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LMC: GPs should consider reporting Covid patients who refuse to self-isolate


CCAS


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.’

READERS' COMMENTS [10]

LMC: GPs should consider reporting Covid patients who refuse to self-isolate – Pulse – SelfIsolation.io is for sale 23 September, 2020 9:53 am

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Dylan Summers 23 September, 2020 10:44 am

I think this is medicolegally questionable. I remember being told by my defence organisation that it may be acceptable to break confidentiality if doing so will prevent harm or a crime.

But what harm will be prevented here? All this will enable – if anything – is the issuing of a fine by the authorities. They do not – as far as I know – have the ability to lock up all covid patients who declare their intention not to self isolate.

Centreground Centreground 23 September, 2020 10:50 am

I am unsure if the LMC should be advising on this and should be left to medicolegal organisations to advise GPs

David Riley 23 September, 2020 11:00 am

I disagree. As suggested if a Covid 19 patient works in a care home they will be putting residents lives at risk. This is the same as patients with uncontrolled epilepsy driving. Notification will maybe result in a fine but will also remove the patient from a place where they may cause deaths.

T F 23 September, 2020 11:35 am

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’.
Why can’t the spokesperson just say yes or no.
It is very specific. An infectious Covid person breaking lockdown rules putting the public at risk.

Andi Williams 23 September, 2020 2:29 pm

how would we know that they are or not if they say they are? I don’t have time for lunch let alone policing the general public. we can let public health know if its a problem, like in care homes etc but we are here to advise not enforce. people lie all the time, we know that as GPs. I guess the rest of the world are just catching up to our reality.

Patrufini Duffy 23 September, 2020 2:49 pm

Great. Then what’ll happen? NOTHING.

Paul Attwood 23 September, 2020 3:30 pm

Don’t we live in a nice world. HMG “Report your neighbours if they have more than six in their house” and now the LMCs “Report people who don’t self isolate” and soon to be announced “Report fatty for visiting the kebab house twice last week”.

What are we the Stasi? Is this 1930s Germany with the Gestapo?

I’m buggered if I will report any of my neighbours. Not my problem if persons do not wish to self isolate. We are going to deal with this pandemic either by herd immunity or by vaccine. Yes we should as far as possible protect the vulnerable but I’m all for the youngsters getting out freely earning a living and keeping the economy going. Lockdown just delays the inevitable viral spread and kills people in other ways.

Alan Gleave 23 September, 2020 7:00 pm

Listen can you hear the stomp of the jackbooted autocrats.

Dave Kew 24 September, 2020 4:52 pm

The only way to keep being a GP at the moment is to socially distance yourself from this Orwellian Stasi Fascist nightmare that has to be rolled backwards.
I bet 99.8% of lockdown breaches are unknowing, hungry or poor and needs to work. A welfare officer via the notification process would be a gentle and far more successful scheme. They could even take food parcels and be a friend.
Download Dido Serco;s app? “Not bleeding likely doctor!”