Latest / Deep Dive Ortho — Orthopaedic Surgery, AI & Digital Health Podcast. / Good Medical Practice 2024: A Professional Guide

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Good Medical Practice 2024: A Professional Guide · Deep Dive Ortho — Orthopaedic Surgery, AI & Digital Health Podcast.

• 0:00
  You know, what is it that really holds professional
• 0:02
  excellence together, especially when the pressure's
• 0:04
  on? Is it just about having the technical skills,
• 0:06
  or is there something, well, something deeper,
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  something about behavior, about how we interact?
• 0:12
  Today, we're diving into the standard set for
• 0:14
  UK medical professionals, but I think we're gonna
• 0:16
  find some really relevant lessons for your professional
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  life, too, whatever you do. Welcome to the Deep
• 0:22
  Dive. We try to cut through the noise and get
• 0:24
  to the heart of important ideas and documents.
• 0:26
  I'm your host. And today, our focus is a really
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  significant piece of guidance. It underpins one
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  of the most trusted professions out there. It's
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  the GMC's good medical practice, the 2024 version.
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  It defines what being a good doctor, physician
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  associate, or anesthesia associate means in the
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  UK. But honestly, it's principles. They echo
• 0:46
  much, much wider. And to guide us through this
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  and help us see those wider connections, we have
• 0:51
  a brilliant expert with us. Joining us is Professor
• 0:53
  Mo Imam. He's known for, well... for making sense
• 0:56
  of complex standards like these and showing what
• 0:58
  they mean for leadership, for culture, for ethical
• 1:01
  practice, basically everywhere. He brings a really
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  unique perspective on how these kinds of standards
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  build trust and help create high performing teams
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  and environments. So let's jump straight in.
• 1:11
  At its core, what actually is this good medical
• 1:14
  practice guidance? When people hear standards,
• 1:16
  they often think, you know, rules, a big list
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  of do's and don'ts. Is that what we're talking
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  about? That's a great place to start. And it's
• 1:22
  key to get this clear from the off. The guidance
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  itself is actually very upfront about this. It's
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  framed not as a rigid checklist, definitely not
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  a rule book covering every single possibility.
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  Instead, it's presented as an ethical framework.
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  Think of it more like the core principles, the
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  values, the sort of overarching standards of
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  professional behavior expected from everyone
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  registered with GMAC. So that's doctors, of course,
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  but also physician associates, PAs, and anesthesia
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  associates, AAs, who are now under the GMC too.
• 1:52
  All right. So it's broader now. Yes. And it's
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  described as a shared agreement. It was developed
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  with professionals, lots of different specialists,
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  but also, really importantly, with patients and
• 2:01
  the public. So it defines good practice from
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  multiple angles. What it doesn't really get into
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  is the specific clinical knowledge, you know,
• 2:09
  the technical skills you need for procedures.
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  That's covered elsewhere in training curricula
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  and educational standards. Oh, I see. So the
• 2:16
  focus here is very much on how you behave as
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  a professional, how you interact with people,
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  colleagues, patients, how you build and maintain
• 2:24
  trust, not the what of the technical tasks. So
• 2:27
  it's the how, not the what. A framework for behavior.
• 2:30
  Okay. This version came into effect early 2024,
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  updated again December 2024. If it's a framework,
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  not rules, how are doctors and other professionals
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  meant to actually use it day -to -day in busy
• 2:43
  clinics, high -pressure situations? Well, they
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  absolutely must be familiar with it. That's a
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  fundamental requirement right there in the introduction.
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  No getting around that, though. No. And it applies
• 2:53
  wherever they work. whatever their role or specialty.
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  But as we said, it's not meant to be used like
• 2:58
  a robot following instructions. The document
• 3:01
  explicitly says professionals must use their
• 3:03
  professional judgment to apply these standards
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  to the specific situation they're facing. OK,
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  so context matters. Hugely. It means using your
• 3:12
  knowledge, your skills, your professional experience
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  to interpret the principles and follow them in
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  a way that Well, that best serves the patient
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  and upholds the standards in that particular
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  context. The language is quite careful, too.
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  You'll see, you must and you should. What's the
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  difference there? You must points to a duty or
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  standard that's pretty much required legally
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  or ethically. You need a very strong reason not
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  to follow it. You should indicate something that's
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  generally expected. good practice, but where,
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  you know, maybe it's not always possible or relevant
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  in every single case. Right. So it needs thought.
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  Yes. Thoughtful, informed application. Yeah.
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  Not just sort of blind compliance. It's about
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  engaging with the principles and making considered
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  choices. And why is it so important that these
• 3:57
  standards keep changing, updated regularly? Surely
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  things like honesty, respect, they don't change.
• 4:02
  The core values, you're right, are pretty timeless.
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  Honesty, respect, kindness, absolutely. But the
• 4:09
  world in which medicine or any profession operates
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  That changes constantly. Technology, society.
• 4:14
  Exactly. The introduction to Domain 1, that's
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  the section on knowledge and skills, makes this
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  point very clearly. It talks about medical practice
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  being a lifelong journey. It stresses the need
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  for professionals to keep up with, and I quote,
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  rapidly changing social, legal, and technological
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  developments. Like AI, data privacy, all that.
