Working with doctors Working for patients

Allocating resources

84. All doctors must make the care of patients their first concern. However, the treatment options that can be offered to patients may be affected by limits on resources.

All doctors

85. If you make decisions about access to treatments on a case by case basis, without referring to agreed policy or guidelines, you risk introducing elements of unfair discrimination or may fail to consider properly the patient’s other legal rights. When making decisions about using resources, you must do the following.

a. Provide the best service possible within the resources available, taking account of your responsibilities towards your patients and the wider population.

b. Be familiar with any local and national policies that set out agreed criteria for access to a particular treatment.21

c. Make sure that decisions about setting priorities that affect patients are fair and based on clinical need and the likely effectiveness of treatments, and are not based on factors that may introduce discriminatory access to care.22

d. Be open and honest with patients23 and the rest of the healthcare team about the decision-making process and the criteria for setting priorities in individual cases.

86. You should involve colleagues, including other healthcare professionals, in discussions about how to allocate wider resources. If issues or disputes about allocating resources arise, you should try to sort them out by discussing options with, for example, patients, the healthcare team, other colleagues (including other health and social care professionals) and managers. You should be open and honest with patients when resource constraints may affect the treatment options available.24

Doctors with extra responsibilities

87. If you have a management role or responsibility, you will often have to make judgements about competing demands on available resources. When making these decisions, you must consider your primary duty for the care and safety of patients. You must take account of any local and national policies that set out agreed criteria for access to particular treatments and allocating resources, and make sure that these policies are available to clinical staff.

88. If you are concerned about how management decisions might conflict with your primary duty to patients, you must take steps to manage or deal with any conflict; for example, by:

a. asking for colleagues’ advice

b. declaring the conflict to your board or other decision-making body

c. asking for advice from external professional or regulatory bodies, including defence organisations, if necessary.