“Good medical practice sets out the standards of care and professional behaviour expected of all medical professionals…”
Those are the opening words of the GMC’s revised 'Good medical practice' (GMP). It's hard to overstate just how important this guidance is for all doctors registered to practise in the UK. GMP is at the core of everything the GMC does - and is possibly the most central tool used by the GMC in its fitness to practise proceedings, thus determining the registration status of doctors.
Consequently, every paragraph and every word in the guidance really does matter, and the GMC's consultation on its content is a once-in-a-decade opportunity for the profession to have its voice heard on what should be in this important document. We are speaking up for members in this debate, so we want to hear what you think.
The GMC last did a complete update of the guidance in 2013. It is now proposing some considerable changes and making a number of notable additions. We want to introduce you to the four new Domains of GMP; the sections that make up the revised guidance.
- Domain 1: Working with colleagues - describing how professionals should treat each other and work together in the interests of patients and service improvement.
- Domain 2: Working with patients - describing the different aspects of good doctor-patient relationships, particularly communication and shared decision-making as set out in the GMC's more recent consent guidance.
- Domain 3: Professional capabilities - an expanded section describing the range of capabilities that underpin safe, effective practice, including demonstrating leadership and reflective practice.
- Domain 4: Maintaining trust - describing the conduct needed to maintain public confidence in the profession, with new duties concerning social media and dealing with sexual harassment.
You can read the proposed new version of the guidance in the GMC's consultation here.
Clarity and comprehension
We want to ensure the guidance delivers for doctors, so you can deliver for patients. For us, the fundamental questions at the heart of this new version of GMP are, "What is the guidance purporting to be?" and, "What, in fact, is it?"
For instance, the guidance now includes the word 'kindness'. It also has obligations on doctors not to condone certain behaviour on social media, and to have regard for 'global health' when taking account of the resources available to treat patients.
All of these - kindness, tackling abuse on social media, climate change - profoundly matter. However, we don't believe that GMP is, or should be, a manifesto outlining the aspirations for the healthcare system. Instead, the duties and responsibilities it places on the profession must reflect the realities of the healthcare system and the individual doctors within it.
To achieve this, the guidance must be accessible, understandable and achievable for doctors.
For example, let's look at paragraph seven of the proposed new GMP guidance, which says, "You should take action, or support others to take action, if you witness or are made aware of bullying, harassment, or unfair discrimination."
Quite rightly, the GMC does not want to be prescriptive about what kind of 'action' should be taken in these situations, but it's then left up to the doctors involved to decide what to do. Would it be enough to simply ask the person on the receiving end of this treatment if they are okay?
The GMC's consultation on its content is a once in a decade opportunity for the profession to have its voice heard...
What if everyone in a team meeting hears a discriminatory comment - are all doctors present expected to be involved in 'taking action'? Also, what if the person subject to the treatment you witness specifically asks you not to take it any further?
These are just some of the open questions posed by additions like this, and they underline why it is so important to have maximum clarity from the GMC without creating sweeping and burdensome duties on individual doctors.
Have your say
We are scrutinising the many changes being proposed to ensure the guidance is compatible with the realities of your working lives, but we also want to hear your views so we can consider members' views as part of the consultation response.
Do you think the updates are an accurate reflection of working practice? What are your thoughts on the new additions? Is there anything else you'd want to see changed or acknowledged?
To share your views, email us at firstname.lastname@example.org by 20 July 2022.