The scene

A practice manager called the MDU for assistance regarding a potential conflict of interest with a member of the practice dispensing team. For some time, this member of staff had not been abiding by the staff sickness policy and after disciplining her, the practice manager thought it likely that she would take out a grievance against the partnership.

However, the same member of staff had also made a complaint regarding their clinical care as a patient of the practice.

MDU advice

This case highlights the potential conflicts of interest that can arise when members of practice staff are registered as patients. Many practices operate a policy that members of staff cannot also be patients.

The GMC guidance in Good medical practice¹ states doctors should, wherever possible, 'avoid treating themselves or anyone with whom they have a close personal relationship and should be registered with a GP outside their family'.

The adviser suggested that separate members of the management team should be dealing with the complaint and the employment matter. This way, the practice can be shown to be keeping the doctor-patient relationship as separate as possible from the employer-employee relationship.

The patient is entitled to have her complaint investigated in the same way as any other patient and so it would be important that the practice follows its complaints procedure to avoid any criticism by the complainant or the Ombudsman should the matter be escalated there.

As the practice was a member of the MDU GROUPCARE scheme, it had access to employment advice from Peninsula Business Services. The adviser suggested that the manager should contact them as soon as possible. It would be important to bear in mind that while the employee may provide information as part of an occupational health assessment (relating to the sickness absence), the practice should be careful not to inadvertently reveal any health details known to them only in the context of the doctor-patient relationship.

It was suggested that the practice may wish to revisit its policies on having staff as patients. The adviser suggested that any decision to ask staff to register elsewhere would need to be communicated sensitively and that the MDU could provide advice as needed.