CONTENTS FROM THE EDITOR


“IT WAS the worst thing anyone would want to hear.” This is how Martin Bromiley recalls the


moment he was told that his wife was in intensive care after a routine sinus operation went tragically wrong. Elaine Bromiley died two weeks later. What happened next was entirely unplanned but had much


to do with Martin’s training as an airline pilot. In the aftermath of the incident he applied his experience of human factors training in the aviation industry to try and make sense of what took place – and this effort eventually led to the establishment of the Clinical Human Factors Group (CHFG), a charity dedicated to reducing the incidence of human error in healthcare. On page 14 he tells journalist Adam Campbell his story. NICE is not without its critics, with some GPs in particular accusing the organisation of being detached from the everyday


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16 AN SUMMONS PUBLICATION FOR MEMBERS Spring 2016


Cover image: Impruneta 12.14, 12th June, James H. Fairgrieve. Acrylic, 1976.


• Curbing legal costs • Q&A: Professor David Haslam • Dentists and the DPA •


James Fairgrieve studied at Edinburgh College of Art between 1962 and 1968. After some time in London he returned to the college to teach from 1969-1998. Nature is a strong theme in his work,


and he has exhibited many times over the years.


Art in Healthcare (formerly Paintings in Hospitals Scotland) works with hospitals and healthcare communities across Scotland to encourage patients, visitors and staff to enjoy and engage with the visual arts. For more information visit www.artinhealthcare.org.uk Scottish Charity No SC 036222.


SPRING 2016


reality of primary care in some of its guidance. In our Q&A on page 10, NICE chair Professor David Haslam addresses some of these criticisms and discusses other challenges facing the organisation in the future. An estimated £1.4 billion will be paid out by the NHS


Litigation Authority in the coming year in claims to patients in England – with over a third of the NHSLA budget going to the legal profession and most of this in so-called “adverse costs” to claimants’ lawyers. MDDUS is also seeing an ongoing rise in litigation and associated legal costs, with a 17.9 per cent increase in claims intimated against medical and dental members across the UK over 2014. On page 12 MDDUS CEO Chris Kenny sets out his strong support for Government plans to impose fixed recoverable costs for lower value clinical negligence claims to help reduce the rise in medical indemnity costs. Dr Barry Parker


WORKING WITHIN LIMITS Professor David Haslam


answers questions on the challenges he faces as chair of NICE


TAKING ACTION ON SPIRALLING LEGAL COSTS


MDDUS CEO Chris Kenny urges support for Government proposals to curb legal costs in England


ACCIDENTS WILL HAPPEN Tragedy led airline pilot Martin


Bromiley on a personal crusade to reduce human error in healthcare


CLINICAL RISK REDUCTION: LYME BORRELIOSIS Dr James Douglas provides a useful summary of this rare but often debilitating condition


Editor:


Dr Barry Parker Managing editor: Jim Killgore Associate editor: Joanne Curran Editorial departments: MEDICAL Dr Richard Brittain DENTAL Mr Aubrey Craig LEGAL Simon Dinnick


REGULARS 4 Notice Board


6 News Digest 8 Risk: Is your prescribing system safe from abuse? 9 Ethics: Ideas about idealism 20 Case studies: Infected dog bite, Lip trauma, An anxious driver 22 Addenda: DeFord anaesthetic inhaler, Book review – NeuroTribes: The Legacy of Autism and the Future of Neurodiversity, Crossword and Vignette – Sir Tudor Thomas, pioneering eye surgeon


Please address correspondence to:


Summons Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA


jkillgore@mddus.com


Summons is published quarterly by The Medical and Dental Defence Union of Scotland, registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. • Tel: 0845 270 2034 • Fax: 0141 228 1208


Email: General: info@mddus.com • Membership services: membership@mddus.com • Marketing: marketing@mddus.com • Website: www.mddus.com The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Articles of Association.


The opinions, beliefs and viewpoints expressed by the various authors in Summons are those of the authors alone and do not necessarily reflect the opinions or policies of The Medical and Dental Defence Union of Scotland.


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Design and production: Connect Communications 0131 561 0020


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DENTISTS AND THE DPA MDDUS Information


governance officer Alex Lyons reflects on a recent ICO report on data protection in the dental surgery


Printing and distribution: L&S Litho


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