Coronavirus Act: how the emergency legislation will impact healthcare professionals
Following pressure to fast-track its procedures, the General Medical Council (GMC) agreed to offer early provisional registration to final year medical students once they have graduated, and early full registration of Foundation Year 1 (FY1) doctors. These graduates and doctors will need to “opt in” and the GMC requires they receive adequate induction and supervision, as well as full necessary personal protective equipment and training on how to use it appropriately.
Medical schools will need to confirm that any final year student who applies for early provisional registration has graduated and is not subject to any fitness to practise considerations. Medical schools are prioritising teaching and assessment for final year students, to enable them to graduate early, with many (virtual) graduations already starting to take place over the last week.
In order to graduate early, these students must have been deemed by their medical school to have met the GMC’s Outcomes for Graduates. This will mean that, if they are willing to do so, final year students who have graduated, will be able to join the workforce and work as FY1 doctors as soon as practicable.
The Foundation Programme is a two year training programme whereby medical graduates have the opportunity to gain experience in a series of placements across a variety of specialties and healthcare settings. This training forms the bridge between medical school and specialty training. By the end of foundation year 1, doctors begin to take supervised responsibility for patient care, including prescribing under supervision. By the end of foundation year 2, doctors are able to take on increasing responsibility for patient care, including a wider range of prescribing responsibilities and making care management decisions.
In order to apply for full registration, FY1 doctors will need to provide a Certificate of Experience from their foundation school, which demonstrates they have met the requirements set out in the GMC’s Outcomes for Provisionally Registered Doctors. The GMC states that these doctors will stay within their current placements to ensure they are familiar with the work and training settings, but could be asked to undertake a broader range of duties.
Early registration will go a long way to assist hospitals as they struggle to cope with the outbreak. Nevertheless, it is vital that healthcare professionals are not expected to perform any duties that go beyond their level of competence, as this could create serious risks for patients.
In practical terms, the GMC and the Nursing and Midwifery Council (NMC) have recognised that these are challenging times and it is likely that members will, in some situations, need to depart from established procedures to care for patients. The GMC has acknowledged that doctors may be working in unfamiliar circumstances or surroundings, or in clinical areas outside of their usual practice. They advise their members that “[a]ll doctors have a duty to recognise and work within their competence. But in these exceptional circumstances, doctors at every level may be required to work at the limits of their comfort zone and in some cases beyond.”
In another recent blog, we discussed the conflict between social distancing and nurses’ obligations to look after patients: individual practitioners must keep in mind the limits of their competence when making decisions about whether to agree to redeployment.
Sadly, we have seen the first deaths of NHS frontline staff due to Coronavirus. This, together with reports of increasing numbers of NHS workers testing positive for the virus, has fuelled the debate over death-in-service benefits for NHS staff, particularly for those returning to help tackle the deadly virus, as they would not be eligible for death-in-service payments. A similar issue arises in relation to serving NHS workers who have opted out of the NHS Pension Scheme (which provides a tax-free lump sum payment equivalent to two times the annual salary, as well as pension benefits for six months, to the families of members who die in service) as they would receive a greatly reduced payment. Additionally, as many General Practitioners are self-employed, they would not be covered by death benefit payments if they died on a day that they were not contracted to work. The Guardian has reported that “[h]undreds of doctors have said they are less likely to return to the frontline or increase their hours to fight Covid-19 because they fear their families will not be properly compensated if they die”.
The British Medical Association (BMA) has called on the government to automatically extend enhanced death-in-service cover to all NHS workers, including those returning on a temporary basis and those who have opted out of the pension scheme. This would ensure that all NHS workers receive the same level of death benefits, and would go a long way to reassuring staff working tirelessly to fight the pandemic that their families will not be left in financial difficulty should the worst occur. You can read the BMA’s FAQs on the benefits here.
It is clear that the increasing spread of coronavirus is putting NHS services across the health and care sectors under extreme pressure. Measures have been put in place to help facilitate increased staff levels; however, further issues need to be addressed by the Government, as outlined above, to ease the burden currently experienced by frontline workers and to ensure a safe working environment.
We have received many questions from frontline health and social care staff during the COVID-19 pandemic. You can read these FAQs here.
We continue to support the NHS throughout this difficult time #NHSHeroes #clapforNHS
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