Professional boundaries – Avoid the Pitfalls

Healthcare regulators take a particularly serious view of breaching professional boundaries. What are personal boundaries and how to avoid the pitfalls. 

What are personal boundaries?

The nature of the patient/carer relationship is such that healthcare professionals are in a position of trust with patients often vulnerable either physically or mentally.  

There is no defined definition of professional boundaries but generally speaking, professional boundaries are the legal, ethical and regulatory limits to the healthcare professional/patient relationship that maintains trust, patient safety and protection and public confidence in the profession. 

Although most often associated with improper emotional relationships or allegations of sexual impropriety, breaching professional boundaries can also encompass expressions of personal beliefs, financial conflicts of interest, and physical harm. 

Fitness to Practise

Breaching professional boundaries often occur, or arise, during the course of practice, but not exclusively so.

As such, health and care professionals must remember that fitness to practise is not limited to just professional or clinical performance.  The conduct of a health and care professional outside of their working environment may involve fitness to practise where it could affect the protection of the public or undermine public confidence in the profession.

Aggravating and mitigating factors

Health and care professionals found to have breached professional boundaries are likely to face allegations of impaired fitness to practise through misconduct.  It is strongly advised that under these circumstances, you seek expert legal advice at the earliest possible time.  You can speak to us today for a free, no obligation assessment of your case.

Healthcare regulators take a particularly serious view of cases involving professional boundary transgressions.  However, in some cases, the facts might not be as clear and straightforward as might be presented.  Common aggravating & mitigating factors that emerge in fitness to practise cases involving sexual boundary transgressions are:

Aggravating factors might include (but not limited to):

• whether the abuse took the form of a serious criminal offence
• the vulnerability of the patient
• whether the healthcare professional took deliberate steps to facilitate the professional boundary transgression(s)
• whether there was any grooming of the patient
• whether the healthcare professional used confidential information to facilitate the professional boundary transgression(s)
• whether the abusive behaviour happened on one occasion or on several occasions, and whether the abuse involved one patient or several patients

Mitigating factors might include (but not limited to):

• factors that might have clouded the judgement of the healthcare professional, such as mental health and/or other personal circumstances
• a relationship with the patient appeared to have started consensually, or even at the patient’s request
• the time that has elapsed since the professional boundary transgression(s)

Insight and remediation

The level of insight and remediation will be important considerations by any fitness to practise panel. 

Reflection and demonstrating insight are important in fitness to practise proceedings.  It is a well-established fact that simply saying sorry is not enough.  Insight and remediation must be genuine and demonstrable. 

“It is important that healthcare professionals engage with us and work together with us to be able to achieve a successful outcome. This is the case for any type of allegation but even more so where allegations are about character and not simply clinical competence.” – Catherine Stock, Kings View Barrister

We work with healthcare professionals on reflective practise, demonstrating insight and remediation.  You can speak to us today for a free, no obligation assessment of your case.

Avoid the Pitfalls

You must not :

• pursue a sexual or improper emotional relationship with a current patient and/or use your professional relationship with a patient to pursue a relationship with someone close to them
• end a professional relationship with a patient solely to pursue a personal relationship with them
• performing additional favours for clients, outside the scope of your role
• contact patients via social media or any other personal capacity

You should take care when:

• pursuing a sexual or emotional relationship with a former patient. What might be deemed appropriate for former patients will depend on each individual case, such as, the time that has elapsed since treatment ceased and the duration and frequency of treatment
• discussing personal problems with patients
• receiving gifts from patients
• disclosing personal information (phone numbers, addresses)

Particular care must be taken when treating patients that are particularly vulnerable.  You should assume that the more vulnerable someone is, the more likely it is that having a relationship with them would be an abuse of power and your position.

You can speak to us today for a free, no obligation assessment of your case.