Good Medical Practice is... getting on with your colleagues
Successful working relationships with colleagues can significantly improve patient care and the working environment for the whole healthcare team, as highlighted in Good Medical Practice (GMP).
Supporting colleagues
The guidance emphasises the importance of working collaboratively with colleagues – doctors, other healthcare staff, managers and administrators – and respecting the contributions that they make to the provision of patient care. Good communication is essential, and doctors have a responsibility to listen to colleagues, and make sure that they pass on the information that is necessary to provide or support care.
Supporting and helping colleagues who are facing difficulties in their professional or private lives is an important professional responsibility.
However, there may sometimes be reason to believe that a colleague’s conduct, performance or health is putting patients’ safety at risk. In these circumstances, doctors’ overriding duty is to patients, and they must act without delay so that concerns can be investigated and patients protected, where that is necessary. In many cases, it will be possible to continue to provide support and advice for colleagues while their practice or health is investigated. But the safety of patients must always come first. To help doctors who are concerned about potential risk to patients, we have published supplementary guidance on raising concerns.
www.gmc-uk.org/guidance/ethical_guidance
Treating colleagues with respect
Lack of respect for colleagues – for example, by patronising or ignoring them – may indirectly affect the quality of patient care. Bullying, harassing or discriminating against colleagues can never be acceptable. Where doctors act as employers or managers they must also ensure that that they understand and comply with their legal obligations to act fairly towards their colleagues, for example, those applying for jobs. Our website provides a summary of equalities legislation for doctors:
www.gmc-uk.org/publications/valuing_diversity
Taking up appointments
Where doctors fail to take up a new job or do not ensure that appropriate cover arrangements are in place, the impact can be more direct, leaving patients with insufficient care and placing unfair burdens on colleagues.
Our guidance on taking up and ending appointments considers the issues from the patients’ point of view. Where doctors have formally accepted posts they must take them up, unless the employer has sufficient time to make other arrangements. We have published some short additional notes on our website, to help doctors interpret our guidance, and to refer them to other guidance on the contractual issues raised in this area of employment:
www.gmc-uk.org/guidance/current/library/taking_up_and_ending_appointments.asp
Shown below are some issues that have been raised in fitness to practice hearings where the doctor’s fitness to practice has been found to be impaired:
- A doctor’s behaviour towards his colleagues was aggressive and disrespectful on a number of occasions: he shouted at a receptionist in front of patients; shouted at two female colleagues, causing them to feel threatened; and shouted at a nurse in front of a patient, upsetting the patient. The doctor also booked a holiday at short notice before telling his employers that he was unwell and unfit to work for two weeks.
- A consultant neurosurgeon was jointly responsible for the care of a patient admitted to hospital. He went on leave shortly afterwards and did not formulate a management plan for the patient during his absence, nor make adequate arrangements for cover. The patient subsequently died.
- A doctor failed to take up an appointment on a vocational training scheme, having applied to be on it whilst already on another training scheme. The doctor failed to provide any notice of not taking up the place and, when contacted, lied about the reasons for not doing so. The doctor failed on a second occasion to take up his place on a scheme and again lied about the reasons for this. The full determinations in, and outcomes of, these cases are linked to the relevant paragraphs of GMP:
www.gmc-uk.org/guidance/good_medical_practice/working_with_colleagues/appointments.asp