Advisory services
The advisory team continues to grow from strength to sanctions, offered by Responsible Officers(normally also trust
strength. We become ever busier as your needs, as members, Medical Directors), for concerns which were not of themselves
keep pace with the ever-increasing complexity of the serious enough to call into question a doctor’s fitness to
medico-legal environment in which we work. We have practise, but which would nevertheless be viewable by the
recruited a number of additional medico-legal advisers to general public. There was no evidence to show that the
equip us with the means to continue to provide you with the proposed Recorded Concernswould involve a proper
high standard of service you are entitled to expect. independent investigation with a right of representation &
One of the major new changes affecting us has been the
response and other important procedural safeguards. The
introduction, earlier this year, of the new NHS patients’
MDU argues on behalf of its members that anyformal adverse
complaints procedures. The new procedures have introduced a
comment made available to the public could have a serious
‘slimmed down’ two-stage process with a focus on the local
detrimental effect on a doctor’s reputation and future career
resolution of complaints and recourse to the Health Service
prospects. It would therefore be unlikely that most doctors
Ombudsman when this fails. The MDU welcomes the increased
would accept such a sanction voluntarily without a proper,
emphasis on local resolution as our experience suggests most
robust and challengeable investigation.
complaints notified to us by members can be resolved quickly The MDU also strongly opposes the concept of recording
and efficiently at this stage. ‘Responsible bodies’(such as PCTs, ‘soft information’whereby employing and contracting Trusts
hospital trusts, primary care providers and other organisations could keep on record, and pass on to other Trusts who are
providing NHS services) are required to have a ‘responsible potential employers or contractors of the doctor concerned,
person’(not to be confused with the Responsible Officer - see information which essentially amounts to gossip and innuendo
below) who will usually be the most senior person in the which has not been properly tested. It is in both doctors’ and
organisation, such as a Chief Executive in a trust, or a senior patients’ interests that any concerns should be properly
partner in primary care. The responsible person will ensure the investigated. They certainly should not be put on a file without
organisation complies with the complaints procedure, and that that doctor knowing or be passed on to another organisation
any actions identified during the investigation of a complaint without having been checked. Once again, we argue that the
are taken. use of such unchecked information would be fundamentally
However, the new procedures do allow for complaints to be
unfair and would be, in any event, unlikely to have a positive
made direct to a Trust and only notified to the
impact on patient welfare.
provider with the consent of the complainant.
This means it is possible that some complaints
“It is in both doctors’
Our workload relating to GMC
investigations continues to grow not
to a Trust may not be notified to the individual and patients’ interests only in terms of number of hearings
doctors involved and this may deprive them of
an opportunity to address the concerns and
that any concerns
but also in terms of the complexity of
cases. We await the introduction of the
learn from whatever may have caused the should be properly Office of the Health Professions
dissatisfaction. It remains to be seen whether
this happens in practice and we will be
investigated.”
Adjudicator (OHPA) scheduled to start
to hear cases in 2011, which will assume
keeping a close eye on this on your behalf. the adjudicatory functions currently
Furthermore, the new regulations do not require a complaint
undertaken by the GMC fitness to practise panels. We support
to be stopped if there is a claim for damages running in
the principle of an independent adjudicator but believe the
parallel. Members would therefore be well advised to keep the
OHPA can only act fairly and independently if it has
MDU closely informed, if any complaint looks as though it
legally-qualified chairpersons and complete independence
might include a claim for financial compensation as well.
from the GMC when setting sanctions. We have made our
views very clear and will continue our involvement on behalf
We have produced detailed guidance for members on the new of our members.
complaints procedure, written by two MDU medico-legal
advisers, Michael Devlin and Udvitha Nandasoma. This is
The medical profession as a whole will soon have to get to
available as a booklet and as a download from the MDU’s
grips with GMC revalidation, and the advisory team is well
website.
prepared for this. Those of us working in the specialty of legal
medicine are not exempt from revalidation. The MDU is taking
Other major changes in the pipeline include GMC revalidation an active role in the new Faculty of Forensic and Legal Medicine
and the related local clinical governance procedures. On your of the Royal College of Physicians of London. During the last 12
behalf a number of MDU doctors took part in government months, members of the MDU staff have contributed towards
workshops to discuss the proposed changes. We spoke against the creation of the new membership examinations in legal
the concept of GMC Affiliates, Responsible Officersand medicine (leading to the MFFLM) and formalised CPD
Recorded Concernswhich were proposed in the White Paper recommendations.
Trust, Assurance & Safety, and although these proposals have
been considerably amended since they first appeared in the
Our most recent customer satisfaction survey saw the advisory
Chief Medical Officer’s original paper Good Doctors, Safer
team receiving a positive rating from every single respondent.
Patients,we still believe they are not necessary on the grounds
But we are not resting on our laurels. We have recently
that with rigorous implementation, existing procedures were
introduced an initiative to monitor and improve the quality of
more likely to promote high standards of patient care without
advice given by the nearly 60 advisers (mostly doctors and a
being excessively time-consuming for doctors themselves.
few in-house solicitors) who assist members through the MDU’s
advisory helpline. As members who have recently needed to
Recorded Concerns were proposed as voluntarily-accepted ring in on the freephone number may know, calls are now
electronically recorded and a random selection of calls are
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