Complaints and Litigation 2007

Action Against Medical Accidents

About AvMA…

  • Independent charity, established 1982
  • “for Patient Safety & Justice”
  • Blend of clinical and legal expertise
  • Specialist Helpline and Casework service
  • Work with CHCs & ICAS
  • Accreditation of specialist solicitors and promotion of good practice in dispute resolution
  • Promotion of better Patient Safety: Patients for Patient Safety project; National Patient Safety Forum

Our experience of current system:

  • 5,000 enquiries a year
  • Poor ‘local resolution’ – complaints staff not valued
  • Culture of Denial
  • Mistakes repeated
  • Inconsistency of support available to complainants
  • Confusing, Fragmented system
  • Odds stacked against the injured patient
  • But not all bad – Healthcare Commission & ICAS show some excellent good practice

‘Fragmentation’ and ‘Inconsistency’

The very problems the Health & Social Care Act sought to avoid – “local one stop shop” – ICAS to be ‘provided by’ PCT Patients Forums

ICAS complaints function not linked to CPPIH or Patients Forums and 3 different providers

Directly overseen by Dept of Health, and Role limited to NHS complaints – inconsistent specialist support

Mixed sector / private complaints

Contradiction between LSC and Complaints regs

NHS Complaints and Litigation

  • 1 million medical accidents a year
  • Up to 40,000 deaths, hundreds of thousands of serious injuries
  • How many claims?
  • Under 6,000

Why take legal action?

Where serious damage or loss has been caused – the only option available to get help with extra care needs or get back lost income

Forced into legal action to get to the truth and a sense of ‘justice’

In the vast majority of successful clinical negligence claims complaints investigations did not result in admissions of failures, and claims are initially defended

What happens with the lessons from litigation?

The Clinical Negligence Scheme for Trusts sets standards

However cases are dealt with as ‘claims’ – no systematic learning

At least litigation has helped put patient safety on the agenda

The NHS Redress Scheme – a better way?

Speedier access to justice without the need for lawyers….However……… Relies on a revolutionary change in culture – the NHS to recognise its own mistakes, admit to them and offer fair compensation – without you having to ask!

Uses the legal test of negligence, but without any of the safeguards of the legal system

AvMA succeeded in getting safety net of independent medical reports and specialist legal advice for contested cases, and The right to receive report on investigation and action plan to improve patient safety

What would a good system look like?

  • A joined up approach
  • Led by patient needs and ensuring lessons are learnt
  • Patients empowered by specialist support when needed
  • Complaints support integrated with monitoring function of Patient Forums/ LINKS and overseen by independent body
  • ‘Avoidability test’ to determine right to compensation
  • Make “Being Open” compulsory!!