Medical negligence Flashcards
Who regulates the GMC?
Professional Standards Authority
What is the GMC responsible for?
Overseeing and certifying the appropriateness of medical education
Also for ensuring that doctors are fit to practice – by publishing its ethical and professional guidance – Good Medical Practice
What sorts of things does the GMC guidance include?
Ethics
Professionalism
Professional Governance
The Law as it affects and governs medical practice
Confidentiality
Consent
Negligence
Record Keeping
Risk management, audit, peer review
Clinical governance
Referral of patients
Dealing with criticism and complaints
Working with colleagues, team working
The duty to report
The duty of candour
Continued professional development
Self appraisal and staying healthy
What is a disciplinary action?
When an employer raises a concern about employee performance or behavior.
It may come in the form of a verbal or written reprimand or the loss of employee privileges
What is a local complaint?
The least severe/ lowest level of complaint
It might be a complaint to local management (i.e GP practice management) or a ward complaint.
Why might a patient make a local complaint?
Error - treatment or results etc
Grief - drives a lot of complaints. Some need to assert blame somewhere
Poor understanding / explanation
Unrealistic expectations - doctor should understand patient’s expectations + respect them. Effective communication to make sure the patient doesn’t have unrealistic ones though
Failure to appreciate needs/wishes of patient - not listening
What must you do if a complaint is made about you?
You must reply to it and deal with it using the complaints procedure.
It is important to respond rationally as this could be quite crucial as to what happens next.
Engage with line managers etc early on about how to manage the complaint.
What are the most common reasons a doctor might face disciplinary action?
Breaking terms and conditions of service - breaching your contract
Job planning - not being on top of your work
Poor time keeping
Absence - not showing up for shifts etc
What is the appraisal system?
Appraisals measure your performance against previously-agreed goals, set future objectives and give staff guidance on their developmental and training needs.
You have an appraisal every year and a lot of issues are usually raised and dealt with during it. You must declare any complaints that have been made against you and discuss them.
If a complaint is made about you to the GMC who hears your case?
The Medical Practitioners Tribunal Service (MPTS) - this is separate to the GMC
If you are found to have been negligent by the GMC what sanctions may they impose?
Sanctions may be that you are more heavily supervised, restrictions on you (prescribing medication etc), suspension and maybe removed from the register.
Give some examples of misconduct that the GMC may investigate
Manner and attitude
Dishonesty
Sexual impropriety/misconduct
Criminal convictions
Health issues – drink driving/abuse of drugs/mental health
Significant Performance issues
What are some types of criminal allegations made against doctors? (5)
Indecent assault
Prescription fraud – prescribing to yourself or family members
Manslaughter – culpable homicide. Didn’t intent to kill someone but you did like a Road traffic accident
Murder
Deception offences – not declaring private incomes etc, fraud
Examples of civil law cases
Family disputes, such as divorce, dissolution of civil partnerships, children’s issues and childcare arrangements
Personal injury cases, such as RTA’s, medical and clinical negligence and slips, trips and falls
Breach of contract or promise, such as cases where money is unpaid or a contract isn’t honoured
Employment law, for example where an employee suffers discrimination
Where will criminal cases be heard?
Magistrates’ court or the crown court (England)
High court of Justiciary (Scotland)
Define medical negligence
A lack of reasonable care and skill as a result of which the patient suffers
In medical negligence, the monetary reward will reflect what?
The financial loss suffered by the patient and not the degree of negligence exhibited
What is the first thing a solicitor will look at to work out whether a doctor has been negligent?
The solicitor will question whether that doctor has a duty of care for the other person.
The answer to this is yes
What is the 2nd thing a solicitor will look at to work out whether someone has been negligent?
The idea of whether the doctor acted in reasonable care and skill.
Has the doctor breached their duty of care?
To find this out, a solicitor would explore whether any other competent doctor of ordinary skill in that field would act in the same way? (This comes from the Hunter v Hanley case)
Bolam test
Assesses what the appropriate standard of care should have been in cases of medical negligence
The medical professional must demonstrate that they acted in a way that a responsible body of medical professionals in the same field would regard as acceptable or reasonable.
Look
It is not sufficient to raise a claim due to negligence alone, if the outcome would have been the same in any event (e.g. the administration of the wrong dose of a drug which fortunately has no ill effects).
ie if drug had been administered at correct dosage - no ill effects
administered at wrong dosage - no ill effects
Examples of losses leading to compensation in a civil case?
Loss of earnings
Expenses incurred – may have to reequip house – disability friendly etc
Impaired enjoyment of life – difficult to prove
Permanent incapacity
Procreative incapacity
Pain and suffering endured
Death
What happens when an aggrieved patient states his complaint to his solicitor?
If the solicitor believes the allegations to have substance, represents the complaint to the doctor (and co-defenders) in writing, demanding financial reward for damages.
The doctor immediately puts the affair in the hands of their legal representatives (Defence Organisation, Health Authority etc)
What are the possible outcomes of a legal battle regarding a medical negligence claim?
It can be settled ‘out of court’ - both parties come to an agreement.
Proceed through the Civil Courts before a judge (sheriff court)
What are some lines of defence in a medical negligence case?
Deny the charge
True facts but not the pursued doctor’s fault, or vicarious liability
Patient took a risk – consented procedure is important. If you explain fully the risk factors and patient understands them + gives consent then you can’t be held liable.
Contributory Negligence - claimant’s own negligence contributed to their loss or damage
Define vicarious liability
Where a person can be heldliablefor the actions of another person (e.g. Health Board can be held responsible for the actions of the doctor)