• 4:34
  Precisely. Think about digital health records,
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  remote consultations becoming normal, new laws
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  on data protection, changing public expectations
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  around equality, diversity. The list goes on.
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  If the standards just stood still, they'd quickly
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  become irrelevant. Or worse, they wouldn't offer
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  proper guidance on these new challenges. So the
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  updates keep it relevant. Exactly. They ensure
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  the framework still works, so it protects patients
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  and the public interest, and reflects how things
• 5:00
  are actually done now. It's like continuous improvement
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  for the rules. mirroring the continuous development
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  expected of the professionals themselves. That
• 5:07
  makes complete sense. The framework has to evolve
• 5:10
  with the practice. Okay, let's really get into
• 5:13
  this guidance then. You mentioned it has four
• 5:15
  domains. Domain one is knowledge, skills, and
• 5:18
  development. It starts with this really basic
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  idea. Professionals must be competent in everything
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  they do, leadership, teaching included, and crucially
• 5:27
  they must work within their limits. Now, for
• 5:31
  our listeners, maybe managing teams or projects
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  outside medicine, how does that idea of competence
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  and limits translate? What can they take from
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  that? Oh, this idea is absolutely universal.
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  Competence isn't just for doctors. It's vital
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  in any field where people rely on your expertise
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  and trust you. Paragraph one in domain one really
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  lays this out as the foundation. For a medical
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  professional, yes, it's clinical skills, but
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  also competence if they're supervising or researching
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  or in management. OK. But the thing that resonates
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  everywhere is the second part. knowing and working
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  within your limits. Paragraph two, hammers this
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  home only practice under appropriate supervision
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  for your level. So how does that look in, say,
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  finance or tech? Well, think of a senior manager
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  in tech. Competence isn't just knowing the code.
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  It's managing diverse teams, understanding the
• 6:17
  market, handling budgets. Right. Working within
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  limits means knowing when a technical issue needs
• 6:23
  the specialist engineer on their team or when
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  a contractual problem needs the legal department.
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  Or maybe they aren't equipped to handle a specific
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  team conflict and need HR's help or advice from
• 6:35
  their own boss. So it's okay not to know everything.
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  It's essential to know you don't know everything.
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  It's about self -awareness. Knowing what's outside
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  your deep expertise and having the integrity
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  to say I need help here or this should go to
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  someone else or even I can't take this on because
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  I can't do it properly. Like a doctor referring
• 6:52
  to a specialist. Exactly the same principle.
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  It protects the quality of the work, prevents
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  mistakes, avoids harm, whether that harm is a
• 7:00
  medical error, a project failure, a budget overspent,
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  whatever. It's about responsibility. That's a
• 7:05
  really helpful way to frame it. Not weakness,
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  but responsibility. And obviously for doctors,
• 7:10
  providing good clinical care is central. What
• 7:14
  does the guidance say defines that standard?
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  And can we pull anything from that for other
• 7:18
  service professions? Yes. Providing a good standard
• 7:22
  of practice and care, as paragraph 6 puts it,
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  is core for patient -facing roles. And straight
• 7:28
  away, it talks about working in partnership with
• 7:31
  the patient. Not just telling them. No. It's
• 7:34
  collaborative, starting with really understanding
• 7:36
  their needs, their priorities, what matters to
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  them. Then any investigations or treatments have
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  to be based on that assessment and on sound clinical
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  judgment about what's likely to work. If we look
• 7:46
  at the specifics in paragraph seven, we can see
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  the parallels. Okay. Adequate assessment includes
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  their history, psychosocial factors, their views.
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  For a consultant, say, That's like really digging
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  into a client's background, the company culture,
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  the psychosocial stuff, and properly listening
• 8:01
  to what the client actually wants and needs beyond
• 8:03
  just the technical brief. Understanding the whole
• 8:05
  picture. Exactly. Then using best available evidence.
• 8:10
  That's universal, surely. Whether it's medicine
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  or marketing strategy, your advice should be
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  based on current solid data and research, not
• 8:17
  just gut feeling or what you did five years ago.
• 8:19
  Makes sense. Consulting colleagues or referring.
• 8:23
  That's collaboration. Knowing when to ask a peer,
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  how would you handle this tricky client? Or bringing
• 8:29
  in a specialist consultant. Even prompt advice
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  or treatment translates to being responsive,
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  delivering solutions on time in any service role.
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  The core ideas are the same. Understand the need
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  fully, use the best info, work with others when
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  necessary, and act effectively. That's a powerful
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  comparison. Patient care principles applied to
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  client service or a stakeholder engagement. It's
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  all about partnership and evidence. The guidance
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  also mentions remote consultations so relevant
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  now. What's the standard there? Yes, this was
• 8:58
  a key update given how much things shifted recently.
• 9:01
  Paragraph 9 is very direct. The basic need to
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  provide safe and effective care is exactly the
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  same whether you're face -to -face or remote.
