Leadership and management for all doctors
Working with colleagues
Most doctors work in multidisciplinary teams. The work of these teams is primarily focused on the needs and safety of patients. The formal leader of the team is accountable for the performance of the team, but the responsibility for identifying problems, solving them and taking the appropriate action is shared by the team as a whole.
You must be willing to work with other people and teams to maintain and improve performance and change systems where this is necessary for the benefit of patients.
You should respect the leadership and management roles of other team members, including non-medical colleagues.
Respect for colleagues
It is essential for good and safe patient care that doctors work effectively with colleagues from other health and social care disciplines, both within and between teams and organisations. Whatever the composition of the teams you work in, you must respect and value each person's skills and contribution.
You must tackle discrimination where it arises and encourage your colleagues to do the same. You must treat your colleagues fairly and with respect. You must not bully or harass them or unfairly discriminate against them. You should challenge the behaviour of colleagues who do not meet this standard.
You must follow and keep up to date with your organisation's policies about employment, equality and diversity. You must get advice on these issues if you need it.
Doctors with extra responsibilities
You must actively advance equality and diversity by creating or maintaining a positive working environment free from discrimination, bullying and harassment. You must make sure that your organisation’s policies on employment and equality and diversity are up to date and reflect the law.3
For example, you must make sure policies accurately reflect employment and related legislation, including the Equality Act 2010. If you are working in Northern Ireland, see The Gaps between GB and NI Equality Law (pdf) (January 2011), which sets out the differences between the legislative framework and protections in Northern Ireland.
Communication within and between teams
Multidisciplinary teams can bring benefits to patient care when communication is timely and relevant, but problems can arise when communication is poor or responsibilities are unclear.
You must make sure that you communicate relevant information clearly to:
- colleagues in your team
- colleagues in other services with which you work
- patients and those close to them in a way that they can understand, including who to contact if they have questions or concerns. This is particularly important when patient care is shared between teams.
You should not assume that someone else in the team will pass on information needed for patient care. You should check if you are unclear about the responsibility for communicating information, including during handover, to members of the healthcare team, other services involved in providing care and patients and those close to them.
You should encourage team members to cooperate and communicate effectively with each other and other teams or colleagues with whom they work. If you identify problems arising from poor communication or unclear responsibilities within or between teams, you should take action to deal with them.
Doctors with extra responsibilities
You must provide necessary and timely information to those you manage so they can carry out their roles effectively. You should also pass on any relevant information to senior managers and make sure that arrangements are in place for relevant information to be passed on to the team promptly.
You must be satisfied that systems are in place to communicate information about patient care.
Responsibility and accountability
Whether you have a management role or not, your primary duty is to patients. Their care, dignity and safety must be your first concern. You also have a duty to the health of the wider community, your profession, your colleagues and the organisation in which you work.
You should establish clearly with your employer the scope of your role and the responsibilities it involves, including non-clinical responsibilities. You should raise any issues of ambiguity or uncertainty about responsibilities, including in multidisciplinary or multi-agency teams, to clarify:
- supervision arrangements for staff and lines of accountability for the care provided to individual patients (for more information on supervision see paragraphs 60 - 62 of this guidance)
- who should take on leadership roles or line-management responsibilities
- where responsibility lies for the quality and standard of care provided by the team.
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.
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.
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.
Doctors with extra responsibilities
If you are responsible for leading or managing a team, you must make sure that staff are clear about:
- their individual and team roles and objectives
- their personal and collective responsibilities for patient and public safety
- their personal and collective responsibilities for honestly recording and discussing problems.
- contribute to setting up and maintaining systems to identify and manage risks in the team’s area of responsibility
- make sure that all team members have an opportunity to contribute to discussions
- make sure that team members understand the decisions taken and the process for putting them into practice
- make sure that each patient's care is properly coordinated and managed.
You are accountable to the GMC for your own conduct and any medical advice you give. This includes while you serve as a member of a decision-making body for a health or social care organisation, such as a hospital or health board.
If, as a member of a board or similar body, you are concerned that a decision would put patients or the health of the wider community at risk of serious harm, you should raise the matter promptly with the chair. You must also ask for your objections to be formally recorded and you should consider taking further action in line with our guidance in Raising and acting on concerns about patient safety 4