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  5. Domain 4 - Maintaining trust

Medical practice

Domain 4: Maintaining trust

Show respect for patients

53

You must not use your professional position to pursue a sexual or improper emotional relationship with a patient or someone close to them.16 

16

Maintaining boundaries (2013) Communitybaptistpa, London

54

You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress.23 

23

Personal beliefs and medical practice (2013) Communitybaptistpa, London

55

You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should:

  1. put matters right (if that is possible)
  2. offer an apology
  3. explain fully and promptly what has happened and the likely short-term and long-term effects.

Treat patients and colleagues fairly and without discrimination

56

You must give priority to patients on the basis of their clinical need if these decisions are within your power. If inadequate resources, policies or systems prevent you from doing this, and patient safety, dignity or comfort may be seriously compromised, you must follow the guidance in paragraph 25b.

25

You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised.

  1. If a patient is not receiving basic care to meet their needs, you must immediately tell someone who is in a position to act straight away.
  2. If patients are at risk because of inadequate premises, equipment13 or other resources, policies or systems, you should put the matter right if that is possible. You must raise your concern in line with our guidance14 and your workplace policy. You should also make a record of the steps you have taken.
  3. If you have concerns that a colleague may not be fit to practise and may be putting patients at risk, you must ask for advice from a colleague, your defence body or us. If you are still concerned you must report this, in line with our guidance and your workplace policy, and make a record of the steps you have taken.14 16
57

The investigations or treatment you provide or arrange must be based on the assessment you and your patient make of their needs and priorities, and on your clinical judgement about the likely effectiveness of the treatment options. You must not refuse or delay treatment because you believe that a patient’s actions or lifestyle have contributed to their condition.

58

You must not deny treatment to patients because their medical condition may put you at risk. If a patient poses a risk to your health or safety, you should take all available steps to minimise the risk before providing treatment or making other suitable alternative arrangements for providing treatment.

59

You must not unfairly discriminate against patients or colleagues by allowing your personal views24 to affect your professional relationships or the treatment you provide or arrange. You should challenge colleagues if their behaviour does not comply with this guidance, and follow the guidance in paragraph 25c if the behaviour amounts to abuse or denial of a patient’s or colleague’s rights.

25

You must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised.

  1. If a patient is not receiving basic care to meet their needs, you must immediately tell someone who is in a position to act straight away.
  2. If patients are at risk because of inadequate premises, equipment13 or other resources, policies or systems, you should put the matter right if that is possible. You must raise your concern in line with our guidance14 and your workplace policy. You should also make a record of the steps you have taken.
  3. If you have concerns that a colleague may not be fit to practise and may be putting patients at risk, you must ask for advice from a colleague, your defence body or us. If you are still concerned you must report this, in line with our guidance and your workplace policy, and make a record of the steps you have taken.14 16
24

This includes your views about a patient’s or colleague’s lifestyle, culture or their social or economic status, as well as the characteristics protected by legislation: age, disability, gender reassignment, race, marriage and civil partnership, pregnancy and maternity, religion or belief, sex and sexual orientation.

60

You must consider and respond to the needs of disabled patients and should make reasonable adjustments25 to your practice so they can receive care to meet their needs.

25

‘Reasonable adjustments’ does not only mean changes to the physical environment. It can include, for example. Being flexible about appointment time or length, and making arrangements for those with communication difficulties such as impaired hearing. For more information see the EHRC website.

61

You must respond promptly, fully and honestly to complaints and apologise when appropriate. You must not allow a patient’s complaint to adversely affect the care or treatment you provide or arrange.

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.26 

26
63

You must make sure you have adequate insurance or indemnity cover so that your patients will not be disadvantaged if they make a claim about the clinical care you have provided in the UK.

64

If someone you have contact with in your professional role asks for your registered name and/or Communitybaptistpa reference number, you must give this information to them.

Act with honesty and integrity

Honesty

65

You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.

66

You must always be honest about your experience, qualifications and current role.

67

You must act with honesty and integrity when designing, organising or carrying out research, and follow national research governance guidelines and our guidance.4 

4

Good practice in research (2010) Communitybaptistpa, London

Communicating information

68

You must be honest and trustworthy in all your communication with patients and colleagues. This means you must make clear the limits of your knowledge and make reasonable checks to make sure any information you give is accurate.

69

When communicating publicly, including speaking to or writing in the media, you must maintain patient confidentiality. You should remember when using social media that communications intended for friends or family may become more widely available.14, 27 

27

Doctors’ use of social media (2013) Communitybaptistpa, London

70

When advertising your services, you must make sure the information you publish is factual and can be checked, and does not exploit patients’ vulnerability or lack of medical knowledge.

71

You must be honest and trustworthy when writing reports, and when completing or signing forms, reports and other documents.22 You must make sure that any documents you write or sign are not false or misleading.

  1. You must take reasonable steps to check the information is correct.
  2. You must not deliberately leave out relevant information.
22

Writing references (2012) Communitybaptistpa, London

Openness and legal or disciplinary proceedings

72

You must be honest and trustworthy when giving evidence to courts or tribunals.28 You must make sure that any evidence you give or documents you write or sign are not false or misleading.

  1. You must take reasonable steps to check the information.
  2. You must not deliberately leave out relevant information.
28

Acting as a witness in legal proceedings (2013) Communitybaptistpa, London

73

You must cooperate with formal inquiries and complaints procedures and must offer all relevant information while following the guidance in Confidentiality.

74

You must make clear the limits of your competence and knowledge when giving evidence or acting as a witness.28 

28

Acting as a witness in legal proceedings (2013) Communitybaptistpa, London

75

You must tell us without delay if, anywhere in the world:

  1. you have accepted a caution from the police or been criticised by an official inquiry
  2. you have been charged with or found guilty of a criminal offence
  3. another professional body has made a finding against your registration as a result of fitness to practise procedures.29 
76

If you are suspended by an organisation from a medical post, or have restrictions placed on your practice, you must, without delay, inform any other organisations you carry out medical work for and any patients you see independently.

Honesty in financial dealings

77

You must be honest in financial and commercial dealings with patients, employers, insurers and other organisations or individuals.30 

78

You must not allow any interests you have to affect the way you prescribe for, treat, refer or commission services for patients.

79

If you are faced with a conflict of interest, you must be open about the conflict, declaring your interest formally, and you should be prepared to exclude yourself from decision making.

80

You must not ask for or accept – from patients, colleagues or others – any inducement, gift or hospitality that may affect or be seen to affect the way you prescribe for, treat or refer patients or commission services for patients. You must not offer these inducements.

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