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  So video calls, phone calls, the standard doesn't
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  drop? No. The method of communication shouldn't
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  compromise the quality or safety of the care.
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  And importantly, there's a safety net built in.
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  If, for whatever reason, safe and effective care
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  can't be delivered remotely in a specific case,
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  the professional should offer a different way,
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  maybe an in -person appointment or make sure
• 9:29
  the patient knows where else they can get safe
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  care. How does that apply outside medicine, remote
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  teams, virtual meetings? Directly, I think. If
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  you're leading a remote team, the quality of
• 9:40
  your communication, your support, it shouldn't
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  dip just because you're not physically there.
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  If you have a really complex negotiation or a
• 9:47
  sensitive feedback session and you feel a phone
• 9:50
  call just won't cut it, you need the nuance,
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  the body language, then the professional standard
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  suggests you should push for video or maybe even
• 9:57
  try to meet in person if it's practical and warranted.
• 10:00
  So choosing the right tool for the job. Exactly.
• 10:02
  If email is causing confusion with a client,
• 10:05
  pick up the phone or jump on a video call. Ensure
• 10:07
  the communication channel actually supports the
• 10:09
  quality and safety needed, whether that's patient
• 10:11
  safety or project safety, relationship safety,
• 10:15
  the principle holds. That's very practical for
• 10:17
  today's working world. Domain 1 also talks about
• 10:19
  maintaining and improving performance. Reflection
• 10:22
  using feedback. This feels key for professionals
• 10:25
  wanting to grow maybe mid -career. Oh definitely.
• 10:29
  This part from paragraph 11 onwards shifts from
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  basic competence to that lifelong journey of
• 10:34
  getting better. Keeping skills up to date, obviously.
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  But paragraph 15 says you must actively monitor,
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  maintain, develop, and improve your performance
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  and work quality. That means things like quality
• 10:44
  assurance, regular training, CPD. Standard stuff
• 10:48
  for many professions. Yes. But the bit that really
• 10:51
  stands out and I think has huge relevance everywhere
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  is the focus on reflection. Paragraph 13 day.
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  You have to reflect on your practice, your interactions,
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  use feedback. But crucially, it's not just reflecting
• 11:02
  on technical mistakes. It explicitly says you
• 11:05
  need to consider how your life experience, culture,
• 11:07
  and beliefs influence your interactions and may
• 11:09
  impact on the decisions they make. Wow. OK, unpack
• 11:11
  that a bit. Think about a manager leading a very
• 11:14
  diverse team or a consultant working with clients
• 11:17
  from different cultural backgrounds. This kind
• 11:19
  of reflection means consciously thinking. OK.
• 11:23
  How might my own background, my own assumptions,
• 11:25
  my own biases be affecting how I see this team
• 11:28
  member's work or how I'm communicating or how
• 11:32
  I'm interpreting that client's feedback? So questioning
• 11:34
  your own perspective. Exactly. Am I making assumptions
• 11:36
  based on my own cultural norms? Is my usual communication
• 11:39
  style landing badly here? It pushes you beyond
• 11:43
  just, what did I do? To, how did my own stuff
• 11:46
  shape my approach and perception and what effect
• 11:49
  did that have? That's a deep level of self -awareness.
• 11:51
  It is. And it's critical for good leadership,
• 11:54
  for inclusive teams, for navigating complex professional
• 11:57
  relationships anywhere. That link between the
• 11:59
  personal and the professional is fascinating
• 12:01
  and maybe not talked about enough. Okay, let's
• 12:03
  move to domain two. Patience, partnership, and
• 12:06
  communication. The introduction here talks about
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  the lasting impact a professional's approach
• 12:10
  can have. What are the core principles here for
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  interacting with people, patients, clients, customers,
• 12:16
  whoever, that we can all learn from? Domain 2
• 12:18
  really gets to the heart of building trust in
• 12:21
  those one -to -one interactions. It starts with
• 12:23
  the basics, dignity and privacy. Respecting those
• 12:26
  is fundamental. Non -negotiable. Absolutely.
• 12:29
  Then fairness. Paragraph 19 says you must treat
• 12:32
  patients fairly. And interestingly, it adds,
• 12:35
  regardless of your personal views about them,
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  or even if you think their own actions led to
• 12:39
  their health issues. That's a high bar. It is.
• 12:42
  And prioritization has to be based on clinical
• 12:44
  need, not favoritism or anything else. Confidentiality,
• 12:47
  of course, is a must, though there are clear
• 12:49
  rules about when disclosure is lawful. How does
• 12:52
  that translate outside medicine? Well, treating
• 12:54
  clients or colleagues fairly, without letting
• 12:56
  your personal feelings or past run -ins cloud
• 12:59
  your judgment, that's basic professional integrity,
• 13:01
  isn't it? Prioritizing tasks based on genuine
• 13:04
  need or strategy, not who shouted loudest or
• 13:07
  who you like best. That's effective management.
• 13:10
  And confidentiality, client data, HR info, strategy
• 13:13
  secrets that applies everywhere. Even the bit
• 13:16
  about conscientious objection, making sure a
• 13:18
  patient isn't disadvantaged if you opt out, translates.
