By Lisa Cheyne, Medico-Legal Manager, SpecialistInfo
Image © Tero Vesalainen
By Lisa Cheyne, Medico-Legal Manager, SpecialistInfo
GMC Response to the Case of Dr Bawa-Garba
The GMC has asked Dame Clare Marx, Chair of the Faculty of Medical Leadership and Management, to lead the independent review to explore how gross negligence manslaughter cases, such as the recent investigation involving Dr Hadiza Bawa-Garba, are initiated and investigated in the UK.
Dame Clare said: ‘Each step of the process will be explored from local investigations post incidents, to diversity matters surrounding the doctors subject to investigation and whether regulatory processes at the GMC could be improved in such cases.
‘Doctors are often working in an immensely pressurised system where mistakes can happen. This work will be valuable for the medical profession and I am pleased the GMC has decided to take this work forward.’
Charlie Massey, Chief Executive of the GMC, said: ‘As well as addressing the issues with criminal prosecutions a further aim of this review is to encourage a renewed focus on enabling a learning, no-blame culture, reflective practice and provision of support for doctors in raising concerns.’
The GMC aims to complete the review by the end of the year.
On the 28th of March, leave was granted by the Right Honourable Lord Justice Simon to take Dr Bawa-Garba’s case to the Court of Appeal stating: “The grounds meet the second appeal test in all respects”.
See: https://www.gmc-uk.org/news/31576.asp
Drug errors in England cause unacceptable levels of harm and deaths
A government commissioned study by researchers at Manchester, Sheffield and York universities has concluded that GPs, pharmacists, hospitals and care homes may be making 237 million errors a year.
The study said most errors caused no problems, but in more than a quarter of cases the mistakes had the potential to cause harm. Drug errors are likely to be a factor in more than 22,000 deaths a year.
The mistakes include:
Health Secretary, Jeremy Hunt, said last month: "We are seeing four to five deaths every single day because of errors in prescription, or dispensing, or the monitoring of medications."
He added that the study was not about blaming NHS staff, but about creating a culture where checks were in place to stop errors happening.
A fifth of the mistakes related to hospital care, including errors made by doctors administering anaesthetic before surgery, with the rest being split between GPs and care homes.
The initial plan is to allow hospitals to access prescribing data collected by an admitted patient’s GP for patients being treated for gastro-intestinal bleeding. To check, for example, if a patient has been taking a non-steroidal anti-inflammatory drug without gastroprotection. The system will be extended to other conditions in the future.
The Department of Health and Social Care believe the roll out of electronic prescribing systems across more hospitals could reduce errors by 50%.
A change in the law is being introduced that will mean pharmacists will not be prosecuted for owning up to genuine mistakes, so that the NHS can learn from these errors.
Full report can be accessed here: http://www.eepru.org.uk/article/prevalence-and-economic-burden-of-medication-errors-in-the-nhs-in-england/
MoJ unveils sweeping PI reform in expanded Civil Liability Bill
Lord chancellor, David Gauke, announced reforms to the Civil Liability Bill on 20 March, which will contain not only reforms to whiplash claims but also changes to the way the discount rate applied to personal injury settlements is calculated.
‘The number of whiplash claims has been too high for too long, and is symptomatic of a wider compensation culture,’ said Gauke. ‘We are putting this right through this important legislation, ensuring whiplash claims are no longer an easy payday and that money can be put back in the pockets of millions of law-abiding motorists.’
Fixed amounts will be set for compensating whiplash claims, and seeking or offering to settle whiplash claims without medical evidence will be banned.
Online private GP safety still not acceptable
The Care Quality Commission has been investigating the private online GP market since November 2016, inspecting 55 companies running services in England. After its inspections this February 40% were not providing ‘safe’ care in accordance to the relevant regulations. However, the inspectors said this was an improvement on their findings a year ago when 86% were not meeting the required standards.
After its recent inspections, five online GPs stopped trading and 13 were found to be in breach of safety standards.
The CQC highlighted problems with prescribing drugs and carrying out checks on patients including cases where:
The CQC also warned there is a gap in its inspection system, as it can only look at firms that are based
in England and are offering services to English patients. It has restated its commitment to work with the Department of Health and Social Care and with its partners outside of England to close the gaps in the regulation of online services that fall outside of CQC’s remit.
Prof Steve Field, CQC chief inspector of general practice, said online services have a "huge potential". But he added: "While innovation should be encouraged, it must never come at the expense of quality."
