These cases are based on actual calls made to MDDUS advisers and are published here to highlight common challenges within general practice. Details have been changed to maintain confidentiality.
Charity work abroad
Q I am a GP and would like to take some time out to work abroad for a few months with a medical charity. Would MDDUS provide me with indemnity in the event that any kind of complaint or claim is made against me while I’m abroad?
A MDDUS assists members undertaking their professional roles in Scotland, England, Wales, Northern Ireland, the Channel Islands and the Isle of Man. We are unable to offer benefits outside of these jurisdictions, other than in respect of Good Samaritan Acts, humanitarian work and limited voluntary or expedition medicine. You can find details of your specific indemnity in the Member Guide and as stated in your individual membership information sheet, which would have been sent with your membership pack. If you are considering charity/voluntary work abroad, you will need to ensure you have the appropriate registration and indemnity in place for this and you should contact MDDUS for specific advice prior to undertaking this work (firstname.lastname@example.org). We also advise you to speak to the charity in order to find out whether they already have appropriate indemnity and registration arrangements in place for volunteers engaged in the type of work you plan to undertake.
Q I recently received a fixed penalty notice for speeding, which included three points on my licence and a £100 fine. Do I need to inform the General Medical Council?
A GMC guidance in Good medical practice states that you must inform the GMC without delay if you have been charged with or found guilty of a criminal offence. However, expanded GMC guidance on Reporting criminal and regulatory proceedings within and outside the UK confirms that you do not need to inform the regulator of “payment of a fixed penalty notice for a road traffic offence”. We would encourage you to read over this guidance for more detail on the matter.
Hit and run
Q Last week a patient dented the car of our practice nurse and drove off. This was clearly witnessed by one of our GPs. Can we retrieve their details off the system and contact them or the police – or is this prohibited under data protection regulations?
A Accessing and disclosing patient details in these circumstances would likely constitute a breach of your professional duty of confidentiality. GMC guidance states that it is permissible to make a non-consensual disclosure of personal data in the public interest where it is “likely to be necessary for the prevention, detection or prosecution of serious crime, especially crimes against the person”. Offences such as property damage are unlikely to reach the required threshold. It may be that the GP noted the registration number of the hit and run driver and it would be appropriate to pass this on to the relevant authorities. However, as the identity of the driver is only known to the practice by the nature of the doctor-patient relationship it would be a breach of confidentiality to disclose the actual identity of the driver.
Retention of house-call logs
Q How long does our practice need to keep visit book diaries? Visit requests are now logged in our computer system but we still hold old paper diaries going back many years.
A There is specific NHS guidance (e.g. NHSX – Records Management Code of Practice 2021) on the retention of medical documents, as well as regulatory guidance on most administrative, financial, and health and safety documents. No specific guidance is provided for some documents that are not part of the clinical records, e.g. appointment diaries and house-call logs. NHSX recommends clinical diaries can by reviewed and destroyed two years after the year to which they relate.
Patient demand to alter records
Q A patient with access to his medical records has contacted one of our GPs demanding that he remove a diagnosis of mild depression recorded five years ago. How should we deal with this?
A Patients have a right to request factual inaccuracies in their records be corrected under Article 16 of the UK GDPR but this does not give them the right to have professional opinions altered or removed. In this case the GP made a diagnosis of mild depression and, if this was a reasonably held opinion at the time, then it would be appropriate to ensure that it remains in the medical records. Patients are entitled in such circumstances to have a note entered into the medical records highlighting entries to which they object but not the right to demand that such entries are altered or deleted.
Paid market research
Q I am a GP and have been offered a small fee to take part in a market research survey regarding a particular clinical condition. Would doing so breach GMC principles?
A There should be no general concerns in participating in such research, providing you comply with GMC guidance in Good medical practice (paragraphs 67 to 69) on being honest and truthful when carrying out research or providing information. It is of particular note that the research is into a medical condition and therefore may assist in future management. We would recommend that you ensure that any such activity is in the best interests of patients generally, and that you are not required to provide any patient identifiable information. In terms of the financial remuneration, the GMC provides guidance in this area in its guidance Financial and commercial arrangements and conflicts of interest. This advises doctors to ensure that they are open and honest in relation to their financial dealings. The GMC also advises that you must not allow such interests to affect the way you prescribe, treat, refer or commission services for patients.