Good Medical Practice – when was the last time you actually read it?

The Good Medical Practice (GMP) is the key document in which the GMC sets out your ethical duties as a doctor, and it is used as a benchmark in virtually all tribunal decisions. 

Is the GMP important?

When listing factors that help to determine the seriousness of sanctions that would be appropriate, the top item on the list is:

“The extent to which the doctor departed from the principles of Good Medical Practice.”

In addition, when listing factors that suggest erasure would be required, the top item is again specifically related to GMP:

“A particularly serious departure from the principles set out in Good Medical Practice where the behaviour is fundamentally incompatible with being a doctor.”

The meaning of fitness to practise according to the GMC

The GMC guidance on the meaning of fitness to practise says a doctor must “maintain effective relationships with patients, respect patients’ autonomy and act responsibly and appropriately if they or a colleague fall ill and their performance suffers.” 

However, these attributes, while essential, are not enough.  The guidance continues “the public is entitled to expect that their doctor is fit to practise, and follows our principles of good practice described in Good Medical Practice.”

Good medical practice: A brief overview

Good medical practice describes what it means to be a good doctor. It says that as a good doctor, you will:

• make the care of your patient your first concern
• be competent and keep your professional knowledge and skills up to date
• take prompt action if you think patient safety is being compromised
• establish and maintain good partnerships with your patients and colleagues
• maintain trust in you and the profession by being open, honest and acting with integrity.

The GMP is split into four sections “which describe the professional values and behaviours” the GMC expect from any registered doctor:

1. Knowledge, skills and performance
2. Safety and quality
3. Communication, partnership and teamwork
4. Maintaining trust

The obligation to comply with GMP comes with registration

As already referred to, GMC guidance published to help tribunal members determine appropriate sanctions outlines the importance of GMP (and related standards and guidance) – particularly as a way of ensuring that doctors from different backgrounds can learn what is expected of them by the GMC:

“Many doctors joining the medical register have previously worked, lived or were educated overseas, where different professional standards and social, ethnic or cultural norms may apply. Doctors are expected to familiarise themselves with the standards and ethical guidance that apply to practising in the UK before taking up employment, although experience of working as a doctor in the UK plays a key role in their development.”

The case of Sastry v General Medical Council serves as a good example of the above.  Mrs Justice May concluded that:

“the MPTS was right to use GMP as a reference by which to judge Dr Sastry’s behaviour, albeit being careful to take into account local conditions. The obligation to comply with GMP [Good medical practice] comes with registration. … A doctor may not practise in the UK without a licence but doctors practising wholly outside the UK do not need to hold a licence, indeed they need not be registered with the GMC at all. However, the Guidance is clear: if doctors choose to be registered with the GMC they must follow GMP. Doctors seeking to obtain or retain GMC registration, with or without licence, are obliged to practise in accordance with GMP… the principles of good practice set out in GMP are sufficiently high-level to be able to be adapted as necessary to accommodate differing guidelines and conditions which may exist in another country”. (Emphasis Added)

When was the last time you actually read it?

But despite its importance, many doctors have only an arms-length familiarity with the contents of GMP:

“I’d be surprised if the majority of new foundation doctors had read Good medical practice (GMP). But it is an essential guide to what’s really important and it underpins everything we do (as well as reminding us why we do it).” – GMC clinical fellow Dr Muj Husain

Good Medical Practice is a short but essential piece of reading – it won’t take long, so do your GMC licence a favour and make time for it tonight.  ‘Good medical practice in action’ also provides online case studies, which help to bring the guidance alive. There are over 70 further topics and each has a few scenarios to try out.