There are a number of basic administrative tasks that doctors absolutely cannot risk forgetting to take care of – otherwise they may unintentionally be guilty of practising illegally. With doctors working under significant stress and workloads, it is surprisingly easy to overlook one of these requirements. Paperwork hardly seems a matter of life or death when compared to clinical elements of your job – but it can have a significant impact on your career if you don’t make sure that you properly dot the i’s and cross the t’s.
Here is a shortlist of commonly overlooked – but essential – tasks that you may inadvertently forget.
Pay The GMC Annual Retention Fee
You can only practise medicine in the UK if you hold a valid current registration with the GMC – so failure to pay your GMC fee would in effect mean that you were practising without a licence, which is illegal under the terms of the Medical Act.
The consequences of an inadvertent registration lapse can potentially be very significant indeed.
Depending on your contract, a valid GMC licence is likely to be a precondition of employment – meaning that your job may be threatened. Depending on the terms of your indemnity, your medical insurance cover may be invalidated – meaning that you may not be legally covered in the case of an adverse incident.
And if the GMC does not receive your annual retention, this will ultimately result in your automatic removal from the register – a process called ‘administrative erasure’.
To help avoid this, the GMC starts sending out payment reminders about 31 days before the fee is due. However, it still makes sense to take advantage of the GMC’s available payment options and set up a recurring Direct Debit payment to automatically cover your registration fees.
You should make a note to update the GMC’s records whenever you move house or switch bank accounts.
Performers List Membership
There are three national performers lists operated by NHS England – one for medical, dental and performers.
These lists “provide an extra layer of reassurance for the public that GPs, Dentists and Opticians practising in the NHS are suitably qualified, have up-to-date training, have appropriate English language skills and have passed other relevant checks such as with the Disclosure and Barring Service (DBS) and the NHS Litigation Authority.”
As with the GMC registration, admission to the relevant performers list is a legal requirement for all doctors in order to practise medicine in the UK (except for a couple of very specific points in certain career transitions).
The performers list application process varies according to region within the UK, and you must be registered in the most appropriate one for the purposes of appraisal and revalidation.
In many cases your employer will make sure that you are registered correctly – however this doesn’t apply if you are a self-employed or locum doctor, and it is ultimately your responsibility in any case. Ignorance is no excuse.
Because you will be working with vulnerable groups, you will normally be required to take out membership of a criminal records certification scheme at the same time as you apply to join a performers list – again this varies between the different nations of the UK:
- England and Wales – Disclosure and Barring Service (previously Criminal Records Bureau and Independent Safeguarding Authority)
- Northern Ireland – Access NI
- Scotland – Disclosure Scotland
Occupational Health Records
Doctors are required to provide comprehensive records demonstrating proof of all relevant immunisations, as set out in section 2 of GMP:
“You should be immunised against common serious communicable diseases (unless otherwise contraindicated).
The list of immunisation records required may vary depending on the nature of the work that you carry out, but at a minimum it will include routine immunisations:
- Measles, mumps and rubella (MMR)
Particularly if you are self-employed or if your career path means that you are likely to change employers regularly, the best solution is to maintain a digital file containing up-to-date copies of all of your occupational health records.
The main threat to your GMC licence here is that failing to provide required records or actively concealing a positive result risks patient safety and may demonstrate dishonesty – so make sure that all of your occupational health checks are correct and up to date.
It is by now well understood that doctors need to ensure that you are indemnified in order to practise medicine in the UK – originally because it was a part of GMP, and more recently when it was given a stronger statutory footing.
However, you really need to ensure that your indemnity is adequate and appropriate – which will depend on your precise circumstances.
The GMC does not really elaborate on what constitutes ‘adequate and appropriate’ – suggesting instead you speak to a medical defence organisation or other insurer:
“The law says appropriate cover is cover against liabilities that may be incurred in practising as a doctor, having regard to the nature and extent of the risks of practising as such. What constitutes adequate and appropriate is a complex area, and you need insurance or indemnity that covers the full scope of your practice.”
You should familiarise yourself with the specific details of your cover – for instance to clarify whether it covers any of the following ‘edge cases’:
- ‘Good Samaritan’ acts – emergency care outwith your workplace
- ‘Good neighbour’ acts – unpaid voluntary work
- writing reports for third parties – including insurance reports and police reports
- moonlighting – additional non-contracted shifts that violate working time regulations
- legal support for criminal investigations
- legal support for GMC complaints, disciplinary or regulatory action
- legal support for tribunal decisions referred by the GMC or PSA to the High Court
- support for giving evidence at inquests – eg coroner’s inquests
- support for appearing in front of the media in relation to the above
Other Mandatory Training
Depending on your role, you may be required to keep your skills up to date – and be able to evidence this with the appropriate certification – in some of the following areas:
- life support training (appropriate to specialism – eg Basic, Advanced, Paediatric)
- child safeguarding
- safeguarding of vulnerable adults
- infection control
- fire safety
- manual handling
Again, your employer may provide appropriate training and annual refreshers – however it is still very much your responsibility to find out about and make sure that you meet any such statutory requirements.
If you are a locum or are self-employed, it will obviously be your responsibility to organise this. However, if as an employee you are involved in a ‘never event’, such as an avoidable death, you will need to be able to prove that your skills were up-to-date – and pointing out that your employer didn’t provide the required training will not discharge your personal responsibility.
While these are unlikely to trigger a complaint or investigation in themselves, they may significantly compound your situation if you are subject to any regulatory action.
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Disclaimer: This article is for guidance purposes only. Kings View Chambers accepts no responsibility or liability whatsoever for any action taken, or not taken, in relation to this article. You should seek the appropriate legal advice having regard to your own particular circumstances.