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The British Medical Association (BMA) has advised medical staff to take care when using social media channels, to ensure that their professional and personal lives do not meet.

There have been several cases where NHS staff have used Twitter and Facebook in an inappropriate manner, and have posted inappropriate photographs and comments which even included a member of staff who joked about her 'wine induced hangover' while at work.

The BMA has specifically warned doctors not to befriend current or ex-patients on social networks, in its new 'Using social media: practical and ethical guidance for doctors and medical students' manual. It said: Because of the power imbalance that can exist in any doctor-patient relationship, it is important that a professional boundary exists to maintain trust and protect patients from the possibility of exploitation.

The guidance is in the public's interest, and warns medical professionals not to share any patient's information. It is an illegal offence to break patient confidentiality, even online.

The BMA guidance advises: 'Even where doctors or medical students post anonymously and are confident that what they say will not breach patient confidentiality, they should consider how such comments will reflect on themselves as physicians or future doctors and bear in mind the potential impact they could have on the public's trust in the medical profession as a whole.'

The Nursing and Midwifery Council (NMC) produced similar guidance earlier this week, and warned that staff could be fired if their boss disapproves of any inappropriate use of social networking sites. The NMC recently estimated that there are now more than 355,000 nurses and midwives who actively use Facebook.

The NMC code of conduct warns its qualified staff : 'Uphold the reputation of your profession at all times.'  And it advises its students:  'Uphold the reputation of your chosen profession at all times.'  The NMC said that the code must also be respected in online behaviour.  And if it the code is not followed, then their careers will be at risk.

The NMC stated that its students and staff must not  'share confidential information online . Post inappropriate comments about colleagues or patients.  Use social networking sites to bully or intimidate colleagues. Pursue personal relationships with patients or service users. Distribute sexually explicit material. Use social networking sites in any way which is unlawful'.

The NMC has not banned the use of social networking, and said that it understands that its staff may want to engage in social networking. It advised: 'You could keep Facebook just for close friends and family, use Twitter for sharing information with people you may not know, and use LinkedIn for building and maintaining professional relationships.'

The NMC has an official Twitter account (@NMCnews) which has more than 1,300 followers, and it has more than 19,000 'likes' on its Facebook page.

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