Negligence Flashcards
How are mistakes categorised in the NHS?
1 - By harm experienced.
2 - By harm potential.
3 - By degree of learning opportunity.
What are the categories of mistakes in the NHS?
1 - Serious incidents where a patient dies due to an avoidable event.
2 - An unexpected or avoidable injury.
3 - Actual or alleged abuse.
4 - A ‘never event’, an incident which prevents the organisation from providing an acceptable level of care.
5 - Major loss of confidence in the service.
According to the NHS serious incident framework, what defines a ‘serious incident’?
1 - The incident demonstrates weaknesses in the system.
2 - The incident reveals a need to prevent further harm.
*Not limited to a set list.
According to the NHS serious incident framework, what defines a ‘near miss’?
An incident where potential harm is avoided but weakness is still revealed.
According to the NHS Never Event Policy and framework, what defines a ‘never event’?
1 - A serious incident that is wholly preventable.
2 - An incident where national guidance / safety recommendations should have been employed.
List 2 examples of a ‘never event’.
1 - Wrong site surgery.
2 - Prescribing errors.
What is a root cause analysis and what stages might it include?
- A systematic process for identifying ‘root causes’ of problems or events, and an approach for responding to them. Can include:
1 - Concise internal (occurs between a few individuals within 60 days).
2 - Comprehensive internal (occurs within the MDT within 60 days).
3 - Independent investigations (occurs externally within 6 months).
What is the duty of Candour?
- GMC:
- “Every healthcare professional must be open and honest
with patients when something that goes wrong”
What is the purpose of a duty of Candour?
1 - Transparency enhances confidence.
2 - Protects against abuse.
3 - Empowers the MDT to speak up.
4 - Learning vs blaming.
What is the difference between guilt and shame?
Guilt focuses on behaviour, whereas shame focuses on oneself.
What is negligence?
A breach of a duty to a patient that causes the patient harm.
Give 2 examples of tests used to assess medical negligence.
Bolam and Bolitho tests.
What is the difference between the Bolam and Bolitho test?
Bolam: States that if a doctor has acted according to proper and accepted practice, he is not guilty of medical negligence.
Bolitho: States that a doctor’s defence cannot be considered reasonable if the body of doctors or supporting witnesses are not capable of withstanding logical analysis (if the management was not demonstrably reasonable).
What must be proven in order to confirm medical negligence?
- Harm has to be proven to be forseeable, not just an accident.
- Patient has to prove causation (any other explanation for the harm they suffered?).
What is gross negligence?
Give an example of a case that involved gross negligence.
- A conscious and voluntary disregard of the need to use reasonable care.
- This is criminal wrong-doing (as opposed to clinical negligence which is civil wrong-doing).
- e.g. Adomoko case.
