When you are asked to work outside your area of expertise

Dr Mark Burns | Medicolegal Consultant, Medical Protection

There may be occasions when management requests that you work outside your designated scope of practice. This is usually during periods of significant staff shortages such as pandemic illness and absence, RMO and nursing industrial action, and resource-limited environments when the appropriate vocationally trained specialists are unavailable. You may also be called on to assist in other emergency situations. Scopes of practice

The Medical Council defines ‘scope of practice’ as the type of work a doctor can perform in New Zealand. It categorises three broad types of scope of practice: • General – usually RMOs and doctors in vocational training • Vocational – for doctors who have completed their vocational training and hold a postgraduate qualification that has been approved by the

Medical Council • Special purpose – for doctors visiting

New Zealand for a specific reason such as to undertake research. Most doctors practising in New Zealand are registered in a general scope of practice and may also have vocational scope. Doctors with unrestricted general scopes – typically New Zealand, Australian, UK and Irish medical graduates – can work in any area of medicine in any setting. Doctors may have conditions on their general scope, such as a ‘hospital-based practice’, meaning they can work in any area of medicine in a hospital setting.

Covid flex

At the beginning of the Covid-19 pandemic, to allow for flexibility for expected staff shortages, the Medical Council allowed that doctors holding general scope with limitations, and those holding vocational registration only (with no general scope), would be authorised to work outside their scope to provide health services related to Covid-19. This included providing cover to relieve other doctors providing Covid-19 related care. This authorisation expired in November 2020, although the Medical Council continues to consider options to support the Covid-19/Omicron response.

Assisting in an emergency

The Health Practitioners Competence Assurance Act 2003 states in section 8 that health practitioners must not practise outside their scope of practice. However, there are exceptions, such as being required to assist in a medical emergency. The Medical Council expectations are that when faced with or called to attend an emergency, a doctor has an ethical obligation to respond and apply their knowledge and skills to assist. It is acknowledged that doctors have different skill and knowledge levels, and if you do