First overhaul of good medical practice guidance in a decade targets toxic workplaces

In a consultation launched on April 27, the regulator called for comments on what would be the first changes to its good medical practice advice in a decade.

Updated guidance for doctors would create an obligation to act, or help others to act, if they become aware of workplace bullying, harassment or discrimination, and outlines a zero-tolerance approach to harassment sexual.

The regulator also updated guidance for doctors on the use of social media, saying they must not “mislead” via digital channels and must make “reasonable checks” to avoid doing so.

Good Medical Practice

The proposed changes to the guidelines described in the consultation are broken down into the sections on working with colleagues, working with patients, professional capabilities and maintaining trust.

Although the existing version of good medical practice includes a requirement to “treat colleagues fairly and with respect”, the proposed update would significantly expand the wording with more explicit requirements.

These requirements cover areas such as teamwork; clear, effective and courteous communication; and a statement that doctors should “not abuse, discriminate, intimidate, exploit, or harass anyone, or condone such behavior by others” and that doctors should take action if they witness such behavior .

The guidance also brings more detail on physicians’ duty to support continuity of care and on delegation of work – with updated lines drawn from other GMC advice areas in some cases.

General practitioner consultations

Other changes take into account changes to the way consultations are delivered, reminding physicians of the need to provide safe and effective care “whether you provide face-to-face clinical care or through remote consultations by telephone, video link or online services’.

GMC’s notes on its proposed changes say the regulator is considering whether sustainability should be factored more into its advice following calls to reflect public health risks from climate change in good medical practice.

Physicians could be told to “provide the best possible service within the limits of available resources, taking into account your responsibilities to patients, the population at large and global health”.

A list of 12 general commitments was also proposed to be added to the guidelines for the first time. The proposed update says, “As a healthcare professional, I will:

  • Make patient care my first concern.
  • Work effectively with colleagues in a manner that serves the best interests of patients.
  • Act quickly if I believe the safety, dignity or comfort of patients or colleagues is compromised.
  • Treat patients as individuals and respect their dignity and privacy.
  • Listen, support and work in partnership with patients, to help them make informed decisions about their care.
  • Provide a good level of practice and care, and be honest and open when things go wrong.
  • Work within my skills and keep my knowledge and skills up to date.
  • Demonstrate leadership according to my role and work with others to make health care more supportive, inclusive and equitable.
  • Protect and promote the health of patients and the public.
  • Act with honesty and integrity.
  • Never unfairly discriminate against patients or colleagues.
  • Ensure that my conduct justifies the confidence of my patients in me and the confidence of the public in my profession.

working pressure

GMC Chief Executive Charlie Massey said: “Good medical practice applies to all physicians registered with us, regardless of specialty, grade, type of role or sector. It is therefore important that it be as relevant and realistic for physicians working in primary care as for those working elsewhere.

“For this reason, we really want to hear from GPs as part of our consultation. We know that GPs continue to face enormous workload pressures and we want our guidance to provide a useful framework for addressing professional and ethical challenges, without creating additional burdens.

GMC’s chief executive said the update was “designed to reflect the kind of fair, inclusive and caring workplaces we all want to see, and which are good for doctors as well as patients.”

The President of the Royal College of Physicians of Edinburgh, Professor Andrew Elder, said: “Given the pressures on medical staff, it is essential that medicine remains an attractive career. As such, every effort should be made to ensure a positive, open, honest and diverse culture in the health service.

“Improving the culture of health services is about improving the well-being of health care workers and ensuring patient safety. Our medical staff must be valued and supported at all stages of their career, from medical student to junior physician, consultant and medical director.