Solicitors should not ‘threaten’ GPs over patient Covid exemptions

The solicitors’ regulator has advised that GPs should not be sent ‘threatening’ letters over patient Covid exemptions, the BMA has said.

It suggested that this has ‘no legal merit’, according to the BMA.

The BMA’s GP Committee bulletin said it comes as ‘a number of’ lawyers have been ‘threatening doctors with legal action’ if they do not provide an exemption for their clients.

It said: ‘The BMA’s medico-legal committee (MLC) has written to the Solicitor’s Regulation Authority (SRA) and has been assured that solicitors should not be “writing in offensive, threatening or intimidatory ways and we also do not expect solicitors to pursue matters which they know have no legal merit”.’

The bulletin urged any GPs receiving intimidating letters to seek legal advice from their medical defence organisation (MDO) and share a copy with the BMA.

The BMA’s medico-legal committee will ‘pursue [it] further’ via the solicitors’ regulator, it said.

Meanwhile, the BMA added that it has met with the Department of Health and Social Care (DHSC) to ask for ‘support that any legal action is against the policy and thus the DHSC and not the GP/surgery’.

It hopes to ‘see a swift and satisfactory conclusion to this matter’, it said.

The BMA understands that further guidance on Covid exemptions will be published that will ‘reiterate that there is no appeal’.

The guidance will also ‘clarify the role of doctors in providing exemption certificates’ and ‘make it clear what conditions do and do not warrant an exemption’, the BMA said.

BMA medico-legal committee chair and Manchester GP Dr Simon Minkoff told Pulse: ‘It is unacceptable for solicitors to write very threatening letters to GPs for doing their job properly. We have met with the DHSC and hope to see some useful improvements to the COVID vaccine exemption scheme.

‘Whilst these letters may reduce now [vaccination as a condition of deployment] has been withdrawn, the principle of protecting doctors who are inappropriately bullied by patients via solicitors remains.’

Medical Defence Union (MDU) head of professional standards and liaison Dr Michael Devlin told Pulse that members have been raising the issue with the medical defence organisation in recent months.

He said: ‘We fully appreciate how distressing it can be to be on the receiving end of such letters.

‘As we move to a new stage in this pandemic, incidents such as these highlight just how important it is for the Government and NHS England to deliver clear guidance for the profession. This must be robust, so GPs do not have to deal with this sort of correspondence.’

Dr John Holden, chief medical officer at the Medical and Dental Defence Union of Scotland (MDDUS), added that it too has seen a ‘handful of cases of patients threatening GPs with legal action [and] claiming discrimination for not completing exemption forms’.

He said: ‘Amid the myriad pressures GPs currently face, we are dismayed to learn that some solicitors – or those purporting to be solicitors – are adding to the situation with letters threatening legal action unless exemption reports are provided.

‘This intervention by the BMA is timely, and we are also pleased to see the Solicitors’ Regulation Authority respond robustly.’

And medical director at Medical Protection Society (MPS) Dr Rob Hendry also said that while it has not yet seen a progression to the claims stage, it is aware of some GPs receiving patient complaints in relation to vaccine exemption requests, as well as a template letter from alleged legal representatives ‘warning against vaccination’.

In July, Pulse revealed that GPs had also been threatened with legal action by patients who objected to being asked to wear a face covering in their practice.

The Government in England has said it expects GPs and specialists to ‘clinically review’ each and every application for Covid vaccination exemptions.

At the BMA England LMCs conference in November, 84% of GPs said they would welcome non-compliance with the contractual requirement to provide Covid exemption certificates.

What is the Covid exemption guidance?

The service helps identify individuals who are unable to be vaccinated and/or tested for Covid-19 for medical reasons and provides a means of proving their exemption through the NHS Covid Pass.

In October, the Government said that GPs and specialists would have to ‘clinically review’ each and every application for a Covid vaccination exemption.

However, it said that patients should not contact their GP to obtain the application form or their GP or the clinician reviewing their exemption unless asked to do so.

A GP or specialist’s clinical decision on medical exemptions is ‘final’ and cannot be appealed by patients, it added at the time.

And the guidance said reasons for medical exemptions are ‘limited’ but could be given in scenarios such as when someone has had an adverse reaction to the first vaccine dose, such as myocarditis.

Other ‘possible reasons’ include:

When someone has ‘severe allergies’ to all currently available vaccines
When vaccination is not in the ‘best interests’ of someone receiving end of life care
When someone has learning disabilities or autism or has a ‘combination of impairments where vaccination cannot be provided through reasonable adjustments’

‘Other medical conditions could also allow you to get a medical exemption’, the guidance said.

Short-term exemptions are also available for those with short-term conditions and for pregnant women until 16 weeks post-partum.

Source: Pulse reporting and NHS Digital