year of the Foundation Programme.

6. The GMC should develop a framework for the accreditation of trainers. It should also look at the case for accrediting the environments in which education and training takes place, in addition to approving posts and programmes as currently undertaken by PMETB.

7. Above all, the GMC should develop a regulatory framework for the education and training of doctors in career posts. This is not only in the interests of the doctors concerned (who are often disadvantaged by limited access to training and CPD opportunities), it will also provide reassurance that these doctors are meeting national standards overseen by the regulator.

8. The public and employers must have confidence in the medical registers, and in the fitness to practise of doctors entering those registers. One factor militating against this is the lack of equivalence between the standards required of UK and European doctors entering the specialist and GP registers. The GMC should explore how this might be addressed. It proposes that European specialists and GPs should only be eligible for inclusion on the medical registers ‘at the point of first revalidation following completion of training’. This would require the GMC to uncouple the completion of specialist and GP training from the decision to allow a doctor onto the specialist or GP register. The move, it says, ‘could provide a mechanism for continuing to meet EC requirements in relation to recognition of training while ensuring greater equivalence in standards at the point of entry to the specialist and GP registers’.

9. The GMC should also examine, with the Department of Health, the current legislative anomaly that makes it possible for doctors not on the specialist register to take up locum consultant posts.

10. At the conclusion of specialty or GP training, participation in CPD is key to maintaining and further developing competence and performance. In 2004, the GMC issued guidance on CPD, but its regulatory role to date has been largely passive. Revalidation will provide a new focus for ensuring effective and appropriate CPD for all doctors but it will require the GMC to re-examine its role in this area. At the very least, it should provide clear guidance on what doctors will be required to do to keep up to date for the purposes of revalidation and the role of CPD within that.

11. The GMC should re-examine the current focus on assuring the quality of the processes used for training doctors. Instead, it should consider placing greater emphasis on outcomes and the quality of the individual trainees produced by those processes. What matters to patients is the quality of the doctors who treat them, not the processes by which they were trained.

Commenting on the report, Niall Dickson, chief executive of the GMC, said: “We have a great opportunity now to create a system in which every stage of education and training is fit for purpose, successfully prepares the doctor for the next one, where standards are constantly rising and which treats all doctors fairly, wherever they come from and whatever stage they are at in their careers.

“I hope the consultation stimulates debate and encourages as many as possible to comment on the conclusions and recommendations of the draft report. This will help us set the way ahead and ensure a robust approach to the regulation of education and training in the years to come.”

Doctors can consult on the recommendations until 9 March. A final report will be submitted to the GMC at the end of that month. Read the full list of recommendations.

Read more on the GMC’s corporate strategy 2010 to 2013.

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Watchdog to examine GMC’s decision on GP

By Mike Broad - 4th February 2010 4:35 pm

The Council for Healthcare Regulatory Excellence is to review a GMC fitness to practise panel decision to allow Dr Jane Barton to continue to work.

The CHRE has the power to refer the case to the High Court if it considers the decision by the panel unduly lenient.

Dr Jane Barton, a GP in Gosport, was found guilty of serious professional misconduct but was allowed to continue working with certain conditions placed on her practise.

She was accused of a series of failings in her care of 12 patients at Gosport War Memorial Hospital in the 1990s. Dr Barton prescribed “potentially hazardous” levels of drugs to elderly patients and was found guilty of putting them at risk of premature death.

Eleven conditions were place on her work, including a ban on injecting opiates for three years. The panel said it had taken her 10 years of safe practise as a GP, and strong local support, into consideration.

Dr Barton said after the ruling: “I am disappointed by the decision of the GMC panel. Anyone following this case carefully will know that I was faced with an excessive and increasing burden in trying to care for patients at the Gosport War Memorial Hospital.”

Following this controversial decision, the CHRE called for the transcripts of the case. The NHS Reform and Health Care Professions Act 2002 gives the CHRE powers and responsibilities for protecting the public.

Under Section 29, it can review all final stage fitness to practise decisions made by healthcare regulators’ committees and panels. These decisions can be referred to court if it considers they are unduly lenient and that referral is necessary in order to protect the public.

Read a blog on the issue.

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The General Medical Council’s strategy 2010 to 2013

By Mike Broad - 1st February 2010 11:23 am

The GMC is entering a defining period.

Many of initiatives intended to make it more accessible, independent and attentive are coming to pass.

Revalidation is finally happening, with the licence to practise being introduced last November and the full process being introduced next year.

In 2011, the GMC will also hand over responsibility for adjudication in fitness to practise cases to the Office of the Health Professions Adjudicator.

And if that wasn’t enough, when it comes to medical education, the GMC is about to merge with PMETB making it solely responsible for the regulation of medical education and training. It even has a new chief executive, Niall Dickson, to oversee all of this.

