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Leadership and management for all doctors

Employment

48

If you are involved in any aspects of employing staff such as recruiting, promoting or rewarding staff, including sitting on appointment or reward committees, you must work within your professional values and your organisation's policies and procedures, and observe the principles of fairness, equality and diversity.

Recruitment, rewards and compensation

All doctors

49

When applying for posts, you must always be open and honest about your experience, qualifications and current employment status.

50

When applying for and accepting posts, you must follow the guidance in Good medical practice 5, bearing in mind how your decisions may affect patient safety.

5

General Medical Council (2013) Good medical practice London, GMC.

Doctors with extra responsibilities

51

If you have specific responsibility for recruitment, promotion or other staff rewards or compensation, you must make sure that the process is fair and transparent, and that decisions are based on objective criteria.

52

You must make sure you have, and anyone you appoint to take part in these activities has, the skills and competence needed and the opportunity to undertake appropriate training, including in relation to equality, diversity and non-discrimination in employment matters.

Induction and mentoring

53

Understanding the systems in place and how an organisation operates helps to make sure that doctors can deliver safe, effective and efficient care to patients as soon as they start a new job. Induction and mentoring schemes and access to other support mechanisms are important ways of achieving this. While important for all doctors, this may be particularly important for doctors if they are new to clinical practice, have trained outside the UK12 or are taking on a role in a new area or at a higher level.

12

Slowther A et al (2009) Non UK qualified doctors and Good Medical Practice: the experience of working within a different professional framework University of Warwick.

Induction

All doctors

54

You must take part in the induction offered by your employer when you join an organisation or move into a new role. You should also contribute to the induction of colleagues when asked.

Doctors with extra responsibilities

55

You must make sure that any new doctor or other healthcare professional you manage is offered relevant induction and that induction policies and procedures contain information that is relevant, accessible and proportionate to the doctor's role and length of employment within your organisation.

Mentoring

All doctors

56

You should be willing to take part in a mentoring scheme offered by your employer.

Doctors with extra responsibilities

57

You should be willing to take on a mentoring role for more junior doctors and other healthcare professionals.

58

If you have agreed to act as a mentor, you must make sure that you are competent to take on the role and that you can fulfil your responsibilities, including undertaking appropriate training and keeping your skills up to date. You must be clear about the aims and purpose of the mentoring, the scope of your role as a mentor and your availability to provide advice and support when needed.

59

You must make sure that staff who are new to an organisation or are moving into a new role have access to an appropriate mentoring arrangement13 , where relevant, depending on the nature of their clinical practice and their responsibilities.13 

13

The Standing Committee on Postgraduate Medical and Dental Education (1998) Supporting doctors and dentists at work: an inquiry into mentoring London, SCOPME, described mentoring as: ‘The process whereby an experienced, highly regarded, empathic person (the mentor), guides another individual (the mentee) in the development and re-examination of their own ideas, learning, and personal and professional development. The mentor who often, but not necessarily, works in the same organisation or field as the mentee, achieves this by listening and talking in confidence to the mentee.’

13

The Standing Committee on Postgraduate Medical and Dental Education (1998) Supporting doctors and dentists at work: an inquiry into mentoring London, SCOPME, described mentoring as: ‘The process whereby an experienced, highly regarded, empathic person (the mentor), guides another individual (the mentee) in the development and re-examination of their own ideas, learning, and personal and professional development. The mentor who often, but not necessarily, works in the same organisation or field as the mentee, achieves this by listening and talking in confidence to the mentee.’

Supervision

All doctors

60

You must recognise and work within the limits of your competence and you must make sure, to the best of your ability, that you are appropriately supervised for any task you perform. You must be willing to ask for advice and support from colleagues when necessary.

Doctors with extra responsibilities

61

You must make sure that the people you manage have appropriate supervision, whether through close personal supervision (for junior doctors, for example) or through a managed system with clear reporting structures.

62

If you are responsible for supervising staff, whatever your role, you must understand the extent of your supervisory responsibilities, give clear instructions about what is expected and be available to answer questions or provide help when needed. You must support any colleagues you supervise or manage to develop their roles and responsibilities by appropriately delegating tasks and responsibilities. You must be satisfied that the staff you supervise have the necessary knowledge, skills and training to carry out their roles.

