Doctors need more support following an unexpected patient death, the MDU says

Doctors should be given more support following the unexpected death of a patient, the MDU has said.

In its submission to the GMC-commissioned review of gross negligence manslaughter and culpable homicide the MDU said that doctors undergoing investigation following a patient’s unexpected death should receive higher levels of support  from their trust or primary care organisation.

The MDU said: 'There is little acknowledgment... of the distressing effect such deaths can have on clinicians... especially if they are under scrutiny.'

The MDU that there needed to be more consistency and fairness in the way trusts and primary care organisations respond to unexpected deaths and the investigations that follow so that doctors ‘report feeling supported and valued, rather than stigmatised and persecuted’.

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'Investigations for gross negligence manslaughter happen too often'

Although the MDU’s recommendations were in answer to specific questions about NHS trusts, the statement highlighted that ‘the recommendations we make for improvement could [also] be applied to primary care’.

Adversarial investigations

The MDU said it ‘often see little attention paid to adopting what we think would be regarded as fair procedure’, and that many doctors under investigation encounter an adversarial approach from investigators.

‘In some cases it seems as if a decision has been taken from the start that a particular individual is "to blame" and the investigation proceeds on that basis in order to provide "proof’" rather than starting with a clean sheet and an attempt to ascertain the facts before reaching any judgement.

‘We believe the same principles of fair and transparent procedures should apply so that NHSE teams seek initially to investigate and learn lessons, rather than to apportion blame.’

The GMC's UK-wide independent review is investigating how gross negligence manslaughter is applied to medical practice in the wake of the Bawa-Garba case.

Dr Bawa-Garba, who was convicted of gross negligence manslaughter following the death of six-year-old Jack Adcock in 2011, is currently challenging the GMC’s successful appeal to have her struck off the medical register.

Marx review

Dr Oliver Lord, MDU medico-legal adviser said: ‘It is right that organisations should focus on those left behind after a close relative or friend has died. But trusts also need to recognise and deal supportively with staff involved as they are often extremely distressed and fearful when a patient’s death is unexpected.

‘Unexpected deaths should be investigated in a fair and transparent way and the NHS should seek initially to learn lessons, rather than to apportion blame. That isn’t to say that doctors shouldn’t be held accountable, but there are separate procedures, such as a GMC or disciplinary investigation, where such decisions can and should be made.’

The MDU added that investigations into serious incidents could be improved if each organisation were required to publicise, and therefore follow, its process. It also suggested that trusts and primary care organisations set minimum levels of resource, knowledge, skills and experience for investigation teams.

In May the GMC said it had made 'significant progress' in making its investigations more supportive of doctors.

The deadline for Marx review submissions has been extended to 10 August. Click here to make a submission.

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