Domain 4: Maintaining trust

Question 1

How does one ‘Show respect for patients’?

Answer 1

1. You must not use your professional position to pursue a sexual or improper emotional relationship with a patient or someone close
   to them
2. You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress
3. You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should:
   A: put matters right (if that is possible)
   B: offer an apology
   C: explain fully and promptly what has happened and the likely short-term and long-term effects.

Question 2

How does one ‘Treat patients and colleagues fairly and without discrimination’?

Answer 2

1. You must give priority to patients on the basis of their clinical need if these decisions are within your power. If inadequate resources, policies or systems prevent you from doing this, and patient safety, dignity or comfort may be seriously compromised, you must follow the guidance in paragraph 25b (see section Domain 2: Safety and quality).
2. The investigations or treatment you provide or arrange must be based on the assessment you and your patient make of their needs and priorities, and on your clinical judgement about the likely effectiveness of the treatment options. You must not refuse or delay treatment because you believe that a patient’s actions or lifestyle have contributed to their condition.
3. You must not deny treatment to patients because their medical condition may put you at risk. If a patient poses a risk to your health or safety, you should take all available steps to minimise the risk before providing treatment or making other suitable alternative arrangements for providing treatment.
4. You must not unfairly discriminate against patients or colleagues by allowing your personal views24 to affect your professional relationships or the treatment you provide or arrange. You should challenge colleagues if their behaviour does not comply with this guidance, and
   follow the guidance in paragraph 25c (see section Domain 2: Safety and quality) if the behaviour amounts to abuse or denial of a patient’s or colleague’s rights.
5. You must consider and respond to the needs of disabled patients and should make reasonable adjustments to your practice so they can receive care to meet their needs.
6. You must respond promptly, fully and honestly to complaints and apologise when appropriate. You must not allow a patient’s complaint to adversely affect the care or treatment you provide or arrange.
7. You should end a professional relationship with a patient only when the breakdown of trust between you and the patient means you cannot provide good clinical care to the patient
8. You must make sure you have adequate insurance or indemnity cover so that your patients will not be disadvantaged if they make a claim about the clinical care you have provided in the UK.
9. If someone you have contact with in your professional role asks for your registered name and/or GMC reference number, you must give this information to them.

Question 3

How does one ‘act with honesty and integrity’?

Answer 3

1. You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.
2. You must always be honest about your experience, qualifications and current role.
3. You must act with honesty and integrity when designing, organising or carrying out research, and follow national research governance guidelines and our guidance

Question 4

Act with honesty and integrity: Communicating information

Answer 4

1. You must be honest and trustworthy in all your communication with patients and colleagues. This means you must make clear the limits of your knowledge and make reasonable checks to make sure any information you give is accurate.
2. When communicating publicly, including speaking to or writing in the media, you must maintain patient confidentiality. You should remember when using social media that communications intended for friends or family may become more widely available.
3. When advertising your services, you must make sure the information you publish is factual and can be checked, and does not exploit patients’ vulnerability or lack of medical knowledge.
4. You must be honest and trustworthy when writing reports, and when completing or signing forms, reports and other documents. You must make sure that any documents you write or sign are not false or misleading.
   A: You must take reasonable steps to check the information is correct.
   B: You must not deliberately leave out relevant information

Question 5

Act with honesty and integrity: Openness and legal or disciplinary proceedings

Answer 5

Openness and legal or disciplinary proceedings
1. You must be honest and trustworthy when giving evidence to courts or tribunals. You must make sure that any evidence you give or documents you write or sign are not false or misleading.
A: You must take reasonable steps to check the information is correct.
B: You must not deliberately leave out relevant information.

2. You must cooperate with formal inquiries and complaints procedures and must offer all relevant information while following the guidance in Confidentiality.
3. You must make clear the limits of your competence and knowledge when giving evidence or acting as a witness
4. You must tell us without delay if, anywhere in the world:
   A: you have accepted a caution from the police or been criticised by an official inquiry
   B: you have been charged with or found guilty of a criminal offence
   C: another professional body has made a finding against your registration as a result of fitness to practise procedures
5. If you are suspended by an organisation from a medical post, or have restrictions placed on your practice, you must, without delay, inform any other organisations you carry out medical work for and any patients you see independently.

Question 6

Act with honesty and integrity: Honesty in financial dealings

Answer 6

1. You must be honest in financial and commercial dealings with patients, employers, insurers and other organisations or individuals.
2. You must not allow any interests you have to affect the way you prescribe for, treat, refer or commission services for patients.
3. If you are faced with a conflict of interest, you must be open about the conflict, declaring your interest formally, and you should be prepared to exclude yourself from decision making.
4. You must not ask for or accept – from patients, colleagues or others – any inducement, gift or hospitality that may affect or be seen to affect the way you prescribe for, treat or refer patients or commission services for patients. You must not offer these inducements.