• 13:21
  If you can't ethically do a task, fine, but don't
• 13:24
  block the organization or client finding someone
• 13:26
  who can. Kindness, courtesy, and respect get
• 13:29
  a specific mention too. Is that just about being
• 13:31
  polite? It's much deeper than just superficial
• 13:33
  manners. It actually defines what respectful
• 13:35
  communication looks like in practice. The guidance
• 13:38
  is clear. It doesn't mean you always have to
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  agree or that you can't deliver bad news. It's
• 13:44
  about how you do it. Paragraph 23 lists things
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  like communicating sensitively, especially with
• 13:49
  difficult news, actively listening to people,
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  valuing their insights for patients, their knowledge
• 13:55
  of their own health, not making assumptions about
• 13:57
  what they want or what matters to them, explaining
• 14:00
  your reasoning. recognizing vulnerability, being
• 14:04
  alert to distress. That sounds like a blueprint
• 14:06
  for good communication anywhere. It really is.
• 14:09
  Think about stakeholder communication. Are you
• 14:11
  just broadcasting your message or are you truly
• 14:14
  listening to their concerns? Are you tailoring
• 14:16
  your approach? Are you asking clients or team
• 14:19
  members about their priorities instead of assuming?
• 14:21
  It's about showing genuine consideration, building
• 14:23
  rapport, building trust. That works in any professional
• 14:26
  setting. Supporting people to make decisions
• 14:28
  is another big theme. What's the responsibility
• 14:31
  there around autonomy, consent? This is huge.
• 14:35
  Every patient has the right to be involved in
• 14:37
  decisions about their care and to get support
• 14:39
  to do that. The starting point, legally and ethically,
• 14:43
  is you must assume adults have the capacity to
• 14:45
  make their own decisions unless there's clear
• 14:47
  evidence they don't. Presumption of capacity.
• 14:50
  Exactly. And consent isn't just a form -filling
• 14:53
  exercise. It's mandatory before you examine or
• 14:55
  treat someone. Professionals need to know the
• 14:58
  relevant laws around capacity too. And outside
• 15:00
  medicine. It translates to respecting the autonomy
• 15:03
  of your clients, your colleagues, your team members.
• 15:06
  Before you make a big change or launch a new
• 15:08
  project direction or even delegate something
• 15:10
  really complex, you need informed agreement.
• 15:13
  You need to be sure the person understands what
• 15:15
  they're agreeing to do. They have the info. Is
• 15:17
  it clear? And that they're agreeing freely. It's
• 15:21
  about involving people in decisions that affect
• 15:24
  them. Shared decision making. And effective information
• 15:27
  sharing seems absolutely critical for that. The
• 15:30
  guidance looks quite specific here. It is, because
• 15:33
  good information is the bedrock of partnership
• 15:36
  and good decisions. Caragraph 28 is key. You
• 15:39
  must give patients the information they want
• 15:41
  or need. Crucially, in a way they can understand.
• 15:44
  Not just medical jargon. Definitely not. It means
• 15:46
  explaining the condition, the outlook, any uncertainties.
• 15:50
  Outlining all the realistic options, including
• 15:52
  doing nothing. And for each option, spelling
• 15:55
  out the potential benefits, the risks, the uncertainties,
• 15:58
  how likely it is to succeed. That's quite comprehensive.
• 16:02
  It is. But it doesn't stop there. You then have
• 16:04
  to listen to their response, encourage questions,
• 16:06
  answer honestly. The information itself must
• 16:09
  be clear, accurate, up to date, based on the
• 16:12
  best available evidence. And you should check
• 16:14
  their understanding. Make sure they've had time,
• 16:16
  support. Checking understanding feels key. It's
• 16:19
  vital. And paragraphs 32 and 33 add, you must
• 16:22
  take steps to meet language or communication
• 16:24
  needs, make adjustments for impairments or disabilities,
• 16:28
  and treat everyone as an individual. Don't rely
• 16:30
  on assumptions. Wow. That level of detail on
• 16:33
  communication. It's almost a mini masterclass.
• 16:37
  It really is. It shows that effective communication
• 16:39
  isn't just talking at people. It's a two -way
• 16:41
  street. Focus on making sure the other person
• 16:43
  truly gets it and feels empowered. Think about
• 16:46
  explaining a complex project update or a change
• 16:49
  in strategy to your team. Are you just dumping
• 16:52
  information? Or are you explaining the why, the
• 16:56
  pros and cons, the what ifs? Are you checking
• 16:58
  they understand? Are you adapting for different
• 17:00
  people in the room? That rigor, that focus on
• 17:03
  understanding and adapting is applicable everywhere.
• 17:06
  Explaining tech issues to non -tech clients,
• 17:08
  discussing performance with someone from a different
• 17:10
  cultural background, it's fundamental. That really
• 17:13
  hits home. Adapting, checking, avoiding assumptions,
• 17:16
  moving communication from just a task to a core
• 17:19
  relationship skill. Okay. The guidance also covers
• 17:23
  being open when things go wrong. The duty of
• 17:25
  candor. Yes, paragraph 45 is very direct about
• 17:28
  this. You must be open and honest if things go
• 17:30
  wrong and a patient suffers harm or distress.
