Medical Protection has urged GPs to consider requests from patients to declare them ‘fit to participate’ in high-risk activities carefully, and ensure they have adequate professional protection in case the patient is injured and makes a claim for compensation. 

Medical Protection, the world’s leading protection organisation supporting over 300,000 healthcare professionals, says GPs face a high number of requests to sign ‘fit to participate’ forms during the summer. It said requests can cover a range of more extreme challenges including skydives, marathons, swimming challenges, polar water plunges and mountain climbing.

Signing such forms for patients is not included in England’s state-backed indemnity scheme, which means GPs must obtain protection from a medical defence organisation in case a clinical negligence claim is brought.  Medical Protection said GPs should ensure protection is adequate, ideally with no limits to the compensation that will be paid in the event of a claim, otherwise the individual GP, or the practice, could be on the hook.

Dr Sarah Townley, Deputy Medical Director at Medical Protection, said: “Declaring patients fit to participate in extreme challenges can present some difficulty and risks to GPs - for example they may not have sufficient knowledge about the patient, the nature of the event or have the clinical expertise on any past injuries or conditions.

“They can also feel under pressure to sign fit to participate forms. Many extreme challenges are once in a lifetime events, raising money for charities close to patients’ hearts. They may have prepared for some time, invested in travel arrangements, and obtained sponsorship. GPs want to be able to support their patients as much as possible.

“First and foremost, before agreeing to sign such forms, GPs must have professional protection, so if a patient comes to harm during the activity and sues their doctor for declaring they were fit to participate, they can request assistance. GPs should ensure their protection is adequate, ideally with no limits. Sadly, although very rare, when extreme events go wrong the injuries may be serious and the compensation sought if a claim is successful may be high – even into millions of pounds. GPs will struggle to pay this from their own pockets.

“We would also strongly advise GP Partners and Practice Managers to check that all GPs in the practice have adequate indemnity, ideally without limits, in case a claim against a GP without adequate professional protection is deflected to the practice under vicarious liability or non-delegable duty of care. Again, this could become very costly and stressful for the GP partners.

“Once adequate indemnity is ensured, we would always advise GPs to remain objective when asked to sign fit to participate forms. They should take a detailed history from the patient and review any relevant clinical notes. They should feel confident that they have sufficient knowledge about the patient and the nature of the event, and should avoid undertaking assessments beyond their area of clinical competence.

“If they feel able to proceed, they should review the wording of any form and declaration carefully, and consider whether they need to provide a qualifying statement, or simply offer factual information regarding a patient’s medical history. For example, the GP may wish to state that they have considered the information that is available to them on the patient’s current and past medical history, which may be relevant to the event, and can see no known health conditions which render the patient unfit to participate.

“Where a patient’s medical history is not straightforward or they are under the care of a specialist, the GP may wish to obtain advice first or refer the patient to a doctor with relevant expertise. The GP should fully explain their actions and any concerns to the patient. When in doubt, GPs should contact Medical Protection or their medical defence organisation for advice.”

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About Medical Protection

The Medical Protection Society Limited (“MPS”) is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world. Membership provides access to expert advice and support together with the right to request indemnity for complaints or claims arising from professional practice.   

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations.

MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.