On 17 April 2020, the Health Professions Council of South Africa provided its latest COVID-19 guidelines to registered practitioners. The guidelines were circulated to registered practitioners via e-mail – as at the date of publication of this article, the guidelines are yet to be published on the HPCSA’s website www.hpcsa.co.za

The HPCSA acknowledges that the healthcare system will need more practitioners for an effective response to the pandemic, which may lead to practitioners being called upon to practise outside the scope of their professions.

As a result, the guidelines state that ‘some adjustments in the application of Ethical Rule 21’ are warranted.

Ethical Rule 21 states that a practitioner must perform, except in an emergency, only a professional act:

  1. for which he or she is adequately educated, trained and sufficiently experienced; and
  2. under appropriate conditions and in appropriate surroundings.

However, apart from recognising that ‘practitioners may be called upon to perform professional acts which are outside the scope of their professions or specialities’, the guidelines do not specify with any particularity, what adjustments are to be made to the rule. The guidelines simply state that when practitioners are called upon to perform acts outside the scope of their professions or specialities, ‘consideration should be made by individual practitioners as to their ability to perform such professional acts with reasonable skills and safety based on their education, training and experience’.

It appears that the enforcement of the rule will be relaxed in cases where practitioners act outside the scope of their profession or speciality if, in doing so, they act with reasonable skill and care.

Practically speaking, the relaxation of the rule is probably most applicable to medical specialists. In terms of the Regulations relating to the specialities and sub-specialities in medicine and dentistry, a medical or dental specialist must confine their practice to the speciality, related speciality, or sub-speciality in which they are registered. The relaxed rule would allow obstetricians, for example, to assist in general medical care of patients who would otherwise not receive that care in an overburdened healthcare system.

The relaxation of the rule is a proactive step by the regulator.

Some other noteworthy points mentioned in the guidelines are:

  • The HPCSA will not act against practitioners who do not submit their Continuous Professional Development (CPD) portfolio or meet expected CPD requirements while the pandemic persists.
  • Institutions of higher learning should put measures in place to compensate for lost undergraduate training time.
  • Activities related to the registration of practitioners with the HPCSA are considered essential services, and practitioners should continue to submit their applications for registration electronically. However, practitioners registered during this period will receive a curtailed registration status expiring on 31 March 2021. After the lockdown, applicants will be required to submit original documents which, once verified, will convert the practitioner’s registration status to permanent. This does not apply to foreign qualified practitioners, whose applications for registration will only be attended to after the lockdown.
  • The revised telehealth guidelines are still applicable until further notice.
  • The HPCSA will continue to process complaints received from members of the public against practitioners, but the extraordinary conditions under which practitioners are working as a result of the pandemic will be considered when complaints are handled. All professional conduct inquiries and contact mediations are suspended until the lockdown is lifted.
  • The HPCSA’s governance structures are continuing to function and conduct meetings using virtual platforms during the lockdown period. There may, however, be delays in processing matters.