The GMC has just launched its strategic priorities for 2010 to 2013, with the key themes being protecting the public, helping doctors, working with partners and delivering value for money.

There is much talk within the aims about increasing the profession’s accountability to the public. There’s a lot less talk, however, about the GMC’s accountability to the medical profession. With the steady demise of self-regulation, one might question why the profession is still paying for it. At the very least, you should know how the regulator is spending the £410 each of you give it every year. It may also inform how doctors view an imminent review of fees.

So, this week, we’ll summarise the GMC’s strategy, while next week, we’ll look at the recommendations of an independent review into the GMC’s regulation of training and education that are currently being consulted on.

The GMC’s strategic priorities for 2010 to 2013 are:

1. To continue to register only those doctors that are properly qualified and fit to practise and to increase the utility of the medical register.

The GMC says the register will be further developed to reflect the introduction of licensing and provide more information related to doctors’ practice and their revalidation. By 2013, it aims to have better quality information available on the nature of doctors’ medical practice and an improved understanding of the role of the register among the public and employers.

2. To give all its key interest groups confidence that doctors are fit to practise.

The GMC says the introduction of revalidation will provide regular assurance that licensed doctors are practising in accordance with relevant professional standards. Revalidation will be one of several mechanisms, which includes fitness to practise procedures, for improving quality and reducing the risks of patient care. It commits to supporting the transition to independent adjudication arrangements in 2011 and wants to ensure the standards and ethics guidance developed by the GMC remains at the core of decisions made on doctors’ fitness to practise.

3. To provide an integrated approach to the regulation of medical education and training through all stages of a doctors’ career.

Following the merger with PMETB on 1 April, the GMC will be directly responsible for the regulation of all stages of medical education and training - from medical school, through postgraduate training, to established practice. For the first time a single organisation will be responsible for delivering an integrated regulatory framework of standards, education, registration and fitness to practise through out all stages of a doctor’s career. It says it will be ‘informed’ by Lord Patel’s review on the way forward. 

By 2013, the GMC wants tangible gains in the efficiency and effectiveness of regulating education and training, and other health bodies to recognise there is greater consistency.

4. To provide doctors with relevant up-to-date guidance on professional standards.

Good Medical Practice sets out these values and the principles that underpin good practice and is supported by web-based case studies, GMP in Action. GMC is aiming to keep the guidance up to date and fit for purpose and reflective of developments in healthcare. It will seek to further embed the guidance in doctors’ professional development and practice.

5. To develop more effective relationships with delivery partners in order to achieve an integrated approach to medical education.

Effective regulation, it says, needs to operate at four levels: personal, team-based, workplace and national. The GMC has to work with others in the health sector to discharge its regulatory functions. It commits to liaising more effectively with local organisations to bridge ‘the perceived gap’ between national and local regulation. A key aim, by 2013, is that NHS and other healthcare providers are working closely with it to up uphold the GMC’s standards of professional conduct.

6. To shape the local, UK, European and international regulatory environment through effective engagement with decision makers, other regulators and interest groups.

The GMC says that supporting regulatory cooperation and learning from good practice elsewhere will help it establish more effective regulation and safer care. It intends to raise the profile of the benefits of more effective and timely information sharing on healthcare professionals between competent authorities.

7. To deliver value for money.

It says it must continue to enhance the credibility of its operations in order to develop its platform to influence policy. It will undertake a range of improvement initiatives to reduce costs and improve the quality of its business processes and services. The GMC claims to have achieved savings of £4m, and will achieve a further £3.2m through the PMETB merger by 2013.

8. To deliver evidence-based policies demonstrating better regulation principles, and to promote equality and diversity.

It commits to consulting in an open, transparent and inclusive manner.

Introducing the strategy, Professor Peter Rubin, chair of the GMC said: “It is vital that we are outward looking and play an active part in the broader regulatory framework, both nationally and internationally. This involves being more in touch with the views of the public, patients and doctors; ensuring that our role in improving standards is understood widely; and working with other healthcare professions, employers and regulators. In this way, our contribution to enhancing the quality of healthcare and patient safety can be maximised.”

On the new developments, he commented: “These complex and extensive changes will be taking place during a period of financial stringency and rapid change within healthcare. The GMC has made great strides over recent years, demonstrating its ability to bring about significant change. So, I am confident that this demanding programme can be successfully delivered. I hope that the importance we place on achieving our aims will be shared by the public, patients, doctors and all the organisations with which we work.”

Read the full strategy and business plan.

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How do we repair the damage of the MMR debacle?

By Mike Broad - 28th January 2010 5:34 pm

So, it looks like Dr Andrew Wakefield is finally going to be brought to book.