• 17:33
  It's a professional duty. What does that involve?
• 17:35
  Several things. Trying to put things right, if
• 17:37
  possible. Offering an apology, clarifying this,
• 17:40
  is about expressing sorrow, not necessarily admitting
• 17:42
  legal fault, giving a full prompt explanation
• 17:44
  of what happened and the likely effects. And
• 17:47
  crucially, reporting the incident internally
• 17:49
  through the proper channels. Why is reporting
• 17:52
  so important? It's not about blame. It's so the
• 17:55
  incident can be looked into, lessons can be learned,
• 17:58
  and systems can be improved to stop it happening
• 18:00
  again to someone else. It's about systemic safety.
• 18:03
  How does that apply outside medicine? A project
• 18:05
  goes wrong, maybe? Exactly. Imagine a big mistake
• 18:08
  happens, delays, costs blow out, client is unhappy.
• 18:13
  The candor principle means you have to be honest.
• 18:15
  explain what went wrong, what the impact is,
• 18:18
  what you're doing to fix it or mitigate the damage.
• 18:21
  An apology for the negative outcome is usually
• 18:23
  appropriate and helps maintain trust, separate
• 18:25
  from legal stuff. And critically, report it internally,
• 18:29
  not to point fingers, but so the organization
• 18:31
  can understand the root cause, learn, and maybe
• 18:34
  change processes to prevent it happening again.
• 18:36
  Transparency and learning from mistakes vital
• 18:39
  for trust and resilience, whether it's patient
• 18:41
  safety or project delivery. OK, this is where
• 18:43
  it gets really interesting for workplace dynamics.
• 18:45
  Moving beyond the patient or client, domain three
• 18:48
  is colleagues, culture, and safety, and domain
• 18:51
  four is trust and professionalism. How do our
• 18:54
  interactions inside the workplace with colleagues,
• 18:57
  managers, fit into good practice? Domain 3 is
• 18:59
  crucial because it acknowledges that you don't
• 19:02
  practice in isolation. You're part of a team,
• 19:05
  an organization, a culture. And that environment
• 19:07
  massively affects your ability to do good work.
• 19:11
  It starts with a basic right. Everyone deserves
• 19:13
  to work and train in a fair place, free from
• 19:16
  discrimination. Then paragraph 48 sets the tone
• 19:18
  for how you treat people day to day. You must
• 19:21
  treat colleagues with kindness, courtesy, and
• 19:23
  respect. That's a must, not a nice to have. Absolutely,
• 19:26
  a professional duty. Then it talks about effective
• 19:29
  teamwork listening, communicating clearly and
• 19:30
  politely, respecting other skills, collaborating
• 19:33
  properly. There's also a point about being compassionate
• 19:35
  towards colleagues having a tough time while
• 19:37
  never letting patient safety slip. So these are
• 19:40
  directly applicable to any team environment?
• 19:42
  Completely. You can't build a high -performing
• 19:45
  team without respect, clear communication, valuing
• 19:48
  different contributions, whether it's coding
• 19:49
  skills, project management, creative thinking.
• 19:52
  And showing a bit of humanity when a colleague
• 19:54
  is struggling helps build a supportive culture,
• 19:57
  which boosts performance and well -being. This
• 19:59
  domain makes it clear. How you treat your colleagues
• 20:02
  is part of your professional practice. The guidance
• 20:05
  also mentions contributing to a positive environment
• 20:08
  role modeling, being aware of bias. That sounds
• 20:11
  quite proactive in shaping the culture. It is.
• 20:13
  It goes beyond just your own behavior to your
• 20:16
  impact on the collective. Paragraph 52 says you
• 20:19
  must help create a culture that's respectful,
• 20:22
  fair, supportive, compassionate. And how? By
• 20:25
  role modeling those behaviors yourself. Leading
• 20:27
  by example. Precisely. Your actions set the tone.
• 20:30
  Paragraph 53 encourages awareness of how your
• 20:33
  behavior affects others, your mood, how you react.
• 20:36
  It all feeds the environment. The paragraph 54
• 20:38
  brings in bias. Again, be aware of the risk of
• 20:41
  bias. Think about how your own background might
• 20:44
  unconsciously color your interactions with colleagues
• 20:46
  or decisions about them. Like in performance
• 20:48
  reviews or assigning tasks. Exactly. It builds
• 20:51
  on that personal reflection we talked about earlier,
• 20:53
  but applies it specifically to team dynamics.
• 20:56
  Show respect for others' experiences, cultures,
• 20:59
  beliefs. For managers, this means actively checking
• 21:02
  assumptions, ensuring fairness, fostering an
• 21:04
  inclusive atmosphere where different views are
• 21:06
  welcome. Role modeling is probably the most powerful
• 21:09
  leadership tool there is for culture change.
