Health and Safety

The primary duty of care of a doctor is to patients. Medical students likewise have this responsibility to the patients with whom they will come into contact and this is set out by the General Medical Council (GMC).

Students should read their documents ‘Achieving good medical practice: guidance for medical students’ (https://www.gmc-uk.org/education/standards-guidance-and-curricula/guidance/achieving-good-medical-practice) and ‘Professional behaviour and fitness to practice’. https://www.gmc-uk.org/education/undergraduate/professional_behaviour.asp

As a medical student, both during study and on placement, you are likely to experience situations that will have an emotional impact on you. At times, you may experience stress and anxiety. This is completely normal and the medical school will support you with safe ways to share and reflect on difficult experiences. If you are concerned about your levels of anxiety, you should seek help from your general practitioner (GP) and other appropriate sources (for example, helplines) to address any issues at an early stage. The School has a comprehensive range of support for you including the personal tutor scheme including your personal tutor, the academic sub-dean, your GP or the student counselling service. School, university and external links are available at https://students.leeds.ac.uk/info/1000039/school_of_medicine/1236/school_of_medicine_student_support and https://students.leeds.ac.uk/#Support-and-wellbeing. Seek help before your studies are affected.

Registered doctors must protect patients from any risk posed by their health. To do this, they must ask for help from a suitable colleague and follow their advice about any changes to their practice the colleague considers necessary. You’ll have significant contact with patients while on clinical placements. Any health issues you have may affect them, as well as your fellow students and teachers. If you know or suspect that you have a condition that could be passed on to colleagues or patients, you must follow your medical school’s guidance about this.

You should be aware that some conditions that are usually minor – such as the common cold – may have a disproportionate impact on some patients, for example those with compromised immune systems. You need to bear this in mind when you decide whether to go to a placement if you are unwell. If you are in any doubt as to your fitness to attend please contact the placement co-ordinator for advice. If you fall ill whilst being away from home on placement you can contact a GP surgery nearby or visit a GP-led health centre. Further information can be found at: http://www.nhs.uk/chq/Pages/how-can-i-see-a-gp-if-im-away-from-home.aspx.

Particularly during winter months, students are at risk from outbreaks of Norovirus that occur on the ward. Please take note of local infection control policies when re-entering the clinical environment (usual policy is to return once symptom free for 48 hours, but check first before returning to the ward).

You must comply with the occupational health policies and procedures of your medical school or university (for example, immunisation against serious communicable diseases). The Occupational Health Service of the Leeds Teaching Hospitals NHS Trust provides this service for University of Leeds medical students, this includes pre-course screening, vaccination and OH assessment and support throughout the course. You must attend appointments as required throughout your studies.

You must engage with the occupational health referral process if your health has deteriorated, or if there are concerns that your health may have an impact on your ability to study. Academic Sub-Deans will refer you to occupational health services, receive reports, and act on the advice received in collaboration with Student Support.

You don’t need to perform exposure prone procedures* (EPPs) to achieve the outcomes of undergraduate medical education. Students with blood-borne viruses can study medicine, but they may not be able to perform EPPs and may have restrictions on their clinical placements. They must also complete the recommended health screening before they carry out any EPPs and must limit their medical practice when they graduate.

Although you do not have to have tests in Hepatitis B, C and HIV to do a medical degree in Leeds. The references below explain the importance of these tests in relation to clinical work you may do as a medical student, in particular, exposure prone procedures (EPP). To be involved in EPP you must have been cleared i.e. tested and demonstrated to be negative or non-infectious for HIV, Hepatitis B and for Hepatitis C.

You MUST be aware that:

1.   EPPs can form an important part of medical training; there will be restrictions in what you can be involved in during clinical work as a student if you are not cleared for EPP.
2.   EPPs comprise part of the normal work of many clinicians, including during Foundation Training years. Trusts will require evidence of appropriate health clearance for these posts.
3.   Also there is a significant health benefit to knowing earlier if you were found to have such an infection.

