Coronavirus questions and answers

UK specific

As a mutual organisation, our only purpose is to look after the professional interests of our members around the world and during the current crisis we will be working hard to support you however we can.

The number of enquiries relating to COVID-19 is unprecedented, and in many instances the questions we are being asked are the same – regardless of the country in which the member practises. So, in an effort to answer as many as possible, the Q&As on this page are reflective of the advice we are sharing with members around the world.

The page features UK specific FAQ pertaining to the COVID-19 situation. To access our main Coronavirus FAQ hub please click here.

  • Subscription relief: What is subscription relief?

    We have announced our intent to help medical members in private practice by offering them two months subscription relief on their membership fees.

    We know that the cost of subscriptions has been a concern for many private practice practitioners, and we hope that this is one less thing for them to worry about.

    You do not need to contact us if you wish to receive a subscription relief payment. We will assume that this is the preferred option for all private practice members unless they notify us that they want to be moved into deferred membership. If we need additional information in order to process your payment, we will contact you personally.

  • Subscription relief: How do I apply for subscription relief?

    You do not need to take any action to received subscription relief, this will be paid automatically to eligible medical members in private practice.

    We will assume that this is the preferred option for eligible private practice members unless they notify us that they want to be moved into deferred membership. If we need additional information in order to process your payment, we will contact you personally.

  • Subscription relief: I am deferring my membership due to my practice being temporarily closed – should I cancel my direct debit?

    No, please leave the direct debit instruction in place, we will not collect payments on this during the period of deferred membership.

  • Subscription relief: Why are some members in public practice being offered subscription relief?

    Any member who has an element of indemnity for private practice included in their membership – even if the majority of their work is in public practice – will benefit from the subscription relief.

    We appreciate that the amount of private work being carried out during the COVID-19 pandemic has reduced considerably and this is having an impact on earnings. The reduced work in private practice will also mean a reduced exposure to risk, so the cost of providing indemnity for these members will be reducing for MPS.

    For these reasons we are offering subscription relief, both to help with affordability, and to reflect the reduced risk of clinical negligence claims from private work.

    Members who work wholly in the public sector are unlikely to have their earnings impacted at this time. For this reason these members are currently out of scope for subscription relief. We are however constantly reviewing the situation.

  • Subscription relief: What are the timescales for receiving subscription relief?

    We are putting the process in place to be able to make the subscription relief payment to members as soon as possible and would like to reassure you that we are working on providing this payment as quickly as we are able to..

    Please do not cancel your Direct Debit instruction; we will manage everything on your behalf.

  • Subscription relief: Why are you still taking Direct Debit payments from me when I’m due a subscription relief payment?

    The subscription relief payments are being managed independently of our normal membership payment process and keeping your Direct Debit in place will enable a smoother process for refund by direct credit.

    If your membership is due to renew, you will receive your renewal documentation in the usual way, stating the amount due. Please ensure that you pay this in full, as the two month subscription relief payment will be made to you as a separate credit and therefore should not be deducted from the amount stated on your renewal notice.

  • Subscription relief: Can I use the “relief” amount as a credit towards future subscriptions instead?

    The subscription relief is being managed independently of our normal subscription process. Whilst we can’t use the relief payment to credit your account directly, we would urge members to use this payment as a contribution towards future subscription costs.

  • Subscription relief: My membership is due to renew, should I deduct this amount from my payment?

    Please do not deduct this payment from your next renewal. It is important that you continue to pay your subscription according to the terms and conditions of membership, to ensure you have the right protection in place for your practice and remain eligible to request assistance.

  • Subscription relief: How will you calculate my subscription relief?

    The amount of your subscription relief payment will be calculated as two twelfths of your annualised subscription.

    If you currently pay your membership subscription by Direct Debit, the payment amount will be different to your monthly payments. This is because your Direct Debit payments are spread over ten months, rather than twelve.

  • Having recently retired, I have been asked to return to practice to provide support during the COVID-19 crisis. Can I reinstate my membership with Medical Protection?
    In response to the work that healthcare workers are undertaking during the COVID-19 crisis, all retired or deferred members of Medical Protection will have their indemnity membership with us automatically reinstated completely free of charge. This is for state-indemnified work only.

