GMC promises to take winter pressure into account

The GMC has reassured doctors working under winter pressures that ‘local realities’ will be taken into account when considering complaints.

In a letter to the profession, co-signed by NHS England’s national medical director, the GMC recognised that doctors may occasionally need to ‘depart from established procedures’ during the busy winter period.

This year, usual winter pressures will be compounded by newly announced junior doctor strike days over Christmas and in the new year. 

The CQC and the Nursing and Midwifery Council (NMC) also joined the GMC in recognising the ‘challenges’ healthcare professionals will face over the coming months, with many concerned about ‘working under pressure’. 

The letter said: ‘Please be assured that your professional code and principles of practice are there to guide and support your judgments and decision-making in all circumstances

‘This includes taking into account local realities and the need to adapt practice at times of significantly increased pressure.

‘In the unlikely event of a complaint to your professional regulator they will, as is their usual practice, consider carefully whether they need to investigate. 

‘If an investigation is needed, they will consider all relevant factors including the context and circumstances in which you were working.’

The GMC’s updated Good Medical Practice (GMP) guide for doctors, which will come into effect from the end of January, includes a new commitment for the regulator to consider ‘any relevant context’ for fitness to practise procedures.

This addition was first proposed in a consultation on the GMP last year, and it was based on a review in 2021 which explored whether the regulator could ‘do more to address the inequalities and systematic issues that exist in medicine’. 

This followed the high-profile case of Dr Hadiza Bawa-Garba, who in 2021 was fully reinstated to practise medicine after the GMC took legal action to have her struck off – despite working amid overwhelming systemic pressures when a child died.

The GMC and NHSE cited ambulance handovers as an ‘example’ of where clinicians may be under particular pressure, highlighting a ‘strong correlation’ between handover delays at emergency departments and ambulance response delays. 

The letter said: ‘It is vital that we have a whole system approach to risk across the urgent and emergency care pathway to provide the best outcomes for our patients. This includes considering actions within hospitals to help improve flow and reduce pressures on emergency departments. 

‘All national regulators will consider the need to keep regulatory oversight proportionate at this busy time, whilst maintaining the focus on patient safety and protection of the public.’

Acknowledging the pressures hospital staff will be under during the strikes, NHS England recently indicated that patients may have to be discharged earlier in order to ‘maintain flow’.

Leaders at the latest public board meeting said conversations around early discharge would be ‘difficult and uncomfortable’ but necessary. 

Pulse recently revealed that GPs in small number of areas received local additional funding to cope with winter pressures, with the majority of UK practices seeing no support.