The man who first suggested a link between the MMR vaccine and autism acted unethically, the GMC found this week. Wakefield’s 1998 study in The Lancet, which was later discredited, caused vaccination rates to plummet and a significant rise in measles.

The GMC ruled that he had acted “dishonestly and irresponsibly” in conducting his research. It found that he had carried out invasive tests on children which were against their best clinical interests, and had even paid children £5 each for blood samples at his son’s birthday party.  

The GMC now has to decide whether Wakefield’s behaviour amounted to serious professional misconduct and, if so, what sanctions should be imposed. He could be struck off the register. But, with Wakefield now being based in America, who knows how far any sanctions will reach in reality.

Wakefield’s legacy in the UK will be a sad one - a lot of children suffering from measles unnecessarily. But, he was aided by the media in spreading fear about the MMR jab.   

His research message was spread by The Lancet and many of the nationals. Have they faced sanctions for their complicity? Of course not.

The other issue that surprises me is the amount of time it’s taken to get to this decision. The hearings have been going on for two-and-a-half years - one of the longest cases in the regulator’s history.

Why should it take so long? How many parents still shun the MMR without realising that both the research and the researcher have now been discredited?

Maybe certain regulators, national papers and academic journals should foot the bill for a public health campaign on the issue…

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European doctors could face quality check in UK

By Mike Broad - 19th January 2010 4:24 pm

A major review of the regulation of doctors’ education and training has taken the first steps in controlling the quality of European doctors entering the UK.

The review’s draft report makes 27 recommendations to the GMC a head of it taking over the regulation of the whole of medical education in April, following its merger with the Post Graduate Medical Education and Training Board.

The report challenges the automatic inclusion of senior European doctors, with supposedly equivalent qualifications, on the specialist register.

Member states of the European Economic Area are required by law to recognise the qualifications of each others’ doctors. It means that the GMC cannot carry out additional assessments of knowledge and skill.

‘This clearly limits the effectiveness of the registers and the ability of the GMC to protect patients,’ the report says.

It proposes that European specialists and GPs should only be eligible for inclusion on the medical registers ‘at the point of first revalidation following completion of training’. This would require the GMC to uncouple the completion of specialist and GP training from the decision to allow a doctor onto the specialist or GP register.

The move, it says, ‘could provide a mechanism for continuing to meet EC requirements in relation to recognition of training while ensuring greater equivalence in standards at the point of entry to the specialist and GP registers’.

Last year, consultant anaesthetist John Hutchinson campaigned for greater monitoring of European locums, while last week an inquiry started into the circumstances surrounding the death of a patient at the hands of a tired, German locum GP.

The independent review, commissioned by the GMC and chaired by Lord Naren Patel, covers the entire career of a doctor, from the first day at medical school to the last day in practice.

On revalidation, the report says: ‘At the very least, the GMC should provide clear guidance on what doctors will be required to do to keep up to date for the purposes of revalidation and the role of CPD within that.’

It also calls on the regulator to focus on delivering the outcomes required from training, rather than simply assuring the process. ‘What matters to patients is the quality of the doctors who treat them, not the processes by which they were trained,’ the report says.

This review is taking a long-term look at the future regulation of medical education and training as a whole and considering how this fits in with the GMC’s other responsibilities.

Niall Dickson, chief executive of the GMC, said: “We have a great opportunity now to create a system in which every stage of education and training is fit for purpose, successfully prepares the doctor for the next one, where standards are constantly rising and which treats all doctors fairly, wherever they come from and whatever stage they are at in their careers.

“I hope the consultation stimulates debate and encourages as many as possible to comment on the conclusions and recommendations of the draft report. This will help us set the way ahead and ensure a robust approach to the regulation of education and training in the years to come.”

Doctors can consult on the report until 9 March. A final report will be submitted to the GMC at the end of that month.

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Doctors are given their licences to practise

By Mike Broad - 20th November 2009 4:49 pm

A historic milestone in the regulation doctors was passed this week with the introduction of licences to practise.

While most doctors have been underwhelmed by the event, it is significant - in order to practise medicine in the UK, a doctor has to be both registered with the GMC and have a licence to practise.

Since Monday, 218,153 doctors now officially have a licence.

The GMC said licensing has a number of implications for doctors and their employers that they should be aware of. The licence gives a practising doctor the legal authority to write prescriptions, sign death certificates and exercise a wide range of other legal ‘privileges’. And it applies to all doctors working in the UK, whether working in the NHS or the independent sector, either on a permanent or locum basis.

Employers must ensure that the doctors they employ have a licence to practise if their work requires them to do so.

