raising concerns at work a guide for foundation doctors produced by stfs trainee representative

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  • Raising Concerns at WorkA guide for foundation doctors

    Produced by STFS trainee representative

  • You must protect patients from risk of harm posed by another colleague's conduct, performance or health. The safety of patients must come first at all times.

    GMC Guidancehttp://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp

  • You must protect patients from risk of harm posed by another colleague's conduct, performance or health. The safety of patients must come first at all times.

    If you have concerns that a colleague may not be fit to practise, you must take appropriate steps without delay, so that the concerns are investigated and patients protected where necessary.

    GMC Guidancehttp://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp

  • You must protect patients from risk of harm posed by another colleague's conduct, performance or health. The safety of patients must come first at all times.

    If you have concerns that a colleague may not be fit to practise, you must take appropriate steps without delay, so that the concerns are investigated and patients protected where necessary.

    This means you must give an honest explanation of your concerns to an appropriate person from your employing or contracting body, and follow their procedures.GMC Guidancehttp://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp

  • Bad Presshttp://news.bbc.co.uk/1/hi/health/1443093.stm

  • Bad PressThe doctor who blew the whistle on the Bristol heart babies scandal said he was forced to emigrate following threats and discrimination.

    Anaesthetist Professor Stephen Bolsin tried first to raise his concerns with colleagues, but when these were ignored he took his worries about the deaths of 29 babies and children at the Bristol Royal Infirmary to the department of health.

    But he said his decision to go public had led to him being forced out of the Bristol Royal Infirmary and having to move to Australia, where he is now Head of Anaesthesia at the Geelong Hospital, near Melbourne, Australia.

    http://news.bbc.co.uk/1/hi/health/1443093.stm

  • Types of concernsConcernsViolenceDiscriminationBullyingSystem failuresIllnessNegligenceIncompetenceInappropriate doctor-patient relationshipsAlcohol/Drug misusePatient welfare in clinical trials

  • How to raise concernsGather informationDiscuss your concerns with the colleague DocumentationInform ConsultantEnsure patient safetySupport colleague

  • How to raise concernsGather informationDiscuss with the colleague your concernsDocumentationInform ConsultantEnsure patient safetySupport colleague

  • Alternative ContactsFoundation Programme Co-ordinator Your Clinical / Educational SupervisorTheir Clinical / Educational SupervisorAny consultant within departmentClinical Director / Medical DirectorSenior manager / Chief ExecutiveFoundation Programme Director / Clinical TutorFoundation School Director

  • You handwrite Actrapid 6U on drug chart. Nurse administers 60 units actrapid. Patient hypoglycaemia comaScenario 1: Systems Failure

  • Scenario 1: Systems failureGather informationWhy did nurse administer 60units? Due to Drs poor handwriting she thought it read 60 not 6 units

    Ensure Patient SafetyTreat patients hypoglycaemia & stabilise patient

  • Scenario 1: Systems failureResolving the IssueDiscuss with nurseComplete an incident formAudit & present results to clinical lead/managersLiaise with other doctors, pharmacists, nurses to come up with solutions to prevent similar errors, and implement changeOutcomeHospital policy that all insulin prescriptions should have units written and not U otherwise nurses will not administer

  • A senior colleague (CT, ST etc) consistently comes late to work or misses shifts.

    Today your team is on call including your SpR and he has not turned up.

    What do you do?Scenario 2

  • Scenario 2Gather informationWhy is the SpR not in? E.g. Is he on annual leave, ill health, childcare issues, transport

    Approximately how late will he be?E.g. If 20mins easier to manage then if several hours and can plan appropriately

    Has he already informed anyone else and arranged cover?E.g. Is another SpR going to cover?

  • Scenario 1Ensure Patient SafetyLocate SpR bleep - is anyone holding it? - if not carry it until can give to some appropriate

    Contact remainder of on call team and prioritise & delegate tasks

    Inform switchboard, bed manager and consultant on call

    ENSURE YOU WORK WITHIN YOUR LIMITATIONS!

  • Scenario 1Resolving the IssueSubsequent to incident discuss with SpR your concerns- persistently being late/absent means more stress and workload for rest of team

    - support colleague E.g. May be temporary - childcare, transport - health issues- difficulties at work

    - explain will inform consultant

  • Scenario 1Resolving the IssueDocumentation- keep a note of when such incidents occur, in case you are asked later- provide accurate feedback on mini-TAB, 360o assessments - incident report forms

    Inform consultant

    DO NOT DISCUSS WITH EVERYONE BE DISCREET!

  • Escalating ConcernsNCAS/GMCConcernLiaison with: HR/ Med Staffing/OH etc

  • Examples from Audience

  • SummaryGather informationDiscuss with the colleague your concernsDocumentationInform consultantEnsure patient safetySupport colleague

  • http://www.bma.org.uk/images/Whistleblowing_tcm41-156406.pdfResources (add NCAS)

  • (n.b. This slide is not part of presentation)Additional 2 slides regarding whistleblowing definition and public disclosure act Have not included as part of presentation as tried to keep it more informal and less frightening prospect for juniors to bring up concerns

  • WhistleblowingThe British Standards Institute :

    when someone who works in or for an organisation...raises a concern about a possible fraud, crime, danger or other serious risk that could threaten customers, colleagues, shareholders, the public or the organisations own reputation.http://www.bsigroup.com/en/sectorsandservices/Forms/PAS-19982008-Whistleblowing/

  • Public Disclosure Act 1998An Act to protect individuals who make certain disclosures of information in the public interest; to allow such individuals to bring action in respect of victimisation; and for connected purposes.

    http://www.legislation.gov.uk/ukpga/1998/23/contents

    http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://news.bbc.co.uk/1/hi/health/1443093.stm*http://news.bbc.co.uk/1/hi/health/1443093.stm*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp**Public Concern at Work is a whistleblowing charity and provides constructive, confidential advice*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*http://www.gmc-uk.org/guidance/ethical_guidance/raising_concerns.asp*