Firstly, employers have a duty of care to all their employees to ensure that the environment is safe to work in. It would be wise to discuss the contingency plans that are in place in your employing organisation now, so that everyone has a clear understanding of the risks that staff may face and the actions and procedures that will be put in place to protect staff.

Your own health is important, and you should ensure that you selfcare in order to protect yourself, your colleagues and your patients.

If you have pre-existing health conditions that place you at increased risk of infection, you should discuss working arrangements with colleagues and your employer. It may be appropriate to ask another suitably qualified clinician to take over the care of patients who are suspected to have, or have been diagnosed as having, Covid-19.

Secondly there is a risk that systems in the healthcare sector will be put under considerable pressure and some may fail to cope or breakdown. If you are worried that patient safety or care may be compromised you should raise your concerns with other clinicians in order to agree the best course of action to ensure the best care for patients.

Doctors should record any concerns in writing, clearly and objectively setting out the reasons for their concerns and the potential impact on patient safety, with examples.

Keep a record of any correspondence or discussions about the problems you have raised and the steps that you have taken to try to remedy matters. If an adverse incident does occur, it can be useful to show that you took action. If those who are responsible do not take proper action you can consider reporting the matter further up the line of management, in line with your workplace policy.
 

There have been no reports of medicine shortages as a result of COVID-19. Some practices may however still face requests from patients for extra medication to stockpile ‘just in case’. With an increasing stack of repeat prescriptions waiting to be signed by GPs, it is crucial not to rush this task or be pressured by patients into overprescribing. The practice should have a good repeat-prescribing policy in place and stick to this unless they receive official advice stating otherwise.

While medicine shortages are not anticipated at this time, the policy should include steps to take if patients do face delays obtaining routine medications.

Where there are no current concerns, honest and open communication will be key if a patient is insisting that they have extra supply, along with explaining and justifying decisions and actions. Despite this, some patients will remain angry about not being able to stockpile their prescriptions. The practice’s complaints process should be offered at the consultation should they remain dissatisfied, and conversations should be noted in the patient’s records.

The World Health Organization’s (WHO) advice in relation to infection prevention and control measures for healthcare workers caring for a patient with suspected or confirmed Covid-19 states that contact and droplet precautions are recommended for all healthcare workers caring for a patient with suspected/confirmedCovid-19. The WHO advise that provision of appropriate personal protective equipment supplies should be a national and institutional priority.
 

Doctors must consider the needs of all patients alongside their primary duty to their own patients and should actively balance these duties to try to get the best possible outcomes where resources are limited.

This means that if doctors are asked to stop some routine work for the benefit of patient’s generally then this would be acceptable. We would advise complying with governmental and regulatory guidance with regards to this.

Medical Protection members should contact us with any concerns.

It is understandable that doctors on the frontline during the pandemic will have concerns regarding their own health and the risk of contracting COVID -19 infection.

The World Health Organization’s (WHO) advice for healthcare workers who come into contact with someone known to have COVID-19 is to assess their risk of infection using an online assessment tool, here.

National guidelines in your country of practice may differ and you should check the latest advice from your government and public health authorities.

The World Health Organization’s (WHO) advice for healthcare workers who come into contact with someone known to have COVID-19 is to assess their risk of infection using an online assessment tool. This tool aids in the risk assessment for HCWs after exposure and provides recommendations for their management.

National guidelines in your country of practice may differ and you should check the latest advice from your government and public health authorities.

This would depend on the specific circumstances of the situation. It is essential that you comply with your organisation's infection control policies and guidance from public health authorities.

Should this circumstance arise, it is important to communicate with patients promptly so they are made aware of the situation and to take all reasonable steps to arrange for alternative provision of care from another source

Clinicians working in the public health service and public hospitals can rely on state indemnity should a claim arise from alleged negligent care and treatment of any patient.

In the event of other professional consequences such as a complaint or a referral to a regulator, Medical Protection members can request assistance in the usual way.

Doctors should make the care of their patients their first concern, adequately assess a patient’s condition and provide or arrange suitable advice, investigation and treatment where necessary, including referring a patient to hospital where this best serves their needs.

In a situation where it is not possible to send a patient to hospital because the hospital is full, then you should consult experienced colleagues for advice on the situation, provide treatment based on that advice and on best available evidence, and take all possible steps to best manage the patient’s illness.

Where you have concerns about patient safety because of a lack of resources or inadequate premises, equipment policies or systems, then you must raise your concern in accordance with relevant regulatory guidance, contractor or employer’s policy, and document the steps you have taken.

As a professional you have an obligation to ensure any report you write or sign is accurate and honest. If you are satisfied that the patient has a genuine medical condition that prevents them from flying, then it is appropriate to provide a certificate.

However, if the patient, has simply decided not to fly because of their concerns about COVID-19, then it is a matter for them to discuss with their travel company.

In general terms, doctors should ensure that they are using a platform that allows the safest solution in the circumstance and should be mindful of data protection laws and maintaining patient confidentiality. Generally advice should be sought from any organisation in which you work including within the private sector and if this is not possible then you must ensure that you maintain your legal and professional obligations to your patient. Use of any app or platform should be agreed by the patient.

United Kingdom

In general terms, doctors should ensure that they are using a platform that allows the safest solution in the circumstance and should be mindful of data protection laws and maintaining patient confidentiality. Generally advice should be sought from any organisation in which you work including within the private sector. If this is not possible it would be appropriate to follow the guidance provided by NHS authorities. Use of any app or platform should be agreed by the patient.

• NHSX: https://www.nhsx.nhs.uk/key-information-and-tools/information-governance-guidance
• NHS Scot: https://www.informationgovernance.scot.nhs.uk/blog/2020/03/16/covid-19-guidance-on-text-messages-and-similar-communications-with-nhsscotland-registered-individuals/
• NHS Wales: https://nwis.nhs.wales/coronavirus/digital-support-updates-for-healthcare-professionals/information-governance/
• NHS Digital advice for approved Videocon systems: https://digital.nhs.uk/services/future-gp-it-systems-and-services/approved-econsultation-systems