Ending your professional relationship with a patient: Guidance

1. In Medical practice1 we say:

62. You should end a professional relationship with a patient only when the breakdown of trust between you and the patient means you cannot provide good clinical care to the patient.

2. In this guidance, we explain how doctors can put this principle into practice. Serious or persistent failure to follow this guidance will put your registration at risk.

Things to consider

3. In rare circumstances, the trust between you and a patient may break down, for example, if the patient has:

  • been violent, threatening or abusive to you or a colleague2
  • stolen from you or the premises3
  • persistently acted inconsiderately or unreasonably
  • made a sexual advance4 to you.

4. You should not end a professional relationship with a patient solely because of a complaint the patient has made about you or your team, or because of the resource implications of the patient’s care or treatment.

Before you end the relationship

5. Before you end a professional relationship with a patient you should:

a. warn the patient that you are considering ending the relationship

b. do what you can to restore the professional relationship

c. explore alternatives to ending the professional relationship

d. discuss the situation with an experienced colleague or your employer or contracting body

and you must be satisfied that your reason for wanting to end the relationship is fair and does not discriminate against the patient (see paragraph 59 of Medical practice).

When you’ve made a decision to end the relationship

6. If you decide to end your professional relationship with a patient you must:

a. make sure the patient is told of your decision to end the professional relationship, and your reasons for doing so; where practical, the patient should be told in writing

b. follow relevant guidance5 and regulations

c. record your decision to end the professional relationship – information recorded in the patient’s records must be factual and objective, and should not include anything that could unfairly prejudice the patient’s future treatment

d. make sure arrangements are made promptly for the continuing care of the patient, and you must pass on the patient’s records without delay6

e. be prepared to justify your decision.

Closing or relocating your practice

7. If you are closing or relocating your practice, you should:

a. give advance notice

b. make sure that arrangements are made for the continuing care of all your current patients, including the transfer (or appropriate management) of all patient records.

Further sources of information and advice

  • British Medical Association – General Practitioners Committee (GPC) .
  • Department of Health Health service circular 2000/001 .
  • .
  • Medical and Dental Defence Union of Scotland .
  • Medical Protection Society (see also factsheets for all four UK countries).
  • Parliamentary and Health Service Ombudsman ; ; .
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  • .

Endnotes for Ending your professional relationship with a patient