Professor Peter Rubin, chair of the GMC, said: “The successful start to licensing is a major milestone towards the introduction of revalidation, a new process by which doctors will have to regularly demonstrate to the GMC that they remain up to date and fit to practise in the job they do.”

The licence to practise does not have an expiry date, but commits holders to revalidation. Revalidation is currently being piloted. The first revalidations will not happen before 2011, and these are likely to be with volunteers.

Read an interview with Prof Peter Rubin.

Read more on revalidation.

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Interview: Prof Peter Rubin, chair of the GMC

By Mike Broad - 12th November 2009 2:03 pm

Prof Peter Rubin, chair of the GMC

Prof Peter Rubin, chair of the GMC

Hospital Dr invites Professor Peter Rubin, chair of the GMC, and Professor of Therapeutics at the University of Nottingham, to answer 12 questions and complete a half written sentence:

1. What is the biggest challenge the profession faces?

“Well, the starting point has to be that opinion polls consistently show that the medical profession is easily the most trusted group in the UK. Over the years, doctors have felt most threatened when the profession as a whole has got out of step with public expectations and felt that change was being done to them. So I think the biggest challenge is for the profession to engage in leading change, recognising that the world around us is always changing.”

2. When did you last laugh?

“About 5 minutes ago.”

3. Which person influenced you the most as a doctor and why?

“There’s no one person who stands out, but several people have influenced me in different ways. For example, Sir George Pickering, who was my tutor for a while in Oxford, taught me the importance of seeing the world from my patient’s viewpoint. A young patient who was dying from cancer when I was a registrar taught me the importance of making decisions with your patient, not just for them. I’ve also been influenced by some pretty dire prima donnas in that I’ve been determined never to be like them!”

4. When were you most in danger?

“If you exclude school rugby in Cornwall, I don’t think I’ve ever been in physical danger.”

5. What are the GMC’s biggest priorities over the next year?

“Continuing the piloting for revalidation; the merging of PMETB; preparing to separate adjudication, while the GMC maintains its role in setting standards of practice and investigating complaints. Moving the responsibility for adjudication to the Office of the Health Professions Adjudicator will further demonstrate that decisions are fair and effective, separate from the regulators, the professions and government.”

6. What is your favourite book?

“Maugham’s Of Human Bondage really gripped me with its insight into why people do the things they do.”

7. Is the medical profession becoming over regulated?

“I certainly hope not. There are 180,000 doctors practising in the UK, of whom I’m one, and at the GMC we’re determined that regulation should be proportionate.”

8. What is your guiltiest pleasure?

“Eating Cornish clotted cream straight out of the tub.”

9. Would revalidation catch another Harold Shipman?

“No. Nor was it ever intended to. Revalidation grew out of the Bristol Royal Infirmary when it became clear doctors were working outside their competence, with other doctors knowing and remaining silent.”

10. What was your most embarrassing professional moment? 

“The time I got renal colic in my clinic. There are all sorts of memories, from my patient helping me on to the couch, to being wheeled off past my waiting patients.”

11. Is doctors’ training being dumbed down?

“No. For the last 150 years it has been regularly claimed that doctors are not what they used to be. There’s nothing new in this world.”

12. What achievement are you most proud of? 

“Leading the development of the Nottingham Vet School.”

Finish this sentence: The merger with PMETB is going to be…

…of benefit to the profession and the public by making the regulation of all stages of medical education by a single organisation a reality.

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First step taken on road to revalidation

By Mike Broad - 6th November 2009 11:22 am

Only 3% of doctors have yet to specify whether they want a licence to practise to the GMC a head of its 16 November licensing deadline.

In the first significant step towards revalidation, 220,000 doctors in the UK were asked to let the GMC know whether they required registration with or without a licence to practise.

In total, 97%, over 213,000 doctors, made their choice. Two hundred thousand doctors have chosen to hold registration with a licence and 13,500 doctors have chosen to be registered without a licence.

The minority of doctors who have not let the GMC know their decision will be granted a licence when licensing is introduced on 16 November 2009.

From this date, in order to practise medicine in the UK, a doctor will have to be registered with the GMC and hold a licence to practise.

The GMC said those doctors who have informed them need do nothing more. Letters have been sent to all doctors who have responded to the campaign confirming their decisions and that their registration will be updated on 16 November to reflect whether or not they hold a licence to practise. This will also be shown on the GMC website.

Professor Peter Rubin, chair of the GMC, said: “The introduction of licensing on the 16 November is the first practical step towards the introduction of revalidation. The first revalidations are likely to begin in 2011 and will mean that all doctors are regularly demonstrating to the GMC that their skills and knowledge are up to date to do the job they do.”

Read a guide on revalidation.

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Updated guidance on working during pandemic

By Mike Broad - 3rd November 2009 10:21 am

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.  

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