Business Dilemmas

Dr Kathryn Leask answers a doctor’s query about when you need to disclose a driving offence to the GMC.

 

 

 

 

 

Dilemma 1

Do I tell GMC I’ve been speeding?

Q I have received a fixed penalty notice, having been found to be travelling 49 miles an hour in a 40mph zone in addition to a fixed penalty for leaving litter. 

A colleague has advised me that I need to disclose this to the GMC. Apparently, she received a driving conviction and did not declare this. 

The GMC was informed of the conviction by the police who then contacted my colleague informing her they had opened an investigation. 

This had implications for her private practice, as her practising privileges were suspended while the investigation was ongoing. 

I understand that there are a number of other circumstances which a doctor must declare to the GMC. Please could you confirm whether I need to inform the GMC of this matter?

A The GMC’s guidance Good Medical Practice does state in paragraph 75 that you must inform the GMC if, anywhere in the world, you have accepted a caution from the police or have been criticised by an official inquiry. 

An official inquiry might, for example, include a coroner’s inquest. You must also inform the GMC if you have been charged with or found guilty of a criminal offence or if another professional body has made a finding against your registration as a result of fitness-to-practise procedures. 

In its more detailed guidance, Reporting criminal and regulatory proceedings, the GMC goes on to say that you must also inform it if you receive a cannabis warning or are given an anti-social behaviour order. 

The guidance also refers to you accepting the option of paying a penalty notice for disorder on the upper penalty tier, where a list of offences can be found on the Home Office and GMC website. 

You will note that littering falls under the lower tier and is not something that you need to declare to the GMC.

The guidance also makes reference to payment of a fixed penalty notice for a road traffic offence. Again, you are not required to inform the GMC about this.

More severe sanction 

But you would need to inform the GMC if you were convicted, cautioned or found guilty of a road traffic offence, as seems to have been the case with your colleague. 

This could, for example, relate to drink or drug driving, driving dangerously or travelling at an excessive speed which would result in a more severe sanction than a fixed penalty notice.

If a doctor is ever unsure about the circumstances under which a matter should be reported to the GMC, it is important that they seek advice from their medical defence organisation. 

A lack of declaration of a relevant offence would be in breach of the GMC’s guidance and is likely to result in an investigation, not only into the circumstances of the event, but also the reason why it was not declared.

 

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Treating patients moved overseas

Private doctors have raised a number of queries about conducting remote consultations with their patients who live abroad. Dr Kathryn Leask discusses the implications in answer to a GP’s question.

 

 

 

Dilemma 2

Any curbs on a video session?

Q I am a private GP and have a number of patients who have moved abroad either temporarily or for the foreseeable future, due to the pandemic. 

These patients have asked that I continue to be their GP and consult with them remotely. Like many healthcare professionals, many of my consultations are being held either by phone or video at the moment and this is likely to continue where appropriate.

I am keen to support my patients and know their past medical histories well. Where necessary, I would refer them on to the appropriate specialist in their current country of residence. Are there any restrictions in being able to consult with patients abroad?

A As you will be aware, the GMC regulates registered medical practitioners in the UK and the GMC can investigate doctors whose fitness to practise is called into question. 

Section 35C(3) of the Medical Act 1983 states that this can include allegations that have occurred outside the UK. From this point of view, therefore, it does not matter where the consultation took place or what the location of the doctor or patient is. 

The GMC has the jurisdiction to investigate allegations that suggest a doctor’s fitness to practise is impaired. 

However, in its guidance on prescribing and managing medicines, the GMC refers to prescribing for patients overseas and the need to consider whether registration with a regulatory body in the country in which the prescribed medicines are being dispensed is also required. 

It is important to check, therefore, whether you need to be registered in each country your patients are residing. 

Not all countries have the same requirements, with some necessitating registration in the patient’s country of residence and others being satisfied with registration in the doctor’s country of residence.

The GMC’s guidance also makes reference to the need to consider how you or local healthcare professionals will monitor the patient’s condition. 

It is also important to take into account differences in the licensed name, indications and recommended dosages of medications and products in the country the patient is residing in. 

Potential clinical negligence claims are another consideration. If a claim were brought against you, it would be better for this to be in an English court applying English law and it is likely that an English court would have jurisdiction if you are practising in the UK. 

However, the courts located in the country the patient is situated may also accept jurisdiction, applying foreign law. 

It is important, therefore, that any healthcare professional intending to consult with patients abroad discusses their indemnity arrangements with their medical defence organisation.

Dr Kathryn Leask medico-legal adviser at the Medical Defence Union

• See ‘An apology can defuse an error’