• 21:11
  And it draws some very clear lines on unacceptable
• 21:14
  behavior. Yes, extremely clear. Paragraph 56
• 21:16
  is an absolute ban. You must not abuse, discriminate
• 21:20
  against, bully, or harass anyone. It lists the
• 21:23
  standard protected characteristics age, disability,
• 21:26
  race, religion, sex, and so on. But also adds
• 21:30
  things like appearance, lifestyle, status. It's
• 21:33
  comprehensive. It covers a lot. It does. And
• 21:35
  paragraph 57 deals specifically with sexual misconduct
• 21:38
  towards colleagues. You must not act in a sexual
• 21:41
  way towards them if it causes offense or distress.
• 21:44
  It defines sexual way. Broadly, comments, images,
• 21:47
  messages, unwanted touching. So these aren't
• 21:49
  just HR policies. They're breaches of professional
• 21:52
  standards. That's exactly right. They undermine
• 21:55
  a safe and respectful environment and are defined
• 21:57
  as professional failings by the GMC. And what
• 22:00
  if you see this kind of behavior happening? What's
• 22:02
  expected then? There's a professional duty to
• 22:06
  act. Paragraph 58 acknowledges it can be hard,
• 22:09
  but says you need to do something. That might
• 22:12
  mean checking in with the person targeted, offering
• 22:14
  support, maybe challenging the behavior directly
• 22:17
  if it feels safe, or reporting it through official
• 22:20
  channels workplace policy, GMC guidance. So,
• 22:24
  not turning a blind eye? No. The guidance says
• 22:26
  everyone has a responsibility to help prevent
• 22:29
  these behaviors poisoning the environment. And
• 22:32
  if you're in a leadership or management role...
• 22:34
  Paragraph 59 makes it even stronger. You must
• 22:36
  act if you see or hear about unacceptable behavior.
• 22:40
  Must act. Yes. Ensure it's addressed promptly.
• 22:43
  Make sure people are supported, escalated if
• 22:45
  necessary. It's a critical point for anyone managing
• 22:48
  people you are professionally required not just
• 22:50
  to avoid bad behavior yourself, but to actively
• 22:52
  tackle it when it happens on your watch. Yeah.
• 22:55
  It's about enabling a culture where people feel
• 22:57
  safe to speak up. That duty to speak up. the
• 23:00
  clarity on unacceptable behavior, and the requirement
• 23:03
  for leaders to act. That feels incredibly relevant
• 23:06
  for creating healthy, safe, productive workplaces
• 23:09
  anywhere. It's about shared responsibility. Domain
• 23:13
  3 also touches on continuity of care, delegation,
• 23:17
  practical things. Yes, continuity is important,
• 23:19
  especially for vulnerable people. The principles
• 23:22
  translate well to project handovers or transferring
• 23:25
  client accounts. It's about sharing relevant
• 23:27
  information promptly with everyone involved,
• 23:30
  keeping the patient or client updated on who's
• 23:32
  responsible now, making sure all the necessary
• 23:34
  info is passed on before the handover, and checking
• 23:37
  someone has definitely taken over. Basically,
• 23:40
  don't let things drop between the cracks. The
• 23:44
  key there is competence and safety. If you delegate,
• 23:46
  you must be confident the person has the skills
• 23:48
  and training needed and you must give clear instructions.
• 23:51
  On the flip side, if a task is delegated to you
• 23:54
  and you don't think you can do it safely or competently,
• 23:56
  you must prioritize safety or the project's integrity
• 23:59
  and ask for help or say you can't do it. It's
• 24:01
  a shared responsibility for getting work done
• 24:03
  properly. Okay, let's move to the final domain.
• 24:06
  Domain four, trust and professionalism. This
• 24:10
  feels like it pulls everything together. The
• 24:11
  foundation of public trust. What are the key
• 24:14
  ideas here? Domain four is all about justifying
• 24:16
  the trust placed in professionals. Paragraph
• 24:19
  81 puts it plainly. Your conduct, professional
• 24:22
  and sometimes personal, must merit that trust.
• 24:26
  It starts with basic honesty. Being honest about
• 24:28
  your experience, your qualifications, your role,
• 24:31
  providing your GMC details if asked. This honesty
• 24:34
  has to extend to money matters, commercial dealings,
• 24:36
  and research too. How does that apply more broadly?
• 24:39
  It's about integrity and everything. Is your
• 24:41
  CV accurate? Are you upfront about your capabilities
• 24:44
  in meetings? Is your reporting, financial, project
• 24:47
  status, whatever, truthful? It's not just avoiding
• 24:49
  lies. It's being actively truthful in how you
• 24:52
  present yourself and your work. Professional
• 24:54
  boundaries are mentioned here too, and they sound
• 24:56
  quite strict. They are. particularly in medicine
• 24:58
  for obvious reasons. Paragraph 86 is an absolute
• 25:01
  ban on sexual behavior towards patients or using
• 25:04
  the professional role to start an improper relationship
• 25:07
  with a patient or someone close to them. That's
• 25:08
  non -negotiable. And personal beliefs. Paragraph
• 25:11
  87 is interesting. It says you must not express
• 25:13
  your personal beliefs, political, religious,
• 25:16
  moral to patients, in ways that exploit their
• 25:18
  vulnerability or might reasonably cause them
• 25:21
  distress. So it's about the impact on the patient.
