COVID-19 - Update and thank you to the medical profession
The following email was sent to all practising doctors by Dr Curtis Walker, Chair of the Medical Council, and Joan Simeon, Chief Executive on 14 April 2020.
14 April 2020
Thank you to the medical profession
The Medical Council thanks all doctors for the essential services you are providing to help Aotearoa New Zealand through the COVID-19 pandemic.
Doctors are providing expert advice to government, you are delivering important public health measures, and many of you are working at the frontline to maintain high quality health services for all New Zealanders who need care. These combined efforts are making a positive difference to the pandemic’s trajectory.
Through all of this, maintaining public health and safety and ensuring high standards of clinical practice remains the central focus for the Medical Council and the profession. In this regard, the Medical Council has received a number of inquiries about how and where doctors may work outside of their “business as usual” roles.
Working outside your scope of practice
As health services are reconfigured in response to the COVID-19 pandemic, or to cover colleagues required to self-isolate, you may be called upon to work outside your scope of practice.
The Medical Council’s scopes of practice are broad and enabling. Most doctors practising in New Zealand are registered in a general scope of practice. However, some doctors with general registration have specific limitations e.g. to one type of medicine, or to hospital-based practice.
Given the need to provide flexibility during the pandemic, the Medical Council has decided that until 30 November 2020, doctors who hold a general scope of practice with limitations, and those who hold vocational registration only (with no general scope) are authorised to work outside their scope of practice to provide health services related to COVID-19. This includes providing necessary cover to relieve other doctors providing COVID-19 related services.
We recognise that doctors have a responsibility to take into account their own limits and their level of competence in their daily work. This duty of care is of particular significance given the authorisation we have made around scope of practice during the COVID-19 response until 30 November 2020.
The Health Practitioners Competence Assurance Act (HPCAA) provides an exception for doctors who, in an emergency situation are required to practise outside their scope of practice. This means that if a doctor is required to perform a health service outside of their scope of practice during an emergency COVID-19 situation the context would be fully taken into account if a question were to be raised about whether the doctor was practising outside of their scope.
Notifications to Council about a doctor’s practice
These are especially demanding times to be a doctor. If the Medical Council were to receive a notification about a doctor’s practice during this period, we will consider and address them in a proportionate way, taking into account the context, the pressures on doctors during the COVID-19 response and the extent to which the doctor acted responsibly and with due consideration. However, all doctors must continue to act professionally and responsibly at all times, with the best interests of patients at the forefront.
Support for the profession
Council has taken a number of steps to expand the size of the medical workforce and to provide support and flexibility for doctors, while continuing to assure public safety and upholding high standards of medical practice.
Over the past three weeks, Council has made the following key decisions:
- Activating a special “pandemic” scope of practice: This scope of practice was specifically designed to allow doctors who have recently left the profession who wanted to help to regain registration at no cost, and to be placed by the Ministry of Health into pandemic services.
- Waiving recertification programme requirements: Ongoing professional development and review of practice plays an essential role in doctors maintaining high levels of competent and safe practice. However, during the COVID-19 pandemic, the focus for doctors is understandably on delivering essential health care. Many recertification events have also been cancelled or postponed. As a result, Council has waived recertification requirements until 28 February 2021.
- Providing guidance and clarity over issuing prescriptions in an environment of social distancing: In accordance with waivers signed by the Director-General of Health, we amended our Good Prescribing Practice statement to allow doctors to issue unsigned prescriptions in some cases. The Telehealth statement was also amended to allow for prescribing of controlled drugs without a face-to-face consultation. However, you must still ensure you have appropriately assessed the patient before prescribing any medication with a risk of addiction or misuse, or psychotropic medication for the first time.
- Changing verification requirements for Australian, UK and Irish graduates: The requirement for primary medical qualifications to be independently verified has been removed for Australian, UK and Irish graduates until 30 November 2020. Medical registration is robust and reliable in these countries, and instead public safety will be safeguarded through direct contact with overseas regulators during this period.
- Extending permitted registration period for short-term “locum” doctors: As the pandemic developed, we were aware some specialist locums were nearing the end of their allowable 12-months of practice. District Health Boards, and the doctors themselves, asked if that period could be extended to allow locums to continue to provide essential services. We have agreed to extend their registration until 30 November 2020 under the already approved terms of supervision and responsibility.
- Extending scopes in interns practice and increased flexibility in the intern training programme: Council has approved interns to work outside of accredited clinical attachments, so long as suitable support and supervision remains available. We have also deferred the requirement to complete multisource feedback until 30 November 2020.
Being a doctor is a challenging and pressured job at the best of times. It is even more so during these times of great change and uncertainty. Like other New Zealanders, doctors are having to manage lockdown and care for themselves as well as their families. Many of you are facing severe impacts on your businesses and livelihoods.
As a doctor, you have your own health needs. Keeping yourself safe and well is an absolute right, and the Medical Council encourages you to seek help and support from those close to you, your own doctor, and other organisations able to assist.
From our team to yours, we thank you for your continuing hard work, care and commitment in keeping our communities safe.
Noho ora mai,
|Dr Curtis Walker
Medical Council of New Zealand
Medical Council of New Zealand