Medico Legal

Doctors are increasingly expected to provide patient care in unsafe environments, where a persistent culture of blame stifles learning and discourages innovation. That is the conclusion drawn from a BMA survey: part of an ambitious project aiming to find solutions to the challenges faced by the NHS.
The project – Caring, Supportive, Collaborative – has seen almost 8,000 doctors provide accounts of their working lives across the NHS. It will go on to look at how working life can be improved.

BMA council chair Chaand Nagpaul said: “It is vital that the government and policymakers heed the views of all doctors who provide care at the coalface; they are in the best place to know the problems the NHS faces on a daily, hourly basis.

“They know the scale of impoverishment in the NHS is staggering and they are working in a culture which has improved little since the publication of the Francis and Berwick reports following the tragedies in Mid-Staffordshire five years ago.”

Confirmation that Health Secretary Jeremy Hunt is to launch an initiative to reduce prescribing and medication errors in the NHS was met with a mixed response from bodies representing the pharmacy sector.

The move was confirmed by Pharmacy Minister Steve Brine MP in his speech to the Royal Pharmaceutical Society’s annual conference in September. Mr Brine said that studies currently indicate that up to 8% of prescriptions have a mistake in dosage level, course length or medication type.

He said: “Patient education and safe management of information will be at the heart of our efforts to tackle this serious issue. For example, we will need to improve how we use electronic prescribing, as well as how we transfer information about medicines between care settings, where there is significant scope for errors.”

Health Secretary Jeremy Hunt has accepted the findings of Professor Sir Norman Williams’s review of the use of manslaughter gross negligence charges against doctors. The review was commissioned by Mr Hunt in February, prompted by the conviction of Dr Hadiza Bawa-Garba following the death in 2011 of a six-year-old boy in Leicester.

The conviction caused an international furore, with the president of the Australian Medical Association in New South Wales commenting: “How on earth was the doctor convicted of manslaughter? We don’t understand it.”

New Government proposals for fixing legal fees in medical negligence cases have been given a cautious welcome by lawyers.

The proposals, currently out to consultation, are for a fixed cap on all clinical negligence cases up to £25,000. The aim, says the Department of Health, is to prevent rising litigation costs within the NHS. Currently, there is no limit on legal costs that can be recouped. It is expected the new cap will save the NHS up to £45m a year.

The department cites an instance where costs of £83,000 were claimed for a case in which the patient was awarded £1,000. The total bill for the NHS was £1.5bn in the financial year 2015-16.

Announcing the proposals, Health Secretary Jeremy Hunt (pictured) said: “It’s important that, when significant mistakes happen in the NHS, patients are able to have an open dialogue with a trust about what went wrong, receive reassurance of what is being learnt and can discuss what form of recompense or redress may be appropriate. Legal action should only be one part of this process.