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GPs face GMC duty on ‘back to work’ drive

Exclusive GPs are set to be required to encourage patients to go back to work as part of their responsibilities to the GMC, under changes to the regulator's core ethical guidance drafted with input from the Department of Work and Pensions (DWP).

A draft revised version of Good Medical Practice, presented to GMC Council last week, included a new duty ‘to encourage patients with long-term conditions to stay in, or return to, employment'.

The GMC told Pulse a submission from the DWP had fed into the draft document, amid fears from GPs over ‘pressure from Government' to enlist doctors in the coalition's benefit crackdown.

The controversial requirement comes as part of a raft of proposed changes in the first major review of Good Medical Practice for five years. But it has prompted outrage among GPs and debate among GMC Council members, who have demanded clarification on the change.

GMC officials said the proposal will be reworded ahead of a public consultation later this month, with the redraft likely to substitute ‘employment' for ‘meaningful activity'.

Niall Dickson, GMC chief executive, said the draft was based on ‘a lot of evidence that people having productive activity can be life-enhancing'.

He said: ‘We don't want to suggest doctors become policemen of the state. It has to be where it is in the patient's best interest that encouragement and support is given.'

But many GPs responded angrily to the proposal, claiming it ignored the complexities of getting patients into work and pressured doctors into putting the needs of the Government ahead of patients. Click here to join the debate in the Pulse forum.

Dr Rob Barnett, secretary of Liverpool LMC, said: ‘I'm a GP, not an employment adviser.'

'GPs have a responsibility to get patients as fit as possible and if that helps get them into work then that's great. However, I'm working in an area of high unemployment. It may be OK for the GMC in London to propose things like this but the reality here is that there are very few jobs around.'

Dr Margaret McCartney, a GP in Glasgow, said: ‘Work in general is good for people, but it is not right for everyone all the time. Doctors need to be quite clear on where our responsibilities are – it is patients first.'

'The reality for people who have complex and multiple chronic illnesses is not well represented in the literature to date. The evidence base for the GMC proposal doesn't really reflect the reality of frontline general practice.'

Dr John Hughes, secretary of Manchester LMC, said: ‘This has rather dubious wording. Work can be good for some patients but the GMC needs to recognise there is an appropriate time and an appropriate sort of work for some patients.

‘I'm wondering how much pressure the GMC has come under from the Government for this.'

The DWP said its submission had been drafted by Dame Carol Black, its work and health tsar, but was unable to provide a copy as Pulse went to press.

A DWP spokesperson said: 

‘The Department of Work and Pensions is supportive in principal of helping people who can work, get back into work.'

Additional duties for doctors

New requirements included in draft Good Medical Practice guidance

• To encourage patients to stay in, or return to, work

• To consider patients' religious, spiritual and cultural history

• To act as a mentor to less experienced colleagues

• To take ‘prompt action' against basic failings in care

• To ensure you or a named colleague retains responsibility for patients' continuity of care

• An explicit duty to be competent in providing care and performing other professional roles

A full draft for public consultation will be published on 17 October.