Introduction

In the inner sanctums of the UK’s medical community, the words ‘General Medical Council‘ (GMC) often resonates with an undercurrent of apprehension, scepticism and cynicism. These sentiments were born from years of navigating the complex interplay between rigorous professional standards and the harsh realities of medical practice. For many seasoned doctors, the GMC is perceived not as an ally but as an imposing entity, distant from the daily grind of patient care and quick to impose what seems like disproportionate penalties. These perceptions, fuelled by decades of collective experiences, have fostered a culture where GMC guidelines are more often met with aversion rather than adherence.

Yet, in the face of prevailing sentiments, there lies an undeniable truth – the GMC’s influence and authority are both formidable and inescapable. As we stand on the brink of the 2024 updates to Good Medical Practice, it is time to confront the perilous consequences of ignoring the GMC’s mandate. These guidelines, often viewed through a lens of scepticism, are in fact vital navigational tools in our pursuit of excellence in patient care and professional integrity. Dismissing them as out of touch or irrelevant not only undermines our professional responsibilities but also jeopardises the very fabric of trust and safety we strive to weave into our patient interactions. Trust must be at the heart of what we do.

This blog seeks to do more than just expound the GMC’s updated guidelines and changes; it aims to rekindle a conversation about why these standards matter. By delving into the nuances of the 2024 updates, we will explore how they align with the realities of contemporary medical practice and the implications of side-lining them. It is an invitation to journey beyond mere compliance, to understand the rationale behind the principles, and to reflect on how they can be integrated meaningfully into our daily practice.

In navigating these changes, let us acknowledge our reservations yet also embrace the opportunity to redefine our understanding of the GMC – and what that means for patients and colleagues. This blog is a call to engage, to have those differences of perspective, and still find a path forward where acknowledgement for the GMC’s authority and a deep commitment to patient care are not mutually exclusive but harmoniously intertwined. Together, let’s embark on this  exploration, not just as practitioners but as guardians of an ethos that places patient welfare and professional integrity at its heart.

The GMC’s 2024 Changes: A Narrative Overview

Here is the GMC’s full list of changes.

Embracing a Culture of Respect and Compassion in the Workplace: The GMC’s 2024 updates bring a fresh focus on creating more respectful, fair, and compassionate work environments. For doctors, this means an increased responsibility to role model behaviours that foster a supportive culture. Notably, there’s a stronger emphasis on treating colleagues with kindness, courtesy, and respect. For those in leadership roles, there’s a new directive to actively create safe spaces for discussing errors and concerns. This shift is not just about compliance; it is a move towards enhancing the overall quality of healthcare by improving workplace dynamics.

Patient-Centred Care at the Forefront: The updated guidelines underscore the importance of patient-centred care. Doctors are expected to engage in open dialogues with patients, ensuring that their voices and concerns are integral to decision-making processes. This approach extends to medication reviews and the overall treatment strategy, emphasising personalised care. The GMC is essentially reinforcing the notion that patient care goes beyond treatment – it is about empowering patients in their health journey.

Addressing Discrimination and Upholding Professionalism: In response to societal changes, the GMC has strengthened its stance against discrimination and unprofessional behaviour. There’s a low-tolerance approach to any form of discrimination or harassment. This extends to sexual misconduct towards colleagues. For those witnessing such behaviours, there’s now a clearer guideline on how to act, especially for those in leadership positions. This change reflects a broader commitment to not only patient safety but also to the wellbeing and dignity of healthcare professionals.

Leadership with Integrity and Inclusion: Leaders within the medical field are now expected to champion inclusivity and fairness. This means ensuring equal access to opportunities and addressing concerns in a prompt and effective manner. The message is clear: leadership in healthcare is not just about clinical expertise but also about fostering an environment where every team member, regardless of their background or experience level, feels valued and supported.

Continuity of Care and Delegation: Acknowledging the challenges in today’s healthcare systems, the GMC emphasises the importance of continuity of care and safe delegation practices. This includes clear communication about patient care during shifts and ensuring that responsibilities are appropriately delegated and understood. These guidelines aim to minimise errors and enhance patient care, recognising the complexities of modern healthcare delivery.

