The GMC is updating Good medical practice – the core guiding principles doctors refer to on the professional values, knowledge and behaviours expected of them while working in the UK. We responded to welcome changes that recognise the importance of research to medicine and reflect the role that doctors can play in making more research that people can trust happen here in the UK to improve care. We also highlighted where we think that they can go a little bit further.
We particularly welcome the addition of a paragraph to signal the importance of research to medicine and the inclusion of research in the professional values and behaviour expected from doctors. The skills and knowledge doctors bring to research in their wider roles as academics and working in the life sciences industry, is fundamental to improving care through health research.
Embedding research in healthcare as a core part of medicine
We feel that the current draft of GMP is missing an opportunity to embed research in healthcare as a core part of medicine, rather than an added extra. It is important that all medical professionals actively engage with research. Doctors play a key role in making sure that NHS organisations and universities facilitate good research, ensuring cultures that are based on use of research evidence, and promoting and facilitating patient involvement. The pandemic demonstrated that when research is seen as the responsibility of all health professionals (with doctors playing a key role) and an option for patients, we can make real progress in improving treatments and services.
So our key recommendation is that a new duty (linked to the existing duty in the draft code to ‘protect and promote the health of patients and the public’) is added to Good medical practice. This would require medical professionals to facilitate or promote research on matters relevant to the health service. They’d also use evidence obtained from research in their practice.
We also highlighted that the guidance would benefit from a clearer distinction between the responsibilities of doctors in delivering research and their responsibilities when they are involved in designing, managing, and reporting research. The UK has a worldwide reputation for the quality of the research conducted here. By embedding a culture of research, and good practice in research, across all medical professionals, we can ensure that more people can be meaningfully involved and take part in research and use these finding to improve care and address health inequalities.
We made a number of other recommendations for changes that could better reflect doctors’ roles in research. This included:
Doctors’ roles in supporting research activity
Doctors also play important wider roles in supporting research activity. These can include roles as Research Ethics Committee members, taking part in funding panels, peer-reviewing or editing papers for academic journals. But it can be hard for them to find the time alongside busy jobs. We emphasised that employers, and medical leaders, need to encourage and facilitate doctors to play these wider roles and value such contributions.
We know that patients, service users and the public want to take part in or support research. When they do take part, we owe it to them to ensure that the research study is relevant to them, ethically designed, well-managed and produces findings that are useful and widely shared. We emphasised that it is important that research, and good practice in research, is embedded in normal clinical activity and doctors have a full understanding of their responsibilities related to research.
We are really pleased that the draft Good Medical Practice now highlights how doctors should ‘act with honesty and integrity in research’. Trust is fundamental to recruit participants and to earn public confidence in research findings. Acting with honesty and integrity in research includes meaningfully involving people in all stages of research and sharing its findings and we set out what this should look like for doctors.
We recommend that doctors should involve the public when designing, organising or carrying out research. Public involvement in research means that patients or other people with relevant lived experience contribute to how research is designed, conducted and disseminated. Involving patients and the public will help ensure that the interests of participants are put first. The HRA supports and encourages researchers to involve patients and the public in their work at the earliest opportunity. Our principles for meaningful involvement of patients and the public in health and social care research support and guide researchers. Involving people with relevant lived experience in the design and development of research improves its quality and relevance so that it can be research that people can trust.
Transparency in research
Doctors should fulfil their duties with respect to transparency when conducting research. Research transparency is central to ethical research practice and earning trust in research. Research studies should be registered, and the results made public, so that participants are protected from unnecessary studies and research funding maximised. The HRA’s Make it Public strategy, in partnership with NHS Research Scotland, Health and Care Research Wales, and Health and Social Care Northern Ireland, is about making transparency ‘the norm’ in research and making information more visible to the public. Through the strategy, the HRA is committed to both helping researchers to be transparent, and taking action where standards are not met.
The GMC’s consultation has now closed and a final version is due to be published in 2023.