Please give me some guidance on the GMC guidance: Domain 2

By Usman Nasir

We are nearly halfway through this GMC series so thanks for joining me yet again. If you haven’t already, have a look at the 2 previous articles in this series and then come back to learn about domain 2 GMC guidance.


So, let’s keep going and break down Domain 2 of the GMC guidance: Safety and Quality


What does the GMC say in domain 2?


Like the first domain, domain 2 is also split into 3 strands. They are all centred around delivering safe and quality care for patients (an ethos which needs to be at the forefront of a healthcare professional’s work). This domain is therefore vital in ensuring that patients not only receive the care they deserve, but the care they should expect.


It can be of comfort that this domain is in place with the sole purpose to protect patients and ensure that all healthcare professionals advocate for this by reflecting upon their work, raising concerns about safety and looking after their own health.


Don’t worry, we will go into more detail for each strand to help you prepare for your interviews…


1. Contribute to and comply with systems to protect patients


After reading this strand, I think it conveys the idea of doctors being open and honest with the healthcare they provide. Doctors need to constantly review and reflect upon their work and the care they provide so they can find ways to improve patient safety and care quality. This can be achieved by listening to feedback from patients, assessing quality care standards in place and identifying any areas that need to be improved.


There is also a strong theme of reporting anything that risks patient safety and assisting in any further inquires into any adverse incidents (e.g. adverse effects of treatments/medical devices). It is a doctor’s duty to report anything that undermines patient safety so it can be dealt with as soon as possible.


How could you use this strand in your interviews?


This strand boils down to advocating for patient safety by finding ways to improve the standard of care and reporting anything that could cause harm. This idea of prioritising patient care and safety is fundamental to the duty of a doctor, so it is important to have a strong understanding of this when applying for Medicine. This idea will be a constant theme that runs throughout your medical school training.


Scrubbed up Top Tip: Think about times in your work experience/volunteering where a healthcare professional prioritized patient care/safety. How did they do this? Why did they do this? What effect did this have on the patient?


Asking yourself these questions will help you apply this strand to your own experiences so that you can use these examples to support your understanding of this strand.


2. Respond to risks to safety


This strand is all about making sure that doctors know that they should always raise concerns if they know/suspect that something is wrong, or a patient may be at risk. This was briefly mentioned in the first strand of this domain, but the GMC assigns a whole strand to emphasise its importance. Firstly, doctors need to play their role in ensuring that the entire multi-disciplinary team is comfortable with raising concerns and they have the means to do this openly and honestly in a safe platform.


Doctors must act quickly and raise their concerns if they believe that safety, comfort, or dignity of patients is being undermined.


Examples include:

  • A colleague not being fit to practise, or risking patient care/safety e.g. being drunk whilst working.

  • Poor equipment or environment that jeopardises patient care.

  • Patients not being provided with the basic care that they deserve to meet their needs.

  • Healthcare institutions have policies and guidance in place to aid the process of raising concerns. Doctors should therefore follow these and record the actions they have take to do so.


How could you use this strand in your interviews?


For your interviews make sure you understand the importance of raising concerns. How does this promote patient safety and care? Can you think of some examples in the news about raising concerns? If you get time, I recommend reading about the Stafford Hospital scandal. Between 2005 and 2008, “appalling” standards of care resulted in many patient deaths. A public inquiry was launched in 2011, as Stafford Hospital did not provide adequate explanations for these deaths. This inquiry revealed shocking conditions for patients and that the hospital neglected their patients. Another theme running through this case was the idea of “raising concerns” as this was not promoted at Stafford Hospital. A nurse who worked at this hospital called for a “culture change” as raising concerns needs to be made a lot easier and safer for healthcare professionals. And the people in positions of power need to be ready to listen.


3. Risks posed by your health


Doctors cannot take care of other people if they do not take of themselves. So, it is important for them to take care of their own health throughout their career. If they have a serious illness, they should not see patients and seek help from a colleague immediately. This is not only for them to receive the care they need, but it is to also prevent patients from being in danger of catching a disease that could be transmitted. As well as this, that illness may affect that doctor’s ability to deliver care, so it is best for them to take time out until their health returns.

It is vital that doctors should also have all the appropriate immunisations and be registered with a GP. This to protect both the doctors and patients.


How could you use this strand in your interviews?


It is important for doctors to recognise their own health as it can impact the care they deliver. If a doctor has an illness, then they should not continue to practise as it would place patients at risk. Doctors may want to power through with their illness and carry on with their jobs, but this may do more harm than good. So, they should seek help and follow any advice they are given.


Whether you are school/college student, university student or part of the workforce it is important to take care of your own wellbeing and health. This could be by taking time out for yourself, getting involved with a hobby you enjoy or making sure you seek help when you are ill. Sometimes we can get so busy with life that we forget about our own health and wellbeing, but its importance cannot be undervalued. To those of you reading this, no matter how busy you get, please take some time out to look after your own health and wellbeing.


Also, remember that work-life balance is important for any career. Interviewers want to know about your ways of managing stress and taking time out from your studies. This could be playing sport, reading for fun or painting. This shows that you are a well-rounded student. So have a think of the ways that you look after your own health and wellbeing.


So, that was domain 2 of the GMC guidance. Thanks for joining me. Hope you enjoyed this article.


Next up…

Domain 3: Communication, partnership and teamwork


References

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice/domain-2----safety-and-quality

https://www.bbc.co.uk/news/uk-england-stoke-staffordshire-50836324

https://www.bbc.co.uk/news/uk-england-stoke-staffordshire-23487863#:~:text=Staffordshire%20NHS%20scandal&text=A%20nurse%20who%20raised%20nearly,could've%20been%20avoided%22.

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