• 25:24
  Exactly. It's protecting that professional relationship.
• 25:26
  Outside medicine, this translates to maintaining
• 25:30
  appropriate boundaries with clients or direct
• 25:32
  reports, not exploiting power imbalances for
• 25:35
  personal gain or inappropriate relationships,
• 25:38
  and also being mindful of how you voice strongly
• 25:41
  held personal views at work, especially if you're
• 25:44
  senior or the other person is vulnerable in some
• 25:46
  way, like a junior team member. It's about ensuring
• 25:49
  your personal expressions don't coerce, exploit
• 25:52
  or cause undue distress within a professional
• 25:54
  context. And what about communication more broadly?
• 25:57
  Publicly, social media, that's a minefield for
• 25:59
  many professionals now. The guidance tackles
• 26:02
  this head on. All professional communication
• 26:04
  written, spoken, online, must be honest, trustworthy,
• 26:08
  and maintain confidentiality where required.
• 26:11
  Paragraph 89 insists on accuracy. Information
• 26:14
  mustn't be false or misleading. That means checking
• 26:17
  facts, not leaving out important bits, not downplaying
• 26:20
  risks, and distinguishing opinion from fact.
• 26:23
  And when communicating publicly. Like on LinkedIn.
• 26:26
  Same standards apply, plus a few extras, according
• 26:28
  to paragraph 90. You must declare conflicts of
• 26:31
  interest. You must not exploit people's vulnerability
• 26:33
  or lack of knowledge. And what you say should
• 26:36
  align with promoting public health. from medical
• 26:38
  professionals. There's also specific guidance
• 26:40
  referenced for social media use. The key takeaway
• 26:43
  for anyone with a professional online footprint
• 26:45
  is your tweets, your posts, your comments. They
• 26:48
  should all meet the same standards of honesty,
• 26:50
  accuracy, and integrity as your work communications.
• 26:53
  Be transparent. Don't make misleading claims.
• 26:56
  And remember, your online persona reflects on
• 26:58
  you professionally and maybe your employer, too.
• 27:00
  Conflicts of interest also get explicit attention,
• 27:03
  a common challenge. Absolutely. Paragraph 94
• 27:06
  is very clear. You must not let any interests,
• 27:09
  financial, personal, whatever, affect or even
• 27:11
  look like they might affect your professional
• 27:13
  decisions, especially about patient care or referrals.
• 27:17
  What if a conflict exists? Then transparency
• 27:19
  is key. Paragraph 95 says you must be open about
• 27:22
  it with those affected patients, employers. Declare
• 27:24
  it formally and be ready to step aside from the
• 27:27
  decision if needed to ensure objectivity. Paragraph
• 27:30
  96 also prohibits accepting or offering incentives
• 27:33
  that could sway decisions. This is directly relevant
• 27:36
  in procurement, sales, consulting, anywhere you're
• 27:38
  making recommendations or allocating resources.
• 27:41
  Declare, be transparent, recuse if necessary.
• 27:43
  That's how you maintain trust. And finally, cooperating
• 27:46
  with legal and regulatory requirements, the accountability
• 27:49
  piece. Yes, this closes the loop. Paragraph 98,
• 27:53
  you must cooperate fully and honestly with inquiries,
• 27:57
  investigations, complaints, procedures. Paragraph
• 28:00
  99 lists serious things you must tell the GMC
• 28:03
  about straight away criminal cautions or convictions,
• 28:07
  major criticisms from official inquiries, findings
• 28:09
  by other professional bodies even if they happened
• 28:11
  abroad. You also have to tell employers and patients
• 28:14
  if your right to practice is restricted. And
• 28:18
  importantly, you must have adequate professional
• 28:20
  insurance or indemnity cover. So cooperating,
• 28:23
  reporting, being insured, basic professional
• 28:25
  accountability. Exactly. It underpins the whole
• 28:28
  system of trust and regulation. In any senior
• 28:30
  or regulated role, these aspects are non -negotiable.
• 28:34
  Okay, drawing all this together now from the
• 28:36
  good medical practice guidance, what's one thing
• 28:38
  you think professionals outside medicine might
• 28:40
  find most surprising or maybe overlook in their
• 28:42
  own fields but could learn from? That's a good
• 28:44
  question. Perhaps the sheer depth and the mandatory
• 28:47
  nature of contributing to systemic safety and
• 28:50
  learning. not just focusing on your own performance.
• 28:53
  You mean reporting errors and concerns? Yes,
• 28:55
  we touch on candor, but Domain 3 really expands
• 28:57
  on this. Professionals are required to actively
• 29:00
  help improve service quality and safety. That
• 29:03
  means taking part in audits, reviews, but also,
• 29:07
  crucially, raising concerns. Concerns about resources
• 29:10
  being inadequate, systems being flawed, or even
• 29:13
  about colleagues whose conduct or performance
• 29:15
  might be risky. That feels like a big step beyond
• 29:18
  just doing your job. It is. It's about helping
• 29:20
  make the whole system safer and better. In many
• 29:23
  other fields, raising concerns like that can
• 29:26
  feel optional, or even career limiting. This
• 29:29
  guidance frames it as a core professional duty.
