In October 2023, over one million appointments were delivered daily, by General Practices and the Primary Care Networks. Despite this reflecting merely half the of patient interactions nationally, it indicates the huge array of people that were cared for, by healthcare professionals, for various ailments and concerns. Each of these patients were unique; they had various traits that embodied their identity: who they were as people.
The General Medical Council recently published guidance concerning the standards of professional conduct in ‘Good Medical Practice’, which is to come into effect in January 2024. The guidelines of conduct prohibit harassment or discrimination based upon any characteristics. These protected characteristics are appearance, lifestyle, culture, socioeconomic status and those protected by the law: age; disability; gender reassignment; marriage and civil partnership; pregnancy and maternity; race; religion or belief; sex; and sexual orientation.
These are various traits that are inherent in each of the millions of patients treated by the National Health Service every day,1 and therefore it is a necessity to prevent any and all discrimination caused by these aspects, as this can influence the success of patient care.
“I will not permit considerations of [Protected Characteristics] to intervene between my duty and my patient” – The Physician's Pledge.
Healthcare professionals must treat all patients invariably, having no shortcoming of respect for patient autonomy, and maintain standards of beneficence, non-maleficence and justice (the Pillars of Medical Ethics). This means that care must never be compromised by the direct bias of a doctor, and this is reinforced by the aforementioned guidelines, and also the ‘NHS equality, diversity, and inclusion improvement plan’, implemented in June 2023. By having a workforce that has due regard for all protected characteristics, patients will feel more comfortable, trust doctors readily and receive recommended treatment. This will lead to successful treatment outcomes, achieving more effective patient care and improved satisfaction.
However, it is important to consider that patient care is not influenced exclusively by the physician, but also by the patient and their own conduct. If a patient verbally abuses a General Practitioner, e.g. due to their sexual orientation, they may be struck off the register of that practice, since they have discriminated against the practitioner based upon a protected characteristic. In such a case, patient care will be negatively impacted since they must seek treatment elsewhere, delaying recovery from the illness they face.
Alternatively, patient care can be impacted through indirect discrimination. This occurs when the provisions or policies of a healthcare system, cause a certain characteristic to be obstructed from receiving the same treatment as another patient. For example, if a hospital does not have disabled parking places then the hospital is less accessible for disabled patients. This leads to patients being unable to attend appointments or receive treatment, negatively impacting patient care as their condition would naturally worsen.
The protected characteristics are attributes found in people around the world. Healthcare professionals should do their utmost to respect all people regardless of these traits, and should not let quality of treatment be impacted. Failure to do so can lead to patient care reducing in efficacy and greater distrust between patient and physician. Success will lead not only to a better standard of patient care, but a more equal and effective system.