    This means that whilst the state will indemnify your for any claims that could arise as a result of you undertaking this work, Medical Protection can offer assistance with other matters such as medicolegal advice and regulatory representation, support with complaints, disciplinary proceedings, inquests and criminal investigations arising from clinical practice.
  • I am a GP volunteering in NHS A&E. Does my membership extend to include this work?
    Before starting it is vital you seek written confirmation from the Hospital as to your duties, and whether they expect you to hold GMC registration and a License to Practice or international equivalent, and to confirm that the Hospital will provide you with an indemnity in the event of a claim of clinical negligence is made. 

    Medical Protection would also expect you to work within the limits of your competence.
  • Should I see patients if the personal protective equipment runs out?

    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.

    Members are always advised to follow the guidance in your country in relation to what PPE must be worn and when.

    There may be occasions when you believe that it is justifiable not to see a patient without adequate Personal Protective Equipment. Ultimately there is a limit to the risk that you would be expected to put yourself at in order to provide treatment to a patient. You should however consider the GMC’s guidance on this matter a link to which is provided below.

    https://www.gmc-uk.org/ethical-guidance/ethical-hub/covid-19-questions-and-answers

    In the section of the GMC’s Covid 19 guidance entitled “Working Safely” the following is stated:

    “We do not expect doctors to leave patients without treatment, but we also don’t expect them to provide care without regard to the risks to themselves or others. This pandemic is an unprecedented challenge in which clinicians are understandably balancing the imperative to provide care with their own fears. 

    We understand that this may lead to doctors having to make very difficult decisions where they have to use their professional judgement.

    Doctors will need to consider:

    · whether treatment can be delayed, or provided by another team;

    · what course of action is likely to result in the least harm in the circumstances;

    · whether alternative actions or additional steps can be taken to minimise the risk of transmission;

    · whether any doctors or other healthcare professionals are at a higher risk from infection than other colleagues.

    You should try to work with colleagues to find the best way forward in the circumstances. Our expectation is that doctors will do their best in the circumstances they face, considering the welfare of the patient and the risk to their own or others’ health to make these difficult decisions.”

    The same FAQs go on to say:

    “While a lower standard of PPE may increase risk to some degree, doctors would need to consider how to provide care to patients, including whether the available equipment allows treatment to continue. 

    If having tried and exhausted alternative means of treating a patient you believe that this is not possible without unreasonable risk to you and to other healthcare professionals, you should escalate your concerns, record your decision and how you tried to address safety concerns.”

    The British Medical Association are also addressing this issue in detail, and their details guidance can be found in the following link:

    https://www.bma.org.uk/advice-and-support/covid-19/your-health-and-wellbeing/covid-19-refusing-to-treat-where-ppe-is-inadequate

    In this guidance entitled “COVID-19: refusing to treat where PPE is inadequate” the BMA, in addition to providing advice on raising concerns, take the following view:

    “…there are limits to the risks you can be expected to expose yourself to. You are under no obligation to provide high-risk services without appropriate safety and protection. You can refuse to treat patients if your PPE is inadequate, you are at high risk of infection and there is no other way of delivering the care.”

    In is clear that employers should be providing adequate Personal Protective Equipment to allow doctors and other health professionals to do their jobs safely. If you are concerned that such equipment is not being supplied, or is in short supply and likely to run out, you should raise concerns in line with the local process for raising concerns within your organisation in the first instance.

    If you are asked to see a patient without the appropriate Personal Protective Equipment, each situation will need to be considered on a case by case basis. You are urged to consider the GMC’s guidance on this matter in making any decision. You should of course be prepared to justify any decision you make in the event that this decision becomes subject of a complaint or investigation at a later time. You should also ensure that any reasoning for any decisions that you make are carefully documented.

    Medical Protection members who do find themselves subject to regulatory or disciplinary proceedings as a consequence of not seeing a patient because there was a lack of appropriate Personal Protective Equipment can contact Medical Protection to seek advice, support and representation.

    Medical Protection has called upon the GMC and employers to provide reassurance that doctors with not face action as a consequence of inadequate provision of PPE. Further details can be found in the following press release: https://www.medicalprotection.org/uk/articles/doctors-should-not-face-investigation-if-they-decide-they-cannot-see-a-patient-due-to-poor-ppe-provision

  • Can I be reported to the regulator if I am ill with suspected or actual coronavirus and can’t see my patients?
    If you know or suspect you are infected, you should follow the current advice from your regulator and Public Health authorities, including self-isolating.