• 29:32
  Oh, and maybe the inclusion of environmental
• 29:34
  sustainability as a professional responsibility
• 29:36
  might surprise some, too. That's quite forward
• 29:38
  -thinking for a standards document. That proactive
• 29:40
  duty for systemic improvement is a powerful idea.
• 29:43
  Okay, imagine someone listening now, maybe a
• 29:45
  manager, a leader, struggling with team dynamics
• 29:48
  or culture in their non -medical organization.
• 29:51
  If they could take just one principle from this
• 29:53
  guidance and apply it today, what would you suggest?
• 29:56
  I put them straight back to domain three colleagues
• 29:58
  in culture, specifically paragraph 52, the idea
• 30:02
  that you help create a respectful, fair, supportive,
• 30:06
  compassionate culture by role modeling those
• 30:08
  behaviors yourself. No off the top. Exactly.
• 30:11
  And for anyone in charge, the absolute duty in
• 30:14
  paragraph 59 to act when they see or hear about
• 30:17
  unacceptable behavior, bullying, harassment,
• 30:19
  discrimination, don't ignore it, address it.
• 30:22
  Culture flows from behavior, especially leaders'
• 30:25
  behavior and what they tolerate. Role modeling
• 30:27
  respect and tackling misconduct head on are probably
• 30:30
  the most impactful things any leader can do,
• 30:33
  starting right now. Any final quick win? An immediate
• 30:36
  action someone could take away from this guidance
• 30:38
  to improve their professional life straight away.
• 30:40
  maybe collaboration, relationships. I'd say revisit
• 30:43
  the communication points in domain two, especially
• 30:45
  paragraphs 31 to 34. Make a real effort in your
• 30:49
  very next important conversation with a colleague,
• 30:51
  a client, whoever, to consciously check for understanding.
• 30:54
  Ask open questions. How does that sound to you?
• 30:57
  What are your thoughts on that approach? Does
• 30:59
  that make sense? Watch their body language and
• 31:02
  pause to think, do I need to adjust my language
• 31:06
  here? Who am I talking to? What assumptions might
• 31:08
  I be making about what they already know or what
• 31:11
  they care about? Challenge those assumptions.
• 31:13
  Yes, just improving the clarity and responsiveness
• 31:16
  of your communication. Making sure it genuinely
• 31:18
  connects can make a massive difference to collaboration,
• 31:21
  trust, and just getting things done more smoothly.
• 31:25
  You could literally practice that in your next
• 31:26
  meeting. Okay, let's try and pull together some
• 31:28
  key takeaways from this deep dive into the GMC's
• 31:31
  good medical practice, thinking about how they
• 31:34
  apply much more widely. One, professional standards
• 31:37
  aren't rigid rules. They're living ethical frameworks
• 31:39
  that need judgment and adapting to the situation,
• 31:42
  always putting safety and integrity first. Two,
• 31:46
  communication is king. It's about partnership,
• 31:49
  clarity, actively listening, really checking
• 31:51
  for understanding, and tailoring your approach
• 31:54
  to the individual. Three, Workplace culture isn't
• 31:57
  someone else's job. It's a shared responsibility.
• 32:00
  Everyone needs to foster respect and fairness,
• 32:03
  and crucially, speak up about misconduct. Leaders
• 32:05
  have a particular duty here to act. Four, honesty,
• 32:09
  integrity, managing conflicts of interest transparently
• 32:11
  and maintaining clear boundaries. These are the
• 32:14
  absolute bedrock for building and keeping trust
• 32:16
  with everyone you deal with. And five, it's not
• 32:18
  just about doing your tasks. True professionalism
• 32:21
  involves continuous learning, reflecting critically
• 32:23
  on yourself, including your biases, and actively
• 32:25
  contributing to making the whole system safer
• 32:27
  and better. Professor Imam, thank you so much
• 32:29
  for walking us through this. It's been fascinating
• 32:31
  to see how these principles designed for medicine
• 32:34
  offer such valuable lessons for building trust
• 32:36
  and excellence. It's been my pleasure. It really
• 32:39
  is a rich document. And those core ideas about
• 32:42
  professionalism and trust are, I think, truly
• 32:45
  universal. You can find the full GMC Good Medical
• 32:48
  Practice 2024 guidance on their website. That's
• 32:51
  gmc -uk .org. And if this deep dive has sparked
• 32:55
  some ideas for you, perhaps something useful
• 32:56
  for your colleagues or network, maybe consider
• 32:58
  leaving us a quick rating wherever you listen.
• 33:01
  It genuinely helps others find these conversations.
• 33:03
  Join us next time on the deep dive for another
• 33:06
  exploration into the sources shaping our world.
• 33:09
  And a final thought to leave you with. How might
• 33:11
  applying these principles trust through communication,
• 33:14
  shaping culture by example, improving the system
• 33:16
  around you? How might that transform your interactions
• 33:19
  and your impact in your own professional field?