1. Avoiding Litigation: Actions and Precautions by Rebecca Cherry Associate Medical Law & Patients’ Rights Irwin Mitchell LLP

2. Aims To reflect on how the issues relate to your practice How you are going to act differently

3. Areas will cover 1.Why people sue 2.What you do if you find yourself in the position of being sued 3.How you can try to avoid being sued

4. 1. Why People Sue Explanation Unsatisfactory Complaints Process Want support in coping with consequences Apology/acknowledgment of their suffering Compensation disciplinary action against individuals

5. Examples Delay in diagnosis of diabetes Poorly managed/monitoring of blood glucose levels causing arterial disease, nerve damage Failure to refer e.g. retinal screening for retinopathy Poor treatment of foot ulceration, foot infection Avoidable amputations

6. 2. What to expect if faced with being sued Patient Complaint Letter of Claim Limitation Analyse what you did and why Whether you agree with any aspects of the complaint/claim Aspects you believe to be inaccurate and why

7. (continued) Interviewed by your manager;Trust Legal Department; solicitor for NHS Panel training

8. 3. How to avoid being sued Note keeping: -legible handwriting -record what the patient says and what advice you give. - detailed notes –v- poor note keeping -ensure plans up to date e.g. “dressing changed as per dressing plan” -if you order investigations, review the results and record you have done so. -clear time entries

9. continued Communication: -take time to discuss patient’s condition with them -false reassurance is a weakness Specialist -experienced –v- “had a go” -proof

10. (continued) NICE compliant: –Protocols/guidelines Referral: - know you pathway of referral - working closely with different groups of heath care professionals = good management. Risk assessments: -Do you do them, when do you do them, do you document proof Prescriber; -are you qualified, can you prove it

11. (continued) Pressure sores -Note the size, location, take photographs -Keep Waterlow Scores up to date -Keep checking for numbness -Swab if you think there are signs of infection, don’t wait til infection develops -Obtain the right aids and equipment, keep abreast of new additions to the market

12. Summary Litigation relating to diabetes is increasing rapidly The cost of getting it wrong is significant to: -the patient -the health care agencies in the UK -YOU.