*Article originally published in July 2020
Since late March 2020, at various times, in various places and for various patients, in-person medical consultations, tests and treatments have been. Every time restrictions are eased, healthcare professionals need to give thought to whether and how in-person patient interactions can recommence in private practice? Unfortunately, it is not straightforward.
A key consideration will be your location. Keep abreast of local and national news of formal announcements, as there are different rules in England, Wales, Scotland and Northern Ireland. Other considerations will likely include your area of medicine, the extent to which the appointment is medically necessary, whether the NHS still requires resources such as private surgical theatres, and any restrictions imposed by your particular private hospital or clinic. To add to the confusion, numerous journalists and other commentators have been adding their views about what is allowed, but not all of these pieces will have been fact-checked carefully.
Complying with restrictions is important from a public health perspective, but also for professional conduct reasons. Your code of conduct includes maintaining public trust in the profession, so anyone breaking the law could be vulnerable to a regulatory investigation. But what if you were simply following the lead of other similar practitioners in your area?
Unfortunately, direct competitors or peers re-starting in-person care does not mean you can safely do the same. They may have misunderstood the official guidance, or have financial pressures that led them to take a professional and public health risk. Pointing to another healthcare professional breaking the rules would not necessarily protect you from criticism.
For those who can resume providing in-person care, how should you plan for returning to practice? We can’t provide an exhaustive list, but here are some considerations for resuming as safely as possible.
Rusty skills? – Plan ahead make sure you and your staff get refresher training on clinical skills, or other issues such as data protection.
New procedures? – Make sure that any new infection control measures are planned in advance, that you have a reliable supply of equipment such as PPE, and that returning staff are trained to comply.
Patient communications? – What do patients need to know before they even arrive at your clinic, consulting rooms or hospital? Consider updating your website, patient appointment letters and leaflets.
Triage? – For most practice areas there will be a backlog of cases, and patients who now feel desperate to be seen in person. You need an effectively triage system to prioritise those with the greatest need.
Over-committing? – You could face a huge back-log of cases through no fault of your own. You may feel under pressure to ‘catch up’ as soon as possible, but you must pace yourself. Being too busy is a known cause of errors and claims.
Recession claims? – The UK (and many other countries) is now in a significant recession. Recessions are known to increase the average number of fee disputes, complaints and claims. Please don’t take it personally – it will be happening to everyone. Make sure you know who to contact at your indemnifier, and have their number in your phone. Incision members have access to a 24-hour medico-legal helpline for assistance and help with notifying any issues to insurers.