The GMC's 'Good medical practice' is also clear that, "You must recognise and work within the limits of your competence."

Although the patient offered assurances that their overseas surgeon is happy to give advice, a UK-based GP would leave themselves open to criticism by relying on advice from a specialist based overseas. As the provider is based in another country, they are not subject to the same regulatory requirements as doctors in the UK and work to different guidelines. There might also be language barriers that would make shared care inappropriate and unsafe.

Taking the above points into account, a GP without the support of a UK-based bariatric specialist could struggle to justify why they took on monitoring for a complex patient if something went wrong.

The MDU adviser suggested the GP liaise with their CCG and bariatric services to see if they would take over the specialist follow-up for this patient, even though the surgery was not performed in their unit. This would mean the GP could access local, specialist advice, such as whether to organise blood tests and advice on any problems encountered in the patient's general care.

Private/NHS interface

Patients entitled to NHS treatment can switch from private treatment to NHS care as long as that treatment is supported by the NHS. However, many patients who opt for surgery abroad do so because they don't meet the criteria for bariatric surgery funded by the NHS, meaning they may not qualify for NHS funded bariatric follow-up care.

It's advisable for GPs in this situation to check what the situation is with their CCG. It would also be appropriate to ask the CCG to confirm their decisions in writing, so that if the patient is advised to self-fund private follow-up, the GP can demonstrate that they did explore the options for NHS care.

Monitoring a patient after bariatric surgery abroad

Managing conflict between doctors and patients

Monitoring a patient after bariatric surgery abroad