Regulation of Health and Social Care Professionals Consultation

Good Medical Practice which covers matters such as the duties of a doctor, good
clinical care, maintaining good professional practice, teaching and training,
appraising and assessments, relationships with patients, probity and health. 40
Some of the regulators, such as the General Dental Council and General
Pharmaceutical Council, adopt the approach of a short high-level code of conduct
which is supported by more detailed guidance booklets that explain how the code
should be implemented.
6.54 It has been argued that codes of conduct are generalised statements of common
values and therefore unenforceable in law. 41 Nonetheless, the Codes are in fact
enforced through administrative decisions made by the regulator, the decisions of
Fitness to Practise Panels and the courts. 42
6.55 Some of the codes themselves contain statements which indicate their legal
status. In the majority of cases this statement will be to the effect that all
registrants must act in accordance with the code or guidance and a failure to
comply will put registration at risk. 43 The main exception is Good Medical Practice
which contains a more detailed statement to the effect that:
(1) the document is guidance and not a statutory code and doctors must use
their judgement to apply the principles to the various situations faced;
(2) where the guidance uses the term “you must” this indicates an overriding
duty or principle, but where the term “you should” is used this indicates
an explanation of how doctors should meet the overriding duty or where
the main duty will not apply to all situations; and
(3) “serious or persistent” failure to follow the guidance will put registration at
risk. 44
Standards of proficiency
6.56 All of the regulators are required to determine from time to time the standards of
proficiency for safe and competent practice. 45 Standards of proficiency are
described as being based on the principle that every practitioner must follow “the
current, sound practice of a reasonable practitioner”. 46 They are applicable to
prospective registrants applying for the first time and existing registrants.
6.57 The standards that are published are generally speaking minimum standards that
are necessary for safe and effective practice, rather than best practice or
aspirational standards. The areas covered typically include assessment skills,
40 General Medical Council, Good Medical Practice (2006).
41 J Stone “Evaluating the Ethical and Legal Content of Professional Codes of Ethics” in J
Allsop and M Saks (eds), Regulating the Health Professions (2003) p 63.
42
For example, General Medical Council v Meadow [2006] EWCA Civ 1390, [2007] 2 WLR
286 at [113].
43 For example, Nursing and Midwifery Council, The Code: Standards of Conduct,
performance and Ethics for Nurses and Midwives (2008), p 2.
44 General Medical Council, Good Medical Practice (2006) p 5.
45 For example, Dentists Act 1984, s 36D and Medical Act 1983, s 5.
46 General Chiropractic Council, Code of Conduct and Standard of Proficiency (2010) p 38.
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