Doctors under pressure need time to get to grips with new ethical standards says MDU

Doctors are concerned about digesting and implementing new standards setting out what it means to be a good doctor due to working pressures, a survey by the Medical Defence Union (MDU) has found.

The revised ethical standards from the General Medical Council (GMC) – called Good medical practice – are published today following a consultation last year.

The MDU survey of 610 doctors, found that nearly all doctors (96%) had made use of the current standards during their career and 62% found them helpful in knowing what was expected of them. Based on the draft guidance, just 15% were confident the new standards could be delivered in their work environment with seven in 10 doctors (68%) saying they were unsure about this and 17% feeling this couldn’t be done.

Crucially, only half (49%) were confident they would have time to fully absorb the new standards before they are implemented with seven in ten (69%) saying they would have to read the guidance in their own time outside of work.

Dr Caroline Fryar, MDU director of medical services, said:

“Good medical practice goes to the very heart of what it means to be a medical professional and is central to regulation. Doctors know how important the guidance is and need time to understand and familiarise themselves with the changes being made.

“The standards have been substantially revised for the first time in a decade. We are calling on employers to ensure they give medical professionals time to digest it and the GMC to do all they can to make sure doctors can easily understand the main changes. Doctors shouldn’t be getting homework at a time when they are already working incredibly hard, around the clock, to deliver safe and effective patient care.”

The MDU has been making a strong case for there to be the maximum amount of time after publication before these standards come into force. The scale of the task facing doctors has been recognised by the GMC, who are taking the rare step of granting a period of five months for this – rather than the usual four.

However, the MDU said it would still be a challenge for doctors to read and absorb the revised standards over the busy winter months on top of their daily duties and responsibilities to patients.

Dr Fryar continued:

“The revised guidance is due to be introduced at a time of ongoing stress and pressure for the health service. The GMC’s own research indicates that morale is extremely low and many doctors are considering leaving the profession. There is much at stake for doctors as failing to follow the standards could lead to a fitness to practise investigation, something nearly half of those responding to our survey (43%) were concerned about.

“For our part, we are doing everything we can to make sure doctors are aware of what this means for them and for patients. We have an extensive educational programme to support understanding of GMC guidance and will be focusing on good medical practice.”

What doctors told us:

1. “The guidance has to take into account the burgeoning workload, staffing crisis and increasing patient expectations and demands. Often less than ideal patient outcomes are blamed on individual doctors rather than system failures which account for many medical errors.” – Consultant.

1. “The guidance needs to reflect the reality of working within an overstretched and burdened system. Doctors trying to follow this guidance often find themselves at the end of moral injury and burnout.”- Foundation doctor.

1. “Delivering good patient care is unfortunately not only dependent on the doctor’s understanding of the guidance, but also on resources, work environment and staffing levels. In the current NHS crisis it is particularly difficult to live up to the standards of the GMC.” – GP specialty trainee (GPST).

1. “There needs to be more protection for doctors trying their best to deliver the best possible care in challenging circumstances – we won’t get it right every time but shouldn’t be unduly punished or investigated if genuine mistakes are made.” –  Consultant.

Doctors’ dilemmas – top five issues doctors consult good medical practice about:

1. Patient consent or capacity to make a decision – 49%
2. Reflecting on a complaint, claim or incident – 40%
3. Whether to protect confidential information or disclose it in the public interest – 39%
4. Raising concerns about a colleague, system or resource – 31%
5. Prescribing – 15%

The MDU surveyed a sample of doctors in June 2023 with the 610 respondents representing a 4% response rate. Respondents included consultants/specialists (33%), GPs/GP trainees (31%), junior hospital doctors (23%) and foundation doctors (12%).