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1.2.1 Good standards of clinical practice

Further resources in this section 

In meeting the standards set out in Good Medical Practice surgeons must provide good clinical care by applying their clinical skills, knowledge and experience to practice. You should:

  • Ensure that patients are treated according to the priority of their clinical need.
  • Take full responsibility for patient management, leading the surgical team to provide best care. Responsibility should encompass preoperative optimisation and postoperative recovery.
  • In conjunction with colleagues in the multidisciplinary healthcare team, construct and discuss with the patient a diagnostic and treatment plan based on clinical evidence and investigation findings. The risks and benefits of surgical intervention and the use of alternative forms of treatment should be considered carefully. Ensure that multidisciplinary team meetings are fully utilised both preoperatively and postoperatively.
  • When providing elective care for patients with non-urgent conditions, carry out procedures that lie within the limits of your competence and the range of your routine practice, and refer where necessary.
  • Carry out surgical procedures in a timely, safe and competent manner, and ensure that you follow current clinical guidelines in your field.
  • Use the skills and knowledge of other clinicians. When the complexity of the procedure is an issue, you should consider shared decision making and shared operating with another expert consultant colleague. When appropriate, you should transfer the patient to another colleague or unit where the required resources and skills are available.
  • Be satisfied that patients are cared for in an appropriate environment where adequate resources, facilities and suitable equipment are available for safe surgery and any special patient needs are taken into account. If such resources are not available, you should consider postponing planned procedures. If patient safety and effective care may be compromised by lack of resources, you should record this and communicate it to the medical director.
  • Make efficient use of the resources available. Any requests to hospital management for the allocation of resources for patient care should be sensible, realistic and proportionate to the needs of the patient.
  • Ensure that patients receive satisfactory postoperative care and that relevant information is promptly recorded and shared with the relevant teams, the patient and their supporters.
  • Proactively support and participate in your organisation’s provisions to ensure that patients in hospital are reviewed by an on-site consultant with appropriate skills and knowledge at least once every 24 hours, 7 days a week, unless it has been determined that this would not affect the patient’s care pathway.
  • Proactively support and participate in your organisations provisions to ensure that consultant-supervised interventions and investigations (along with accompanying reports) are provided seven days a week if the results may change the status of the patient’s care pathway before the next working day. This includes interventions that may determine additional care needs or enable a shortened length of stay or immediate discharge.
  • Where appropriate for the patient’s care pathway, be satisfied that support services can be accessed seven days a week to ensure that the next steps in the patient’s care can be taken, as determined by the daily consultant-led review. If effective care may be compromised by lack of support services, this lack should be recorded and communicated to the medical director.
  • Ensure that, when the patient is discharged from hospital, appropriate information is shared with the patient, the patient’s supporters and the extended care team. In addition, unless the patient requests otherwise, all relevant information should be sent to the patient’s GP, where possible in electronic form, within 24 hours. For complex cases, consideration should be given to a telephone communication with the patient’s GP.
  • Accept patients on referral by GPs, consultant colleagues or as emergency through the accident and emergency department. If you agree to see a patient directly without referral, the patient should be informed that the GP will receive a report unless the patient requests otherwise.
  • Provide adequate time for patients and their supporters prior to surgery to discuss the proposed procedures and implications, risks and benefits, and allow the patient to make a fully informed decision before signing a consent form as described in section 3.5.1.

« Previous: 1.2 Apply knowledge and experience to practice 
 
Next: 1.2.2 Emergency surgery »

Resources

Title/Link Author Published Date
Seven Day consultant Present Care AoMRC 2012
Surgical Workforce Report 2011 RCS 2011
Developing a Modern Surgical Workforce RCS 2005
Delivering Surgical Services: Options for Maximising Resources RCS 2007
Ensuring the Provision of General Paediatric Surgery in the DGH RCS 2010
Surgery for Children: Delivering a First Class Service RCS 2007
Standards for Children's Surgery RCS 2013
Male Circumcision: guidance for healthcare practitioners RCS 2000
Professional Standards for Cosmetic Practice RCS 2013
Access all ages: Assessing the impact of age on access to surgical treatment RCS 2012
Treatment and Care towards the End of Life GMC 2013
The Higher Risk General Surgical Patient RCS 2011
Regional Trauma Systems: Interim guidance for commissioners RCS 2009
Reshaping Surgical Services: Principles for change RCS 2013
Handbook for College Assessors RCS 2007
Good Practice in Prescribing and Managing Medicines and Devices GMC 2013
Surgical Assistants - A Position Statement RCS 2011
Clinical Guidelines and Integrated Care Pathways for the Oral Health Care of People with Learning Disabilities RCS 2012
Poly Implant Prothèse (PIP) breast implants: Joint surgical statement on clinical guidance for patients, GPs and surgeons Intercollegiate 2012
Laryngeal Transplantation report RCS 2011


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