Organisation, management and administration for MRCGP AKT

A patient asks the practice for a copy of their full medical record under UK GDPR. Which is the correct response?

1. Ask the patient to give a reason before releasing anything Wrong. A person does not have to explain why they want their own data.
2. Provide the record within 40 days after a £50 fee Wrong. That was the old Data Protection Act 1998 rule. UK GDPR replaced it in 2018.
3. Provide the record free of charge, normally within one month correct Correct. A subject access request must be answered within one month. It can be extended by two more months if the request is complex. There is no fee unless the request is clearly unfounded or excessive.
4. Release only the entries the GP thinks are suitable to share Wrong. You can only hold back information that would cause serious harm to the patient or someone else, or that identifies a third party. Each withheld item needs a reason.
5. Ask the Information Commissioner's Office to approve the release Wrong. The practice is the data controller and answers the request itself. The ICO only gets involved if someone complains.

The point: Subject access request: answer within one month, free of charge, no reason needed. You can extend by two months if it is complex. Remove third-party details and anything likely to cause serious harm, and write down why for each removal.

Source: ICO: Right of access Information Commissioner's Office · tier 1, national regulator or guidance

A GP registrar tells you she feels exhausted, dreads her surgeries and has started to feel detached from her patients. She has made two prescribing near misses in a fortnight. She asks you not to tell anyone. Which is the most appropriate response?

1. Refer her to the GMC today Wrong. The GMC is for serious concerns that local support cannot manage. This is a supervisor and occupational health matter first.
2. Encourage her to talk to her supervisor and use NHS Practitioner Health, and explain you cannot keep it secret if patients are at risk correct Correct. She needs support and a clear route to it. Being honest about what you can keep private is what makes your offer believable.
3. Promise to keep it confidential and offer to check in weekly Wrong. The near misses are a patient safety issue. Promising secrecy you may have to break is worse than being honest about the limits now.
4. Tell her everyone feels like this and it will pass Wrong. This dismisses her burnout and ignores two prescribing errors.
5. Suggest she takes annual leave and says nothing Wrong. Leave may help her rest, but hiding the problem leaves both her health and the safety issue unaddressed.

The point: A struggling colleague: support them, be honest about the limits of confidentiality where patients may be at risk, and escalate in proportion. Use the supervisor, occupational health and NHS Practitioner Health before thinking about the regulator.

Source: GMC: Good medical practice (2024) General Medical Council · tier 0, exam blueprint / regulator

A 38-year-old man asks for a sick note. He has been off work with back pain for 5 days and has not seen anyone about it yet. Which is the correct position?

1. No fit note is needed yet, because he can self-certify for the first 7 days correct Correct. People can self-certify for the first 7 calendar days off sick, including weekends. A fit note is only needed from day 8.
2. His employer must ask the practice directly for the certificate Wrong. The fit note is given to the patient, who passes it to the employer. The practice does not contact the employer without his consent.
3. Only a hospital doctor can issue the first fit note Wrong. GPs, nurses, pharmacists, occupational therapists and physiotherapists can all issue fit notes.
4. A fit note is needed from the first day off work Wrong. This is not the rule, and it would create needless appointments.
5. A fit note is needed from day 4 of absence Wrong. Day 4 is not a cut-off in the self-certification rules.

The point: Self-certification covers the first 7 calendar days off sick. After that a fit note is needed. Several professions can now issue one, and it can say 'may be fit for work' with changes the employer could make.

Source: DWP: Fit note guidance for healthcare professionals UK Health Security Agency · tier 1, national regulator or guidance