WORK FORCE I S SUE S
Among the many reports highlighted in
the paper, the authors cited an independent review on diversity and inclusion from the Royal College of Surgeons of England, which highlighted that ‘jokes’ were made about rape and sexual assault. Of the 800 respondents who stated they had suffered harassment/abuse, only one quarter had reported it to someone. Prof. MacEwen said that, when women in medicine report this sort of behaviour as something “widespread, rather than a shocking one-off”, this suggests that a more general lack of respect for colleagues is at the root of it. “All these things have a direct impact on patient safety, on doctors’ wellbeing, and on their desire to remain in the profession,” she argued.
It is against this backdrop, that the GMC has introduced new duties for doctors, to tackle toxic cultures that threaten patient safety and staff retention, as part of its updated core ethical guidance. The regulator has launched a consultation on the content of Good medical practice, last updated in 2013, which outlines the professional values, knowledge and behaviours expected of doctors working in the UK. The updated draft follows months of working with doctor, employer and patient representatives, as well as other stakeholders, and reflects the issues faced in modern-day healthcare workplaces. Included for the first time is a duty for doctors to act, or support others to act, if they become aware of workplace bullying, harassment or discrimination, as well as zero tolerance of sexual harassment. The document states that: “Fair, civil,
The twelve commitments
1. Make the care of patients my first concern.
2. Work effectively with colleagues in ways that best serve the interests of patients.
3. Act promptly if I think the safety, dignity or comfort of patients or colleagues are being compromised.
4. Treat patients as individuals and respect their dignity and privacy.
5. Listen to, support and work in partnership with patients, to help them to make informed decisions about their care.
6. Provide a good standard of practice and care, and be honest and open
Fig 1
and respectful working cultures are essential for patient safety and staff wellbeing. Good medical professionals work effectively with colleagues in ways that best serve patients’ interests. This includes developing and maintaining respectful and effective relationships and contributing to a positive working culture. It also includes taking responsibility for continuity and coordination of care, maintaining and improving quality of care, and responding to risks.” The GMC also adds that doctors must treat colleagues “fairly and with respect”, whether or not they are a medical professional. It emphasises that doctors must develop and maintain effective teamworking, communicating clearly and
courteously with colleagues. The regulator calls on doctors to “contribute to a positive environment” by being aware of how their attitudes and behaviours may influence or affect others. This includes role modelling “supportive, inclusive and compassionate behaviour”. The draft guidance also responds to calls from doctors for greater clarity on their use of social media. A new duty makes clear that they must not use digital communications channels to mislead, and they should ‘make reasonable checks’ to avoid doing so. For the first time the guidance – which will also apply to physician associates and anaesthesia associates when they come under GMC regulation – proposes 12 commitments (See Fig 1.) In all, the draft updated Good medical
practice runs to 16 pages. It provides detailed guidance for medical professionals covering areas including ‘working with colleagues’, ‘working with patients’, ‘professional capabilities’ and ‘maintaining trust’.
GMC chief executive, Charlie Massey,
said: “Good medical practice is not a set of rules, but it is the bedrock that helps guide ethical practice in a world of increasingly complex medicine. This update is designed to reflect the type of fair, inclusive and compassionate workplaces we all want to see, and that are good for doctors as well as for patients. There is a lot of evidence of the damage bad workplace cultures can do to patient safety and, ultimately, to the UK’s ability to retain the healthcare professionals it needs. Toxic cultures can also spread online, undermining public trust in the medical profession. It is important our guidance reflects the reality of what doctors face and the cultures many are working in, and that it supports them to be
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7. Work within my competence and keep my knowledge and skills up to date.
8. Demonstrate leadership as appropriate to my role, and work with others to make healthcare more supportive, inclusive and fair.
9. Protect and promote the health of patients and the public.
10. Act with honesty and integrity. 11. Never discriminate unfairly against patients or colleagues.
12. Make sure my conduct justifies my patients’ trust in me and the public’s trust in my profession.
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