PLAB 1 NHS Protocols & Professional Practice

Question 1

A patient under your care develops a serious unexpected complication after surgery that may have been caused by a system failure. What is the most appropriate action under NHS duty of candour?

Accepted Answer

Be open and honest with the patient and family, acknowledge what happened, offer an apology, provide information about any investigation, and explain what steps are taken to prevent recurrence

Answer

Duty of Candour (statutory for NHS organisations under regulation 20 of the Health and Social Care Act 2008, and a professional duty for individual practitioners under GMC Good Medical Practice) requires openness, honesty, and transparency when something goes wrong that causes or may cause harm, including a meaningful apology.

Question 2

According to the GMC's Good Medical Practice, what are the four domains of Good Medical Practice?

Accepted Answer

Knowledge, skills, and performance; safety and quality; communication, partnership, and teamwork; maintaining trust

Answer

GMC Good Medical Practice is organised around four domains: (1) Knowledge, skills, and performance; (2) Safety and quality; (3) Communication, partnership, and teamwork; (4) Maintaining trust. All registered doctors must meet the standards in all four domains.

Question 3

A 14-year-old discloses during a consultation that she is being physically abused by a parent. She asks you to keep it confidential. What should you do?

Accepted Answer

Explain that you cannot guarantee confidentiality in child protection matters, and refer to the child safeguarding team — child protection takes priority over patient confidentiality

Answer

Child safeguarding must take priority over patient confidentiality. NICE, GMC, and Working Together to Safeguard Children guidance require healthcare professionals to refer safeguarding concerns. Confidentiality can be breached when there is serious risk of harm to a child. You should explain to the child what you must do and why.

Question 4

A foundation year doctor prescribes a medication and realises they have made an error that has not yet reached the patient. What should they do?

Accepted Answer

Report the error through the hospital incident reporting system, inform the supervising consultant, document the near-miss, and take steps to prevent recurrence

Answer

Near misses and errors should be reported through the hospital incident reporting system (e.g., Datix). The supervising consultant must be informed. Near-miss reporting is a key patient safety mechanism that allows system improvements. GMC guidance requires openness and honesty about errors.

Question 5

Which of the following best describes the GMC's guidance on social media use for doctors?

Accepted Answer

Doctors must maintain professional standards, protect patient confidentiality, clearly identify themselves as doctors where relevant, and not post anything that could bring the profession into disrepute

Answer

GMC guidance on social media: maintain professional boundaries, protect patient confidentiality (even with apparent anonymisation), treat people with respect, do not make misleading statements about treatments, and maintain standards regardless of the platform. Even personal accounts reflect on the profession.

PLAB 1 Practice Test

PLAB 1 Practice Test

PLAB 1 NHS Protocols & Professional Practice