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Independents' Day

Blow whistle if colleague having sex with a patient, GPs urged

By Georgie Hobbs

GPs have been urged to whistleblow on colleagues if they suspect they may be having an affair with a patient.

The call comes as landmark guidelines defining doctor-patient boundaries were published today by the Council for Healthcare Regulatory Excellence (CHRE).

If a GP discovers that another doctor has crossed the line, they have an ethical and professional duty to speak out. Concerns about their own job security must not deter them, the guidance warns.

And if a patient reveals a doctor's inappropriate behaviour but says they want to remain anonymous, the confidante must override thier wish. They must do their best to get the patient's consent before disclosure, but speak to the doctor concerned and alert the authorities even if the patient refuses.

The CHRE, which oversees nine healthcare bodies including the GMC, was commissioned by the Department of Health after multiple high profile inquiries into serious breaches of sexual boundaries within the NHS, including that of the former GP, Peter Green who was convicted of nine indecent assaults over 12 years in 2000.

As a result, GP's are also warned never to date a patient.

Sexual activity with former patients is likely to remain ‘inappropriate however long ago the professional relationship ended', it adds.

The guidance claims the power imbalance created by the doctor-patient relationship can lead to GPs' influencing treatment not in the patient's best interest.

A BMA spokesperson said: ‘It is difficult to see a retired doctor being prosecuted for having a relationship with a patient. And if they met them socially, in different circumstances years later, I don't think it would be a problem.

'But, doctor's know certain things about their patient and it wouldn't be ethical to pursue a relationship with an ex-patient. The doctor can be very vulnerable to complaint if the relationship ends acrimoniously. '

The GMC welcomed the new guidance which they said 'makes a useful contribution' to its own Maintaining Boundaries advice. It said the punishment for those found guilty of breaches ranged from suspension to erasure and had not changed.

The new guidance, Responsibilities of Healthcare Professionals is available on the CHRE website.

Key Points - the guidance in brief

- A GP who displays sexualised behaviour towards a patient breaches trust, acts unprofessionally, and may be committing a criminal act.

- Breaches of sexual boundaries by one doctor can damage confidence in all.

- GPs should offer all patients a chaperone before intimate consultations, and record that the offer was made if the patient declines.

- If the patient is unhappy with the chaperone, GPs should offer to postpone the consultation if the matter is not urgent.

A GP must not:

-Ask for or accept a date. If a GP finds their patient attractive and is unable to remain objective as a result, they must find alternative care for the patient in a way that makes it clear the patient has not done anything wrong.

- Joke about sex during consultations

- Watch a patient undress (there must be a curtained screen) unless observation is a necessary as part of a clinical assessment and the patient understands and consents to this.

- Continue with treatment or examination when consent has been withdrawn.

- Unnecessarily expose the patient's body

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