Full report can be accessed here:
http://www.cqc.org.uk/news/releases/signs-improvement-some-concerns-remain-regarding-providers-online-gp-services
Trust liable for hypoxic birth injury and psychiatric injury caused to mother and grandmother in landmark case: RE (a minor) v Calderdale & Huddersfield NHS Foundation Trust [2017] EWHC 824 (QB) (High Court, 12 April 2017 – Goss J)
In a landmark hypoxic birth injury case, involving Calderdale & Huddersfield NHS Foundation Trust, the High Court awarded damages for Post Traumatic Stress Disorder to two “secondary victims” (the mother and grandmother) caused by the index event.
Judge Goss found that the infant had suffered from a shoulder dystocia following crowning of the head and had become stuck. As a result of the failure of the midwife to recognise this, she suffered a hypoxic insult caused by a negligent delay in delivery.
In relation to the psychiatric injury claims, Goss J accepted that the mother was a primary victim and was entitled to damages for her injury. This was on the basis that at the point at which the negligence occurred, and the onset of the condition (PTSD), the infant was not a legally separate entity from her mother, still being in the birth canal.
She was also a secondary victim (as was the grandmother) and satisfied not only the Alcock criteria but also the new criterion set out in Ronayne v Liverpool Women’s Hospital NHS Foundation Trust [2015] PIQR P20, that there must be a sudden appreciation of an objectively horrifying event. Goss J found that the sight of the baby satisfied that criterion. Judgment was accordingly entered for all three claimants.
The case has potentially powerful implications for secondary victim claims in a clinical negligence setting, as this is one of only very few reported cases where such claims have succeeded.
https://high-court-justice.vlex.co.uk/vid/hq14x01554-677397069
The Future Direction of Alternative Dispute Resolution (ADR)
A workshop was held on 6 March this year to obtain practitioner and service provider views on a new approach to ADR. About 70 delegates attended, representing not only the judiciary, practitioners and mediators, but also service providers, NHS Resolution (the re-named NHS Litigation Authority) and HMCTS. Unmet needs were identified including clinical negligence – building on the existing NHSR Mediation Pilot but including arbitration. And, following a significant intervention by Andrew Ritchie QC, separating liability from quantum to facilitate earlier resolutions.
The place of online solutions to enable ADR was discussed for the predicted increase in litigants in person (LiPs) using the system after the increase in the personal injury small claims limits in April 2019. This could be bad news for experts working in the personal injury sector, who may find their instructions dry up in 2019.
Read more at: https://www.lawgazette.co.uk/comment-and-opinion/adr-at-a-turning-point/5065313.article
NHS failing patients with mental health problems
Vulnerable patients with mental health conditions are being badly let down by the NHS, causing them and their families needless suffering and distress, according to a Parliamentary and Health Service Ombudsman report published in March.
The Ombudsman has also found that NHS mental healthcare staff can lack the capacity, skills and training they need to do their job effectively, and do not always have the support they need to learn from mistakes.
Following an analysis of over 200 mental health complaints upheld by the Ombudsman, the report highlights five common failings that are compromising patients’ safety and dignity:
• Failure to diagnose and/or treat the patient
• Inappropriate hospital discharge and aftercare of the patient
• Poor risk assessment and safety practices
• Not treating patients with dignity and/or infringing human rights
• Poor communication with the patient and/or their family or carers
Full report available at: https://www.ombudsman.org.uk/news-and-blog/news/nhs-failing-patients-mental-health-problems
SpecialistInfo Expands the Faculty of Expert Witnesses (the FEW)
The Faculty of Expert Witnesses (the 'FEW') promotes high quality expert witnesses to law firms and insurance companies. All grades are expected to adhere to specified standards of good practice covering compliance, availability and service by conforming to a Code of Good Practice.
Associates (AFEW) are Consultants and GPs who:
• Have their Medico-Legal CV listed on SpecialistInfo
Members (MFEW) are Consultants and GPs who in addition:
• Have undertaken appropriate Medico-Legal training and agreed to undertake CPD training every 3 years so that they are consistently up to date with all the latest rules and procedures.
Fellows (FFEW) are Consultants and GPs who inaddition:
• Have satisfied SpecialistInfo’s lawyers as to the quality of their reports, including presentation and compliance with Civil Procedure Rules, by submitting an anonymised sample report for review
Subscribers to the Specialistinfo.com Medico-Legal Section can search for the contact details of over 10,000 expert witness doctors and see whether they are FEW Associates, Members or Fellows.
Please contact emma@specialistinfo.com for subscription information.
Published by: