Under-pressure doctors need time for patients, says GMC

Heavy workloads are undermining doctor-patient relationships by eroding the time they have together to discuss treatment and care, the General Medical Council (GMC) has warned.

The warning comes as the regulator launches a consultation on the draft of its updated consent guidance. The updated guidance responds to feedback from the profession and aims to assist doctors on how they can work most effectively with patients to make decisions about their care.

Professor Colin Melville, the GMC’s Director of Education and a former consultant in intensive care medicine, said:

‘Consent is at the heart of the doctor-patient relationship and getting it right is fundamental to good medical practice.

‘I worked as a front line doctor for many years and experienced the pressures doctors face daily but I know the situation has become even more challenging for the profession today.

‘In the 10 years since we first published guidance on consent much has changed. Patients have more access to medical information outside the consulting room and rightfully expect to discuss options with their doctors before important decisions are made about their care. Health services and staff are more stretched and it is important that the guidance reflects the extra pressures doctors are facing.

‘We want our guidance to be useful and accessible to doctors who will use it daily on the medical front line, and so it is hugely important that they provide feedback as part of our consultation. What doctors and patients tell us will be taken into account, so ultimately we can help them to have good conversations, in partnership, about their care.’

"We want our guidance to be useful and accessible to doctors who will use it daily on the medical front line, and so it is hugely important that they provide feedback as part of our consultation. What doctors and patients tell us will be taken into account, so ultimately we can help them to have good conversations, in partnership, about their care."

Professor Colin Melville

the GMC’s Director of Education and a former consultant in intensive care medicine

The GMC’s draft guidance is designed to help doctors navigate the complex practical challenges surrounding good consent practice in each of the four UK countries.

It includes advice for doctors faced with different situations, such as treating patients who may lack the capacity to make decisions, and assessing or treating a patient under mental health legislation.

Deborah Bowman is a professor of medical ethics who chairs an expert group advising the GMC on the consent guidance. Since beginning work on the guidance she has been diagnosed with cancer, giving her a new perspective on consent.

Prof Bowman said: ‘Consent and the ways in which people approach it will, inevitably, vary, but the constant remains the commitment on the part of professional and patient to collaborate.

‘Choices, wherever they are made and in whatever clinical specialty, are based on sharing, openness, attentiveness and responsiveness. There will be constraints and challenges, but a disposition that recognises the primacy of partnership and the power of effective consent should be commonplace.

‘We want to hear from patients and doctors during the consultation to know about their experiences and priorities in seeking or providing consent.’

The GMC’s draft guidance and consultation documents, including short surveys for doctors and patients, are available on its website. The consultation is open until 23 January 2019. Consultation responses will be considered before a final version of the updated guidance is published next year.

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