Medico-legal

Question 1

what does the NHS litigation Authority do?

Answer 1

Manage negligence and other claims against the NHS in England since 1995

Question 2

Why are patients more likely to make claims now?

Answer 2

There is an increase in public awareness of the legal system

Belief that sub-optimal outcome is the fault of another

opportunity for a financial settlement

Question 3

in 2018/9 what percentage of claims did Radiology account for ?

Answer 3

4%

Question 4

radiology claim areas

Answer 4

ultrasound - detection of abnormalities and image reporting

interventional procedures

medical imaging interpretation

Informed consent - IV contrast

incident reporting

working outside scope of practice

Question 5

expectations of a radiographer

Answer 5

working within scope of practice

understanding and adhering to policies and procedures e.g. IR(ME)R

Question 6

Patients Rights (NHS Constitution Jan 2021)

Answer 6

Patients have the right to complain, the right to informed consent, the right to reasonable standard of care, the right to acknowledgement, explanation and apology when mistakes occur, the right to give or withhold consent and receive information

Question 7

HCPC (standards of proficiency for Radiographers 2013) states

Answer 7

Radiographers must work within their scope of practice

They must maintain fitness to practice and a safe working environment

understand the importance and obtain informed consent

be aware of current legislation related to their work

Practice within the legal and ethical boundaries of profession

Question 8

Society of radiographers (code of professional conduct 2013) states

Answer 8

radiographers have accountability for the quality of the compassionate care and treatment they offer.

Radiographers must work within legal, ethical and governance frameworks concerning their role.

Question 9

Duty of care

Answer 9

the obligations placed on people to act towards others in a certain way in accordance to standards.

practitioner is responsible for the patient’s care

Question 10

standards if care

Answer 10

the degree of care that a person is expected to exercise in a particular circumstance or role.

Question 11

what documents outline radiography standards

Answer 11

standards of proficiency and code of conduct

Question 12

Tort

Answer 12

is the unintentional violation of another person’s rights, usually due to negligence

Question 13

Tort is subject to….

Answer 13

civil action and judgement for payable damages

Question 14

Clinical negligence (Tort law)

Answer 14

This is applied when a patient has been harmed by medical care, where the practitioner has failed to take reasonable care.

Question 15

5 requirements for negligence

Answer 15

1. the defendant owed the claimant a duty of care
2. the defendants performance was below the expected standard
3. The injury was caused by the breach of duty of care
4. Demonstration of actual harm as a consequence of the HCP departure from standards of care

Question 16

5 requirements for negligence

Answer 16

1. the defendant owed the claimant a duty of care
2. the defendants performance was below the expected standard
3. The injury was caused by the breach of duty of care
4. Demonstration of actual harm as a consequence of the HCP departure from standards of care
5. Foreseeability: HCP would be able to predict the harmful consequences of action

Question 17

what is negligence?

Answer 17

when a patient is harmed by medical care in circumstances where a practitioner or organisation has failed to take reasonable care.

Question 18

examples of negligence

Answer 18

working outside of scope of practice

failure to document

failure to communicate

failure to assess/monitor/follow up

misdiagnosis

not following protocol

failure to use equipment responsibly

failure to obtain informed consent from the patient

institutional unsafe practice

Question 19

Avoiding negligence

Answer 19

Adhere to clinical guidelines, policies and procedures

work within scope of practice

Have high level of communication skills

obtain informed consent

accurate documentation

CPD and training courses

Question 20

Accountability

Answer 20

An obligation or willingness to accept responsibility for one’s actions

Question 21

Arenas of accountability

Answer 21

PUBLIC, PATIENT, EMPLOYER, PROFESSIONAL

Question 22

public arena accountability

Answer 22

criminal law and criminal courts

Question 23

Patient arena of accountability

Answer 23

civil law and civil courts

Question 24

professional arena of accountability

Answer 24

Code of conduct, HCPC (fitness to practice) and SOR

Question 25

Employer arena of accountability

Answer 25

Contract of employment

tribunal

Question 26

what is consent?

Answer 26

The voluntary decision of a competent patient to undergo any form of medical intervention

Question 27

what is the meaning of competence

Answer 27

the ability to understand and weigh up relevant information and communicate a decision

Question 28

Elements to consent

Answer 28

• must be given voluntarily
• person needs legal capacity
• should be informed - provide information
• must be specific
• patient advocacy

Question 29

consent - mental capacity act 2005

Answer 29

All adults are presumed to have sufficient capacity to decide on their own medical treatment, unless there’s significant evidence to suggest otherwise.

Question 30

consent - legislation

Answer 30

Gillick Competence

mental capacity act 2005

Question 31

consent Gillick Competence

Answer 31

The ability to give valid consent will depend on a child’s maturity and ability to understand what the treatment involves

Question 32

impaired capacity

Answer 32

patient is not able to understand the information relevant to the decision

• they are unable to retain information
• Pt is not able to weigh the information as part of the process of making the decision
• Pt is not able to communicate his or her decision