Intended for healthcare professionals


Doctors will have a duty to report lapses in patients’ basic care

BMJ 2011; 343 doi: (Published 28 September 2011) Cite this as: BMJ 2011;343:d6251
  1. Clare Dyer
  1. 1BMJ

UK doctors are to be put under an explicit professional duty to take action if they see that patients are being denied basic care such as help with feeding or washing, in the wake of the “appalling” standards of care found at Mid Staffordshire NHS Foundation Trust.

The duty is spelled out in the draft of the proposed 2012 edition of the General Medical Council’s Good Medical Practice, which outlines the duties with which doctors must comply. The draft will go out for consultation in the week beginning 17 October and the final version will replace the current 2006 guidance.

The new section on reducing risks to patients says doctors must take “prompt action when problems with basic care for patients who are unable to drink, feed or clean themselves may lead to patient safety, dignity or comfort being compromised.”

A Healthcare Commission investigation in 2009 found “appalling standards of care and chaotic systems for looking after patients” at Stafford Hospital. But several witnesses at the current public inquiry into the hospital’s failings have remarked on the failure of clinicians to blow the whistle on what was happening.

The revised edition of Good Medical Practice will be shorter than the current guide, in response to early consultation which recommended that it be clear and concise and more patient centred. The draft includes for the first time an explicit duty to be competent in carrying out care and in other professional roles, and contains additional guidance on ensuring continuity of care.

Doctors will be under a new duty to seek out a mentor in their first years of practice and when changing roles, and senior doctors will have a corresponding duty to be willing to act as a mentor to less experienced colleagues.

There will also be a duty to encourage patients with long term conditions to stay in or return to employment.

The section on discrimination contains new guidance that doctors must not end a relationship with a patient solely because of a complaint he or she has made, or because of the resource implications of the patient’s care.

The GMC is also planning to produce new explanatory materials covering financial and commercial interests, ending relationships with patients, delegation and referrals, working with colleagues, and doctors’ use of social networking.

GMC chief executive Niall Dickson told the Commons health committee last July that large numbers of doctors at Mid-Staffordshire “must have seen something that they should have blown the whistle about,” but they did not. He said there were ongoing fitness to practise cases which had been put on hold pending the end of the inquiry.

Asked by the committee chairman, Stephen Dorrell, “Does that include doctors whose individual practice was blameless but who should have reported what they saw?” Mr Dickson replied: “It does. There are a number of doctors in that category.”


Cite this as: BMJ 2011;343:d6251

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