Clarity and Accessibility: Finally, the GMC has made efforts to make these standards more accessible and easier to understand. The restructuring with clear section titles and subheadings, along with defined terms ‘must‘ and ‘should‘, is intended to make it easier for busy professionals to grasp and apply these standards in their daily practice.

Details of key changes in Good Medical Practice 2024 

These changes are structured under different themes, each addressing crucial aspects of medical practice. Below is a summary of the changes:

1. Creating Respectful, Fair, and Compassionate Workplaces:
   • Must:
     • Create a culture that is respectful, fair, supportive, and compassionate by role modelling appropriate behaviours (para 52).
     • Treat colleagues with kindness, courtesy, and respect.
     • Listen to colleagues, communicate clearly, politely, and considerately, recognise and respect colleagues’ skills and contributions, and work collaboratively (paras 48, 49).
     • For leaders/managers, take active steps to create an environment where errors and concerns can be safely discussed (para 76)​​.
2. Promoting Patient-Centred Care:
   • Must:
     • Listen to patients and encourage open dialogue, allowing them to express their concerns (para 29).
   • Should:
     • Check patients’ understanding of information given, and ensure they have time and support for informed decisions (para 31).
     • Review medications regularly to ensure they meet patients’ needs and that benefits outweigh risks (para 40).
     • Ask about other care or treatment patients are receiving, and ensure compatibility (para 39).
     • Support patients in self-care (para 38)​​.
3. Helping to Tackle Discrimination:
   • Must:
     • Not abuse, discriminate against, bully, or harass anyone based on personal characteristics (para 56).
     • Not act in a sexual way towards colleagues that causes offence, embarrassment, humiliation, or distress (para 57).
     • For leaders/managers, address such behaviours promptly and support those affected (para 59).
   • Should:
     • Take actions against observed discriminatory behaviours (para 58).
     • Understand personal biases and how they influence interactions and care provided (paras 13, 54, 55)​​.
4. Championing Fair and Inclusive Leadership:
   • Must:
     • For leaders/managers, create an environment for safe discussion of errors and concerns, ensure equal access to opportunities, and address concerns promptly (paras 64, 76).
   • Should:
     • Offer professional support to colleagues, especially those new to practice in the UK, returning from a break, or lacking access to support (para 63).
     • Be accessible to colleagues for information, advice, or support (para 50).
     • Be aware of the influence of personal behaviour on others (para 53)​​.
5. Supporting Continuity of Care and Safe Delegation:
   • Must:
     • Share relevant patient information promptly with others involved in care, both within and across teams (para 65a).
     • Inform patients about their care progress, responsible clinicians, and lead clinician or team (para 65b).
     • Ensure ongoing care information is shared when finishing a shift or transferring care (paras 65c, 65d).
     • For delegating tasks, provide clear instructions and support (para 66).
   • Should:
     • Prioritize patient safety and seek help if uncertain about safely carrying out a task (para 67)​​.
6. Making Standards Easier to Navigate:
   • Restructuring with clearer section titles reflecting content.
   • More descriptive subheadings for easy navigation.
   • Updated definitions of ‘must’ (legal or ethical duties) and ‘should’ (duties or principles that may not always be applicable or within control)​​.

These changes reflect an evolution towards more patient-centred care, respect for colleagues, and responsibility in leadership roles, underpinned by a clearer definition of the obligations denoted by ‘must‘ and ‘should‘. This approach aims to enhance the overall quality of healthcare delivery and professional conduct within the medical community.

The Path Ahead

The GMC’s 2024 updates to Good Medical Practice are not just regulatory changes; they are a reflection of an evolving healthcare landscape, one that demands our adaptability, empathy, and unwavering commitment to excellence. As doctors, we hold the dual responsibility of being guardians of patient welfare and standard-bearers of professional integrity. These changes, while they may initially seem daunting, are in fact stepping stones towards a more resilient, inclusive, and patient-centric healthcare system.

Let us embrace these updates not as mere obligations, but as opportunities to refine our practice, to strengthen our teams, and to deepen the trust our patients place in us. As we integrate these standards into our daily routines, let us remember that at the heart of all these guidelines is the fundamental ethos of medicine – to care, to heal, and to protect.

As we move forward, let the essence of these changes resonate in our interactions, decisions, and the compassionate care we provide. In a world where the only constant is change, let us be the steadfast protectors of health, dignity, and life.