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Chief medical officers’ 12 March letter on supporting doctors in a coronavirus epidemic

Supporting doctors in the event of a Covid-19 epidemic in the UK

12 March 2020

If Covid-19 becomes an established significant epidemic in the UK, NHS and HSC services in primary and secondary care and public health across all four nations will be put under extreme pressure. This pressure will inevitably be exacerbated by staff shortages due to sickness or caring responsibilities. It will be a challenge for our profession. We are confident doctors will respond rapidly and professionally and want to assure colleagues that we recognise this will require temporary changes to practice, and that regulators and others will take this into account.

A significant epidemic will require healthcare professionals to be flexible in what they do. It may entail working in unfamiliar circumstances or surroundings, or working in clinical areas outside of their usual practice for the benefit of patients and the population as a whole. This can be stressful and you may have concerns about both the professional practicalities and implications of working in such circumstances.

We need to stick to the basic principles of being a good doctor. All doctors are expected to follow GMC guidance and use their judgement in applying the principles to the situations they face, but these rightly take account of the realities of a very abnormal emergency situation. We want doctors, in partnership with patients, always to use their professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles set out in their professional standards. A rational approach to varying practice in an emergency is part of that professional response.

It is the responsibility of GP practices, hospitals, trusts and health boards to ensure that clinicians working in their organisations are supported to do this. They must bear in mind that clinicians may need to depart, possibly significantly, from established procedures in order to care for patients in the highly challenging but time-bound circumstances of the peak of an epidemic.

We expect employers, educational supervisors, professional bodies, and national NHS and HSC organisations to be flexible in terms of their approach and the expectations of routine requirements. Healthcare professional regulators, including the GMC, have already committed to take into account factors relevant to the environment in which the professional is working, including relevant information about resources, guidelines or protocols in place at the time.

Due consideration should and will be given to healthcare professionals and other staff who are using their skills under difficult circumstances due to lack of personnel and overwhelming demand in a major epidemic. This may include working outside their usual scope of practice. The healthcare regulators have already released a joint statement to explain this.

We are determined to ensure the long-term prospects of doctors in training are not compromised. The GMC, together with the education bodies in the four nations, are considering this.

Finally, we would like to thank you all for all the efforts you are already making. Many doctors across the NHS, HSC and public health services have already made major contributions to the response to COVID-19. We are very proud of the response of the medical profession in many disciplines whether clinical, public health or laboratory to this challenge. It has been exemplary. We are confident of the commitment, dedication, professionalism and hard work the whole profession has and will continue to have in the very testing event of a significant epidemic in the UK.


Dr Frank Atherton, Chief Medical Officer for Wales

Dr Catherine Calderwood, Chief Medical Officer for Scotland

Dr Michael McBride, Chief Medical Officer for Northern Ireland

Professor Chris Whitty, Chief Medical Officer for England

Dr Michael McBride, Chief Medical Officer for Northern Ireland

Dr Colin Melville Medical Director and Director of Education and Standards, GMC