Teaching and training

All doctors

63

Many of the skills of being a doctor can be learnt only by specific, on the job training in the work placements begun at medical school and continuing through the early postgraduate years. Every doctor who comes into contact with trainee doctors, medical students and other healthcare professionals in training should act as a positive role model in their behaviour towards patients, colleagues and others.

64

If you are formally involved in teaching in the workplace - for example, teaching trainee doctors on placements - you must develop the skills, attitudes and practices of a competent teacher. This includes respecting cultural diversity and making reasonable adjustments for those with a disability without affecting patient safety or educational outcomes.

Doctors with extra responsibilities

65

If you are responsible for managing teaching and training in your organisation, you must make sure:

  1. Only people with the appropriate knowledge, skills and attitudes carry out any teaching and training for which you are responsible.
  2. There are enough staff members from appropriate disciplines, and with the necessary skills and experience14, to deliver teaching and training and to support the learning and development of trainees and students.
  3. Systems are in place to identify and record the educational and training needs of students, trainees and staff, including locums, so that the best use is made of the time and resources available for keeping knowledge and skills up to date.
  4. An appropriate environment for training is provided, including by implementing reasonable adjustments to meet individual trainees' needs in line with the Equality Act 2010.15 
  5. You provide opportunities for those you manage to keep up to date and develop their skills as teachers and trainers, and make sure that there are systems in place for regular feedback and appraisal of those skills.
14

GP trainers are required to be approved under section 34I(1) of the Medical Act 1983

15

General Medical Council (2011) Gateways to the professions: advising medical schools: encouraging disabled students London, General Medical Council.

Grievance, performance and health

Grievance

All doctors

66

You should understand the difference between a personal grievance, that is a complaint about your own employment situation, and a concern about a risk, malpractice or wrongdoing that affects others. This is particularly important if patients or members of the public are at risk of harm.16 It can sometimes be difficult to separate personal grievances from a concern about patient safety. If these overlap, you should acknowledge any personal grievance that may arise from the situation, but focus on patient safety.17 You should as far as possible make sure you use the correct procedure to make your personal grievance known or raise your concern.18 

16

A more detailed discussion on the difference between a personal grievance and raising a concern can be found in Speak up for a healthy NHS.

18

For further information see Speak up for a healthy NHS.

67

If you have a personal grievance that you cannot resolve informally, you should follow your organisations grievance procedure. If you have a concern about patient safety, you must follow the guidance in Raising and acting on concerns about patient safety 4 

4

General Medical Council (2012) Raising and acting on concerns about patient safety London, GMC

Doctors with extra responsibilities

68

You should help staff you manage to identify the appropriate procedure for dealing with their personal grievance or concern about patient safety.

Performance and health

All doctors

69

You must make sure that your own health does not put patients at risk and you must follow the guidance in Good medical practice 5 on doctors' responsibilities in relation to their own health.

5

General Medical Council (2013) Good medical practice London, GMC.

70

You should be aware that poorly performing colleagues may have health problems and respond constructively where this is the case. You should encourage such colleagues to seek and follow professional advice and offer them appropriate help and support. You must not unfairly discriminate against colleagues because of an issue related to their health or a disability.

71

You should, as far as possible, support colleagues who are experiencing performance problems.

72

But, in all cases, you should remember your duty to raise concerns where you believe a colleague may not be fit to practise or may otherwise pose a risk of serious harm to patients.4 

4

General Medical Council (2012) Raising and acting on concerns about patient safety London, GMC

Doctors with extra responsibilities

73

You must promote the health and wellbeing of staff you manage.

74

You must make sure that there are clear and effective procedures for responding to concerns about colleagues' conduct, performance or health. This includes referring them to occupational health or other services, where appropriate, and making sure that staff are aware of these procedures.

75

You should be prepared to discuss constructively and sympathetically any work problems that the people you manage may have. You must deal supportively and, where possible, openly with problems in the conduct, performance or health of people you manage.19 

19

General Medical Council (2017) Confidentiality: good practice in handling patient information London, GMC.

76

You must make sure that people you manage have access to support for any health or performance problems they have. You must make sure that people are not unfairly discriminated against because of their health or disability.

77

You must make sure that you respond appropriately to requests for reasonable adjustments for staff with a disability or health condition in line with the Equality Act 2010.

Writing references

78

If you have been asked to or have agreed to write a reference for a colleague, you must follow the guidance in Writing references.20 

20

General Medical Council (2012) Writing references London, GMC.