    Where possible it is important to make alternate arrangements for patients so their care is not compromised, this may include delegating to a colleague or signposting them to other resources.

    Should a patient make a complaint to a regulator, that you were unable to see them, it is important to be able to demonstrate that you acted in accordance with advice from your regulatory body and Public Health authorities.

    United Kingdom
    The GMC guidance ‘Good Medical Practice’ at paragraph 28  states that:

    “If you know or suspect you have a serious condition that you could pass on to patients, or if your judgement or performance could be affected by a condition its treatment, you must consult a suitably qualified colleague. You must follow their advice about any changes to your practice they consider necessary. You must not rely on your own assessment of the risk to patients.”

    Ireland
    The Medical Council in Ireland provides equivalent guidance in its document “Guide to professional conduct and ethics for registered medical practitioners” which states, at paragraph 58.2  

    “If you have an illness which could be a risk to patients or which could seriously impair your judgement, you must consult an appropriately-qualified professional and follow their advice.  This professional will have a dual role: to help and counsel you, and to make sure you do not pose a risk to patients and others. If such a risk exists, you must inform the Medical Council as soon as possible.”
  • I am working in a hospital with inadequate numbers of ventilators for the number of patients who need them - am I liable?

    The level of resourcing (including the number of available ventilators and who is eligible for them) should be a matter for the Trust/Health Board. When resources are limited, dialogue between clinical staff and the body responsible for allocating limited resources needs to take place. In a hugely challenging environment such as this when resources may well be unavailable, doctors and employers will face major ethical challenges on ITU, as elsewhere.

    The GMC’s duties of a doctor require that you make the care of your patient your first concern. Paragraph 25 of ‘Good Medical Practice’ states, "you must take prompt action if you think that patient safety, dignity or comfort is or may be seriously compromised."

    In response to the COVID-19 Pandemic the GMC has issued guidance which can be read here:
    https://www.gmc-uk.org/news/news-archive/supporting-doctors-in-the-event-of-a-covid19-epidemic-in-the-uk

    It states:

    "We need to stick to the basic principles of being a good doctor. All doctors are expected to follow GMC guidance and use their judgement in applying the principles to the situations they face, but these rightly take account of the realities of a very abnormal emergency situation. We want doctors, in partnership with patients, always to use their professional judgement to assess risk and to make sure people receive safe care, informed by the values and principles set out in their professional standards. A rational approach to varying practice in an emergency is part of that professional response."

    For those doctors working within an NHS setting, should a claim in negligence arise from the lack of suitable resources, it would be a matter for the Trust or Health Board.

    In the event of a complaint to the GMC the doctor would be expected to be able to demonstrate that they complied with their professional obligations as set out in the above guidance.

  • I am deferring my membership due to my practice being temporarily closed – should I cancel my direct debit?

    No, please leave the direct debit instruction in place, we will not collect payments on this during the period of deferred membership.

  • Can I sign a Medical Certificate of Cause of Death (MCCD) if the patient has not been seen by any doctor during their final illness?

    The recently introduced Coronavirus Act 2020 removes some of the limitations placed on doctors completing a MCCD, in acknowledgment of the current restrictions on clinical practice.

    NHS England and NHS Improvement have produced the following helpful guidance on this matter:

    Coronavirus Act – excess death provisions: information and guidance for medical practitioners

    Further, more detailed guidance can be found here:

    Guidance for doctors completing Medical Certificates of Cause of Death in England and Wales

    The Act now allows a doctor to complete an MCCD for a patient who has not been seen by a clinician within the 28 days prior to death, providing they are able to state the cause of death to the best of their knowledge and belief. This is likely to require a review of the patient’s medical record to gain an understanding of their past medical history and any recent care they have received.

    Deaths should still be referred to the Coroner if a doctor is unable to state a cause of death or in situations where the death was violent or unexpected, as was the case prior to the Coronavirus Act.

    The changes above are of a temporary nature during the Coronavirus emergency.

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The Medical Protection Society Limited (MPS) is a company limited by guarantee registered in England with company number 00036142 at Level 19, The Shard, 32 London Bridge Street, London, SE1 9SG. 

MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association. MPS® and Medical Protection® are registered trademarks.