Phone advice So what is a typical week like for an MDDUS medical adviser? “Te week is quite variable depending on case work and teaching commitments,’’ says Barry, “but we each have a number of regular half-day sessions providing phone advice to members.” In the six months up to June 2011


MDDUS medical advisers in two offices in London and Glasgow handled over 3,400 calls on a wide range of topics. A trainee doctor might be worried about whether she is obligated to inform the GMC of a traffic offence. A practice manager might be seeking advice on the wording of a response letter to a patient complaint. A consultant surgeon could be phoning to say that he has been called as a witness in a coroner’s inquest and is worried that his actions may come in for criticism. Or it may be a simple matter of confirming vicarious indemnity coverage for general practice staff offering flu vaccinations. “Te single commonest issue we


get called about is doctor-patient confidentiality,” says Barry. “Examples include – can you show the records of a child to an estranged father? How do you assess parental responsibility? What about someone who is not medically fit but wants to continue to drive? When do you contact the DVLA? What can and can’t you tell police about a patient’s health details? It covers a wide range of possible scenarios.” Most advice calls to MDDUS are put


through directly to an adviser from a secretary. Te advisory team strives to avoid call-backs though at busy times, such as Monday mornings, this may not always be possible. Tere are no case handlers or triaging of calls. A doctor phoning MDDUS for advice will always speak with a doctor and the same goes for dentists. “Doctors like to talk to doctors,” says


Barry. “Tey like the reassurance of speaking to someone who is medical and understands the clinical scenario they’ve found themselves in.” In addition to his weekly phone sessions


Barry also does an out-of-hours rotation for a week every couple of months. Tis involves carrying a mobile phone and taking any emergency calls. “Calls are usually for acute situations


such as a casualty doctor phoning because there is a patient attending who has doubtful capacity to consent to treatment, or a doctor who is about to be interviewed by police regarding a clinical incident.’’ Sometimes advisers get calls they cannot


answer immediately. In such cases they will call back having consulted other resources including written policies and procedures, GMC and other regulatory guidance. Each week the advisory team also meets in formal sessions to go over more difficult cases and pool knowledge. “We have some very experienced senior


colleagues who offer a wealth of information. Our in-house legal teams are also always available to consult.”


either in person or via video link. Advisers will also attend GMC hearings to support members and offer representation in hospital or primary care disciplinary proceedings. MDDUS considers such contact vital. Part of the role of an adviser is to provide members with an understanding of the processes and procedures they may face when dealing with the GMC or in court. Tis includes explaining what will be involved in a hearing and the type of questions that might be asked. “It’s important just to reassure members


that at the end of the day, all that they are expected to do is give an honest account of what has happened. Tat’s all that’s being asked,” says Barry. Another aspect of the job is outreach and


education. Each week MDDUS receives numerous requests for advisers to give talks or run workshops in practices or hospital departments or at medical meetings. “We give presentations to


“Doctors like to talk to doctors... We are the first point of contact”


Member support When not handling advice calls Barry spends much of the rest of his time in case management. Cases generally involve claims of negligence or investigations by the GMC in regard to a professional’s fitness to practise. “At MDDUS we make sure it is a medical


adviser dealing with medical colleagues right through all of these things,” says Barry. “We are the first point of contact and take members through the process, telling them what is going to happen at each stage.” An adviser will correspond with the


member over the course of a case, facilitating requests for information and arranging any necessary meetings with solicitors or counsel in advance of hearings or panels,


everyone from medical students up to consultant grades on a whole range of topics including confidentiality, consent, clinical negligence claims, fatal accident inquiries, coroner’s inquests, recent changes in death certification. Pretty much anything people ask us to cover as long as it has a medico-legal slant to it.”


Advisers also participate and comment


on consultations for initiatives or guidance produced by the NHS or GDC and GMC, including the current and ongoing review of Good Medical Practice. It makes for a busy and at times


challenging role, but Barry hesitates only a moment when asked if he misses clinical medicine. “Occasionally,” he replies. “I think you


inevitably miss something you’ve done for most of your life. But you can’t go on being a clinician forever. All I’ve done is stepped out of it 10 or 15 years earlier. And now I’m doing something new which I find really stimulating and rewarding.”


nJim Killgore is editor of MDDUS Summons


WINTER 2012


17


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