Management station

Question 1

NHS values

Answer 1

1. working together for patients - pt first
2. respect and dignity - value every person, seek to understand priorities needs, abilities and limits
3. committment to quality of care - striving for safety effectiveness and pt experience
4. compassion - respond with humanity and kindness
5. improving lives - health and wellbeing
6. everyone counts - max resources for benefit of whole, no exclusion/discrimination

Question 2

Duties of a doctor

Answer 2

1. knowledge, skill and performance
2. safety and quality
3. communication, partnership and teamwork
4. maintaining trust

Question 3

Definition of clinical governance

Answer 3

“framework through which NHS organizations are accountable fo rcontinually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”

— your own words
- quality assurance process
- designed to ensure standards of care are maintained and improved
- NHS is accountable to the public
-

Question 4

Escalating sickness/one colleague down

Answer 4

• reg on cal
• cons on call
• site manager

Question 5

Escalating mental health issues colleague

Answer 5

Suggest they contact
- ES
- OH
- GP
- psych if applicable
- programme director - if explored the above and may need time away from training

Question 6

Escalation/advise for colleague immediate risk to pt

Answer 6

• senior colleague
• medical indemnity
• ES (later)
  keep ppl to a minimum

Question 7

Outcome of escalating risk to pt (i.e alcohol)

Answer 7

• professionalism meeting with CS
• decision to escalate is by consultant CS
• outcomes = formal warning, referral to GMC for review and/or suspension
• referral to appropriate services - psych/addiction support

Question 8

issues with missing pt notes

Answer 8

• confidentiality
• duty of candour
• patient safety

Question 9

Define duty of candour

Answer 9

open and hones w/ pts about problems encountered

Question 10

what duty of candour if missing notes

Answer 10

• notify pts + appology
• try to locate notes - minimize risk
• inform site manager + pt consultant = aware of complaints/ aware of breech + aware if notes haven’t been backed up

Question 11

support for you if make an error

Answer 11

• medical indemnity
• BMA
• ES
• medical defense lawyers

Question 12

situations where breach of confidentiality is allowed without consent

Answer 12

• required by law - court order/police officer
• justified in public interest - protect pts and others from serious harm/death
• sharing info w/ HCPs involved in their care
• disclosure to statutory regulatory body - GMC
• tx of children or incompetent adults
• abuse or neglect of incompetent persons

Question 13

Issues raise by bullying

Answer 13

unaccesptable and no place – RCS and GMC guidelines

Detrimental effects on individuals in team:
- impact on clinical performance and motivation
- incr rate of staff sickness
- incr employee turnover

Above impact patient care

Question 14

Escalating bullying by senior

Answer 14

• escalate to ES who should aid in raising complaint formally
• log instances of bullying
• encourage other people being bullied to raise complaint
• escalation depends on hospital - may be a antibullying lead, check with HR; BMA provides advice

Question 15

Escalate unavailable senior

Answer 15

• higher on call (cons)
• site manager - suggest other methods of contact
• ensure all jobs in your capacity are done/stablize pt/prepare pt fot treatment

Question 16

shoudl do procedure?

Answer 16

no bc lack of experience
- pt safety - harm or not benefit
- medicolegal - GMC/malpractice

Question 17

Bad news - delayed surgery

Answer 17

• Environment - private, free from distraction (leave bleep with colleague if possible)
• Support - nurse may be useful
• Patient’s knowledge of the situation
• explain - (i.e life threatening cases take priority)
• sincere apology on behalf of surgical team
• pause to process
  -listening
• empathetic statements
• offer solution if possible
• offer support - analgesia, abx

Question 18

5 steps of audit

Answer 18

1. planning - local/national standards and write proposal approved by consultant or reg with audit department
2. collect and analyse data
3. feedback findings - local clinical governance meeting
4. implement change
5. re-revaluate

Question 19

Escalating no beds unwell patient

Answer 19

• surgical reg = aware; review unwell pt; discuss if pts can be safely discharged
• bed manager and clinical site manager = other beds/escalation beds
• A&E nurse in charge = ensure suitably monitored until situaton is resolved

Question 20

Patient wants to make formal complaint

Answer 20

• try to resolve informally
• inform has every right to make formal complaint
• through PALS
• ensure pt knows it won’t affect the care they receive
• inform your consultant - aware of situation

Question 21

What is PALS

Answer 21

• patient advice and liaison service
• 3rd party (separate from hospital workings)
• service for patients, families and carers
• offer advice and support => answer health-related questions, resolve concerns and aid in writing formal complaints

Question 22

Guidelines about consenting pts for surgery

Answer 22

GMC - person taking consent must
- suitably trained and qualified
- sufficient knowledge of the proposed investigation or treatment, understands risks involved
- understands and agrees to act in accordance with the guidance in good medicalpractice

Question 23

Escalate being asked to consent a patient you don’t know how to

Answer 23

• the reg/consultant who asked you – explain outside of scope, offer to assist/learn to consent in future
• offer to aid in other jobs to manage workload