Good Medical Practice update 2024 – what do I need to know?

First produced in 1995, Good Medical Practice describes the core professional standards expected of doctors. Whilst this can all sound a bit dry, a working knowledge of the standards is essential as they form the basis of how doctors are regulated and they are used as the benchmark against which our appraisals and revalidation are framed. The last version dates back over 10 years to 2013. It’s safe to say that there has been a fair bit of change in society, medicine, and general practice during that time! Whilst the core standards remain, there are some changes in emphasis and important new standards especially on workplace culture, fairness and tackling discrimination as well as supporting continuity of care, ‘safe delegation’ and remote consulting.

The update centres around 5 key themes, with effective teamwork being the overarching aim:

1. Create respectful, fair and compassionate workplaces for colleagues and patients
2. Promote patient centred care
3. Tackle discrimination
4. Champion fair and inclusive leadership
5. Support continuity of care and safe delegation.

One of the areas that has moved on dramatically over the last 10 years is how we interact with patients. The overnight switch to remote consulting at the start of the pandemic demonstrated the remarkable adaptability of general practice but left guidance playing catch up:

‘You must provide safe and effective clinical care whether face to face, or through remote consultations via telephone, video link, or other online services. If you can’t provide safe care through the mode of consultation you’re using, you should offer an alternative if available, or signpost to other services’

Interestingly no single modality is prioritised. Aside from the obvious case where the patient needs an examination it listed indications that face-to-face may be preferable including doubts over capacity, not being the patient's usual GP, a lack of access to the medical record, complex clinical needs or consideration of high risk treatments (see decision aid) 

Fostering good teamwork is particularly pertinent to modern general practice. Over recent years the teams we work in have evolved, with ARRS roles bringing valuable new skill sets to the mix. The guidance stresses the importance of working collaboratively, listening to colleagues, and treating everyone with respect; leading or following as the situation requires. Key to working in new teams is ensuring all are supported and not placed in situations outside of their competence. GMP makes it clear that when delegating/ handing over care we must give clear instruction, and to encourage the recipient to ask questions and seek support or supervision if they need it. 

GMP contains new guidance that doctors ‘must not act in a sexual way towards colleagues with the effect or purpose of causing offence, embarrassment, humiliation or distress’. This is further clarified to include verbal or written comments and displaying or sharing images. For any that doubt whether such guidance is needed in the medical profession we sadly only need to look at the experiences of our surgical colleagues (BMJ 2023). Importantly, the guidance places responsibility for safeguarding our colleagues on  ALL OF US, encouraging anyone who witnesses such behaviour to act when possible. I encourage you to read the advice about what this could involve, including checking in with the affected individual(s) to let them know you feel that the behaviour you witnessed is unacceptable. Those in a formal leadership role MUST adequately address such behaviours. 

If you are after ideas for your PDP there are a couple of clear candidates. Firstly, there is a new requirement to consider the environmental impact of healthcare.  ‘You should choose sustainable solutions when you’re able to, provided these don’t compromise care standards. You should consider supporting initiatives to reduce the environmental impact of healthcare’ . They provide further information here. Why not start with tackling inhalers (listen to the Hot Topics Improving Asthma Care and Thinking Green Clinic for more info)?

Secondly, there is a new reference to regularly reviewing medications, considering the overall impact of the patients’ treatments and ‘whether the benefits outweigh any risk of harm’. It is a reminder that polypharmacy is an increasing concern in our aging population. The new Hot Topics Course has a brilliant section on the risks of anticholinergic medication, assessing anticholinergic burden and considering alternatives- maybe one for a cheeky audit?

Overall, this update highlights treating our patients, our colleagues and the planet with respect. Not a bad aim! And just recording and reflecting on this important update will already have earned you some valuable CPD towards your next appraisal 