COVID-19 is creating highly challenging circumstances in which healthcare professionals are forced to operate. In recognition of this situation, 11 UK statutory health and care regulators released a joint statement in early March 2020 in an effort to clarify their approach to professional regulation as the virus continues to spread.
In this joint statement, the UK regulators:
Recognise that registrants may need to depart from established procedures in order to care for patients and service users, and
Highlight that the regulatory standards in place across the professions are designed to be flexible and provide a framework for decision-making.
Context in challenging circumstances
Interestingly, the UK regulators also specifically recognise that registrants may feel anxious about how context will be taken into account if concerns and complaints are raised about their decisions and actions during these challenging circumstances. In this regard, the UK regulators have sought to assure registrants that, where a concern or complaint is raised, it will always be considered on the specific facts of the case, taking into account the factors relevant to the environment in which the registrants are working.
While this statement does not provide a blanket absolution for decisions and actions taken during the COVID-19 outbreak, it should provide some reassurance to UK registrants working at the frontline that the context of any necessary departure from established procedures will be considered in the event of any complaints made against registrants.
The Irish position
In Ireland, the Medical Council, Nursing and Midwifery Board of Ireland (NMBI) and the Pharmaceutical Society of Ireland (PSI) have all recently issued statements on COVID-19.
The Medical Council has expressly acknowledged that the significant workload and potential travel disruption arising from COVID-19 may cause difficulties for practitioners meeting or recording their ongoing CPD requirements. The Council has asked practitioners who will not meet their CPD requirements for related reasons to:
Advise their Professional Competence Scheme, and
Self-declare on their Annual Retention Application Form
Where practitioners take both of these steps, the Council has confirmed that it will take the circumstances surrounding the COVID-19 outbreak into consideration and if compliance with the CPD requirements has been consistent in the past, this deviation should not cause the doctor any great concern.
The NMBI has reiterated to its registrants that decision-making, including in emergency situations, should be informed by NMBI’s scope of practice framework document. In the event of any concerns being raised about actions or decisions taken this Framework document supports nurses and midwives taking appropriate actions provided the overall benefit to the patient is being served.
Lastly, the PSI has reminded its registrants of the important role of pharmacists as trusted healthcare professionals in reassuring the public with accurate and responsible information. To assist registrants the PSI has modified its website to provide access to up-to-date resources regarding COVID-19. It has also reminded registrants of the established guidance documents to facilitate compliance with pharmacy and medicines legislation.
The UK regulators joint statement provides some assurance to UK registrants if departures from standard practice are required while working at the frontline of the COVID-19 outbreak. However, it is important to note that the UK system operates under a different legislative structure and to a different standard of proof than that in Ireland.
While no specific guidance on procedural deviations has issued here, Irish regulators have issued helpful guidance on some of the challenges facing registrants due to COVID-19. The Medical Council has acknowledged that there will be leeway in appropriate circumstances where CPD requirements cannot be met due to COVID-19. The NMBI has reminded registrants that its scope of practice framework supports appropriate decision-making in emergency situations provided it serves the overall benefit to patients and the PSI is ensuring its registrants are equipped with all relevant, up-to-date information.
While it is to be expected, in our view, that registrants may seek to rely on these challenging circumstances as mitigating factors if any complaints do arise from decisions and actions made during the COVID-19 outbreak, it is clear that Irish healthcare regulators are acknowledging the challenges that face their respective registrants, and providing guidance and reassurances, where possible.