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GMC waters down ‘back to work’ duty for doctors



GPs will have a new duty to encourage ‘fulfilling  activity’ in their patients under new guidance approved by GMC Council, after the regulator backed away from a previous proposal to specify that they must urge patients to go back to work.

The change to the Good Medical Practice guidance comes after criticism from GPs that the regulator had been pressurised by the Government to force doctors into supporting its back to work drive.

Pulse reported a year ago that the GMC was proposing to include a duty on doctors ‘to encourage patients with long-term conditions to stay in, or return to, employment.’ 

But the proposal – drafted with input from the Department of Work and Pensions and based on evidence that work can be ‘life-enhancing’- was met with heavy criticism from GPs and the BMA.

In a strongly worded submission to the consultation earlier this year, the BMA warned the duty was a ‘possible political capture of Good Medical Practice’ and undermined the duty on doctors to put patient care first.

In response, GMC Council has reworded the duty to remove the reference to ‘employment’ and has approved a duty on encouraging patients to develop ‘fulfilling activities’. The final guidance will be published in November, subject to approval by the GMC chair, and will come into force next year.

The final draft says: ‘You must support patients in caring for themselves to empower them to improve and maintain their health.

‘This may, for example, include… supporting patients to make lifestyle changes were appropriate, including changes to diet, exercise, smoking and alcohol consumption, doing voluntary or paid work or other fulfilling activities.’

In minutes from a meeting held last month the GMC admitted that the emphasis needed to be on doctors ‘empowering’ patients to improve their health.

‘The working group considered in detail the range of views expressed by Council on the inclusion of guidance on supporting patients in caring for themselves.

‘The Group concluded that some amplification of the principle was valuable, but that the emphasis should be on doctors empowering patients to improve their health, rather than specifying ways in which the patient may do this.

‘Nonetheless, the Working Group agreed that the guidance should include a reference to – amongst other things – “doing voluntary or paid work or other fulfilling activity”.’

Dr Kambiz Boomla, a GP in Tower Hamlets, said the guidance was unlikely to have much affect when there is little other support for patients out of work.

He said: ‘The real issue is not the wording in the guidance, it is that the Government not putting the infrastructure in place to help people back into work.

‘We have had people come into the practice crying and in tears over being told they have got to work and their benefits are being cut off, although it is clear to everybody that they are not capable of doing what they are asked to do, or the jobs aren’t available.

It is not joined up Government, to advise people to go back to work while making austerity cuts to the voluntary sector for example.’