Needle stick injuries – advice for medical students on clinical placement can be found here: Needlestick advice med students.docx.

Student Safety and Student Indemnity on Placements in the community Setting.

This guideline is based on information that is currently given to medical students at the University of Leeds and at other medical schools in the UK. Advice has also been obtained from the University of Leeds and the Medical Protection Society.
It is integrated into ICUs which have a placement in the community setting (non-clinical or clinical).

The guideline below has the intention of reducing potential harm to students during community visits but also to reduce complaints being made to students by people in the community.

Principles: Both the student and the Medical School (and tutor) have responsibilities.

Student:
All students should at all times conform to standards of professional behaviour. This includes their attitude, comments and dress.

• All students should be aware of the importance of initial presentation.
• All students should clearly introduce themselves and respect the feelings of the people that they are visiting. This includes an awareness of dress that may be inappropriate, such as tee-shirts with slogans, revealing clothing that may be considered unacceptable (especially by an older generation) and large amounts of body and face jewellery.

All students should be aware that they should not put themselves in a position where they are at unnecessary risk.

•   Visits to patient’s homes will usually be accompanied either by another student or the tutor, although on some occasions the placement team may judge it safe and appropriate for the student to be on their own and an appropriate risk assessment will have been carried out. Variations to the planned visit require the tutor to be aware so that they can judge the potential risk.
•   A common sense approach, such as plan the journey so that they know in advance where they are going, keep to well-lit areas, carry some identification, exercise judgement in using stairs and lifts, carry just enough money for expenses, talk and behave confidently. This advice can be augmented by information on personal safety from Student Union or Police.
•   When phoning patients, 141 can be dialled in front of the number (which prevents receiver getting your number). If a contact number is needed, then the ICU administrator contact details should be used. Variations require the tutor to be aware of the potential risk.
•   If at any time on a community placement you feel threatened or upset then you should discontinue the visit and discuss the matter with your tutor.
•   Awareness of specific ICU guidelines on safety in clinical settings.

Personal Indemnity:
We know doctors work hard to deliver good quality healthcare. But sometimes, things go wrong. If a patient has suffered harm as a result of a doctor’s negligence, it’s important that doctors have adequate and appropriate insurance or indemnity to compensate the patient. The University has insurance to cover their students but the following links are to companies that will provide you with additional cover throughout your undergraduate degree free of charge.

https://www.medicalprotection.org/uk/studentjoin
https://www.themdu.com/for-students

All students are strongly encouraged to become student members of one of the indemnity organisations.

Medical School:
The University has a legal responsibility (and carries appropriate insurance) for the safety and indemnity of all students on community placements where the community placement is part of their training. Clinical placements, in which visits are directed by a healthcare professional, should follow existing guidance on health and safety in NHS facilities.

The general principle is that all reasonable steps should be made by the Medical School to ensure that students are appropriately “supervised” and are given advice on personal safety and not exposed to risks where these can be reasonably foreseen.

This supervision will be at several levels, including ICU manager and tutor, depending on the circumstances related to the visit.

Prior to any community placement, the ICU manager should take all reasonable steps to ensure that they themselves are aware of any potential risks to the student:

•   Previous visit to the placement by a member of the ICU team
•   Asking community organisations to report on any potential risks
•   Responding to complaints or comments made by students.

All students should be made aware of the need to ensure professional behaviour and safety:

•   An introductory lecture prior to each community placement or ICU
•   Relevant information in all Study Guides
•   Advice to discontinue the visit if they feel threatened or concerned

We will monitor the safety of students and any concerns should be appropriately dealt with, including discontinuation of the community placement.

Good practice includes:
•   Ensuring that Health and Safety is a standing item on all ICU and Course Management Team meetings
•   Long term discontinuation of visits to placements where concern has been identified
•   All ICU managers to be aware of the guideline and take steps to implement the suggestions as appropriate to their ICU
•   All students advised that they are expected to join one of the indemnity organisations that provide free student cover. This reflects their professional response to being a medical student.