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GPs ‘should be cautious when declaring patients fit to run marathons’

GPs should take caution when asked by patients to sign forms declaring them fit to run marathons, medico-legal advisers have said.

GP indemnity provider Medical Protection said the advice comes as GPs are faced with a growing number of fitness-to-participate requests, also including for events such as ‘fat camps in the desert, mock hostage situations, or events where a patient must undergo psychological torture’.

But it said GPs need to ensure they have sufficient knowledge before signing such forms, and may only wish to sign with a qualifying statement.

Medical Protection senior medico-legal adviser Dr Pallavi Bradshaw pointed out that ‘GPs must be confident that they have sufficient knowledge about the patient and the nature of the event before deciding whether they can assist’.

She said: ’GP’s may not always have the required expertise to deem the patient fit to take part without risk, and will understandably be worried about the implications of signing such a form.

’GMC guidance requires a doctor to do their best to ensure reports they write are not misleading, and says they should not undertake assessments beyond their area of clinical competence.

But she said there were ‘some options where doctors can assist within the limits of their competence’.

She said: ‘Depending on the wording of any declaration, signing the form with a qualifying statement may be appropriate.

’The GP would consider the information they have on the patient’s current and past medical history, which may be relevant to the event, and state that there are no known health conditions which render the patient unfit to participate.’

But she added that ’where a patient’s medical history is not straightforward or they are under the care of a specialist, the GP may wish to obtain advice first or refer the patient to a doctor with expertise in sports medicine’.

Medical Protection said this comes as a record number of people are signed up to next week’s London Marathon, over half of which are first-time marathon runners.