Good Medical Practice Flashcards
Knowledge skills and performance domain key points (4)
1) patient 1st concern
2) good standard of care
3) knowledge up to date
4) limits of competence
Safety and equality domain (2)
1) prompt action if safety, dignity or comfort compromised
2) protect and promote health
Communication partnership and teamwork (3)
1) treat as individuals (dignity politeness and right to confidentiality)
2) work in partnership with patient (ICE, information given, shared decisions and support to reach that decision)
3) work with colleagues in patients best interests
Maintaining trust (3)
1) honest & open & integrity
2) never discriminate unfairly
3) never abuse patients or public’s trust
If a patient requests a second opinion?
You MUST respect their right to one
Can you treat yourself or someone with whom you have a close personal relationship?
You MUST AVOID doing this (wherever possible)
Times to make sure you have consent?
Ex, Ix, Tx, teaching, research
When should you make records/notes?
At the same time as the events/ASAP after
What should records include? (5)
1) clinical findings
2) decisions/actions agreed (who made them)
3) info given to patient
4) Ix, Tx given
5) who is making notes and when
Ways to keep patients safe (5)
1) contribute to confidential enquiries
2) adverse event recognition
3) adverse incidents (medical devices)
4) ADRs
4) responding to organisations monitoring public health
Whilst respecting patient’s confidentiality
What if a patient is not receiving basic to cover their needs?
Immediately tell someone who is in a position to act straight away
(You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised)
If patients are at risk because of inadequate premises/equipment/resources/policies/systems?
Put matter right if possible
Raise concerns
Record steps taken
(You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised)
Concerns that a colleague may not be fit to practise and may be a risk to patients?
Ask for advice from a colleague
/defence body
/GMC
If still concerned, report this
And record steps taken
(You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised)
What should you do if an emergency arises in a clinical setting or the community?
You must offer help
Take account of your own safety
Your competence
And the availability of other options for care
What if you have a condition you could pass to patients? Or your judgement or performance could be hindered by a condition or it’s Tx?
You must consult a suitably qualified colleague
You must follow their advice about any changes to your practice they consider necessary
(You must not rely on your own assessment of the risk to patients)
What if you need to leave work early?
Patient safety may be affected if there is not enough medical cover.
So you must take up any post you have formally accepted, and work your contractual notice period before leaving a job
unless the employer has reasonable time to make other arrangements.
Writing references?
You must be honest and objective when writing references, and when appraising or assessing the performance of colleagues
including locums and students
References must include all information relevant to your colleagues’ competence, performance and conduct
What if colleagues have problems with their health?
You must support them
But patient safety always 1st
What information must you share with patients?
1) their condition, it’s likely progression & Tx options (incl risks and uncertainties)
2) your role and responsibilities within team
3) who is responsible for what, and how information will be shared around
4) + additional info needed if in research/teaching
Does confidentiality count after someone’s died?
Yes!
What if you have a conscientious objection to a procedure?
You must explain to patients
must tell them about their right to see another doctor
make sure they have enough information to exercise that right
In providing this information you must not imply or express disapproval of the patient’s lifestyle, choices or beliefs
If it is not practical for a patient to arrange to see another doctor, you must make sure that arrangements are made for another suitably qualified colleague to take over your role
What to do/say if something goes wrong?
You must be open and honest with patients
1) put matters right (if possible)
2) offer apology
3) explain fully and promptly what has happened and the likely short-term and long-term effects
What if a patients condition puts you at risk?
You must not deny Tx
If a patient poses a risk to your health or safety, you should take all available steps to minimise the risk
Before providing Tx or alternative arrangements
What if a colleague is refusing to Tx a patient due to their personal views?
You must not unfairly discriminate against patients or colleagues by allowing your personal views to affect your
1) professional relationships
2) Tx provided or arranged
You should challenge colleagues if their behaviour does not comply with this guidance
Follow the guidance (Domain 2: Safety and quality) if the behaviour amounts to abuse or denial of a patient’s or colleague’s rights
How to respond to complaints?
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
When is it appropriate to 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
Do you have to give someone you have been - professionally - in contact with you name and GMC number (if asked)?
Yes!
Must always be honest about…? (4)
1) experience
2) qualifications
3) current role
4) research guidelines
How to ensure honesty whilst writing reports?
Make sure document is not false or misleading
Must not deliberately leave out relevant information
When must you always let the GMC know about legal/disciplinary procedures? (3)
If anywhere in the world:
1) you have accepted a police caution, or been criticised by an official inquiry
2) you have been charged with or been found guilty of a criminal offence
3) another professional body has made a finding against your registration as a result of fitness to practise procedures
What 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
What if you are faced with a financial 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
What if patients give you gifts?
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/gifts
What does “colleague” mean?
anyone a doctor works with, whether or not they are also doctors
