GPs should consider reporting patients who will not self-isolate with Covid-19 to local authorities’ health protection teams, local GP leaders have advised.
An advisory notice from Lincolnshire LMC to members said GPs should ‘weigh up’ the risks if a patient ‘advises that they will not self-isolate, or you suspect that they will not’.
The notice said: ‘If you suspect that the patient will not self-isolate, you are under certain circumstances able to break confidence to inform Health Protection of your concerns.’
The LMC quoted GMC guidance which states: ‘If it is not practicable or appropriate to seek consent, and in exceptional cases where a patient has refused consent, disclosing personal information may be justified in the public interest if failure to do so may expose others to a risk of death or serious harm.
‘The benefits to an individual or to society of the disclosure must outweigh both the patient’s and the public interest in keeping the information confidential.’
Lincolnshire LMC said GPs should therefore:
- Try to get consent to inform Health Protection
- Weigh up the risk that the patient does have Covid-19 or not
- Weigh the risk of transmission if the patient does not self-isolate
- Weigh the risk to others if transmission occur (such as by asking whether the patient works in a high risk setting like a care home)
The notice added: ‘If you are unsure you can contact the health protection team for advice. If you have significant concerns, you should inform the health protection team, and you can share patient information under these circumstances.’
A GMC spokesperson told Pulse that ‘where GPs are considering disclosing information around breaking isolation rules, they must be satisfied this meets the high bar we set for disclosure in the public interest’.
They said can be found in existing GMC guidance but includes weighing up potential risks of undermining trust in doctors against the potential benefits – to individuals or society – of releasing the information.
Lincolnshire LMC medical director Dr Kieran Sharrock told Pulse: ‘We had a practice where a patient had been advised to self-isolate because their child had Covid-19 symptoms, and the parent told the GP “I can’t self-isolate, I’ve got to go to work”.
‘The practice contacted us and we sought advice from our local health protection team, and we then advised the practice accordingly. We then thought it may be helpful to share the advice with our other constituent practices.’
However, the BMA’s GP Committee chair Dr Richard Vautrey instead suggested ‘it was up to individuals’ to take responsibility for self-isolating.
He said: ‘When it comes to fighting Covid-19, we’re all in this together, and while GPs will always do their best to advise patients on how to stay safe, it’s ultimately up to individuals to play their part and take reasonable precautions.
‘The BMA has been calling on the Government for clear, consistent, and logical messaging to help the public navigate this virus, and it’s essential this is done to ensure everyone knows how to stay safe so that we can defeat Covid-19 once and for all.’
GP Dr Phil Williams, a partner in Lincoln, told Pulse he agreed with his LMC’s advice.
He said: ‘It’s in keeping with established rules, such as people with epilepsy continuing to drive, and people who are HIV positive purposefully having unprotected sex.
‘I think it’s our professional duty to protect the public.’