Mistakes, Complaints, Referrals
Mistakes happen to everyone. It can be really difficult to deal with this, both as the person directly involved, or as a witness, and both personally and practically. The aim of this document is to help with some of the practicalities, anxieties, and questions that are raised.
This article will cover:
The Royal College of Surgeons has produced an excellent guide for trainees and trainers supporting surgeons following adverse events:
Disclaimer: this article is not meant to constitute legal advice and that the advice of an independent legal adviser or defence union should always be sought.
1. Mistakes and learning from them
Mistakes happen to everyone and it is important to own, reflect and learn from them. Below are some tips on how you and the Deanery can learn from them constructively:
Discuss with your CS/AES
The first port of call for discussing cases and situations you felt were difficult is with a trusted senior colleague. This will hopefully be your CS or AES, but if not, any trusted
member of staff can help you to understand the learning points from a case productively and avoid excessive or unnecessary self-doubt or self-confidence. The RCS/Bournemouth University have produced a really good structure that can be used for these meetings:
Duty of Candour applies in circumstances affecting patients:
2. Complaints
This excellent podcast “Complaints and How to Survive Them” provides a great overview and some real experiences:
https://youarenotafrog.com/episodes/78/
Responding to a complaint
When you receive a formal complaint, it is important to take some simple first steps:
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Never submit a formal response without getting your indemnity insurer to review it first
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Seek senior input regarding this from the start
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Contact your defence union
Here is some advice about responding to complaints:
MDU: https://www.themdu.com/guidance-and-advice/guides/how-to-respond-to-a-complaint
BMA: https://www.bma.org.uk/advice-and-support/complaints-and-concerns/complaints/dealing-with-complaints-made-against-you-personally
MPS: https://www.medicalprotection.org/newzealand/casebook/casebook-may-2014/responding-to-complaints
3. Clinical Negligence
Unfortunately, there may be times when you may be contacted by the Trust's Solicitor about allegations being made against the Trust regarding a case where you have been
directly or indirectly involved. This may occur years after the event in question.
Tips:
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Speak to your medical defence union/indemnity insurer as early as possible to provide advice.
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Speak to the other clinicians / consultants involved with the case as you are going through the process together.
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The process moves very slowly (years). Take your time drafting a statement and send it to your defence union.
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The defence union will help to improve the quality of your statement by questioning poking holes (often known as stress testing) in your statement. This is a frustratingand difficult process but is worthwhile persisting with and certainly prepares for any cross examination of your evidence should a matter come to Court.
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This experience frequently provokes a range of emotions; whether it be anger, frustration or guilt. It is important to understand these but they shouldn’t bias yourstatement. Stay as objective as possible.
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The vast majority of cases are settled rather than attending court. However, if it proceeds to court you are given significant advanced warning and can submit dates for which you are not available.
This article gives an introduction on clinical negligence and has links about the steps of the process:
https://www.themdu.com/guidance-and-advice/guides/introduction-to-clinical-negligence
Listen to this Podcast on clinical negligence from the MDU:
https://www.themdu.com/-/media/files/mdu/podcasts/clinical%20negligence.mp3
A Glossary of legal terms related to clinical negligence:
https://www.themdu.com/guidance-and-advice/guides/glossary-of-legal-terms
4. GMC referrals
Throughout the course of your training (and career) you may receive a letter/email informing you that a GMC referral has been received about you. Alternatively, you may have been advised to self-refer by your defence union. This can be scary but below is a list of important points to consider and help you navigate the process as calmly as possible.
What happens?
Here is the GMC’s summary of what to expect if a referral is made or you self-refer:
Doctors Defence Service provides an excellent series of articles covering all aspects of a possible GMC investigation as well as recommending some legal services:
https://doctorsdefenceservice.com/remediation/
5. Support
It is really important to discuss your anxieties, fears and emotions with a trusted colleague. This can be informal and does not need to be documented in any way.
Doctor’s Support Group. Aims to provide support and assistance for medical professionals facing suspension, exclusion, investigation of complaints and/or allegations of professional misconduct.:
https://doctorssupportgroup.com/
BMA Doctor Support Service:
6. Edits / updates / improvements?
These support / welfare articles require constant updating to reflect the changing world of the modern Orthopaedic trainee.
If you have any edits / updates / improvements for this article please email them to:
wins@bota.org.uk
Thank you for your support.
Original article by Robyn Brown.
Adapted for BOTA by Florence Shekleton.