supporting staff involved in an incident, complaint or

of 43

Supporting Staff Involved in an Incident, Complaint or Claim Policy

The 5 key messages the reader should note about this document are:

1. Staff involved in or affected by an incident, complaint or claim must be provided with appropriate and timely support.

2. Staff may need support after the incident and on closure of any investigation

3. Support will be given to any staff attending Court, Inquest or Tribunal

4. Any statements requested externally must be shared with Complaints or serious incidents departments as appropriate

5. Staff may require ongoing support.

You & Your Care www.bdct.nhs.uk

http://www.bdct.nhs.uk/

of 43

This document has been approved and ratified. Circumstances may arise where staff become aware that changes in national policy or statutory or other guidance (e.g. National Institute for Health and Care Excellence (NICE) guidance and Employment Law) may affect the contents of this document. It is the duty of the staff member concerned to ensure that the document author is made aware of such changes so that the matter can be dealt with through the document review process.

NOTE: All approved and ratified policies and procedures remain extant until notification of an amended policy or procedure via Trust-wide notification, e.g. through the weekly e-Update publication or global e-mail and posting on the Intranet (Connect).

Document details: Supporting Staff Involved in Incidents, Complaints and Claims Policy

Version: 5-03 Final

Persons / committees consulted: Directors Operational Heads Professions Council Quality and Safety Committee

Approved by: Professional Council

Date approved: 28/09/2015

Ratified by: Quality and Safety Committee

Date ratified: 06/11/2015

Title of originator / author: Sharon Lumb, Serious Incident Lead

Title of responsible committee / group (or Trust Board):

Quality and Safety Committee

Title of responsible Director: Nicola Lees, Deputy Chief Executive/Director of Nursing

Date issued: 14/12/2015

Review date: 06/11/2018

Frequency of review: 3 years

Target audience: All Staff

of 43

Responsible for dissemination: Sharon Lumb, Serious Incident Lead

Darren Shipman, Governance and Clinical Audit Manager (responsible for uploading to the Intranet/Connect).

Copies available from: Connect on BDCFT Intranet

Where is previous copy archived (if applicable)

Connect on BDCFT Intranet

Amendment Summary:

Amendment detail:

Amendment number

Page Subject

1 Appendix D,E and F

All appendices updated to reflect revised Templates and Advice re coroners inquests

2 Throughout Renamed the term Debrief to Post incident review

3 12 Updated references to Breathe to counselling through the Trust Employee Assistance Programme and the Employee Health and Wellbeing Team

4 16 Support from SI Team at Coroner’s Inquests added

5 16 Removed requirement for Medical Director to review medical statements for Coroners Inquests

6 24 Statement added to ensure that staff should inform the Serious Incident lead that a request for a report has been received from HM Coroner

of 43

Contents 1 INTRODUCTION .......................................................................................................... 7

1.1 Why Staff May Need Support ................................................................................. 7

1.2 Which Staff May Need Support?............................................................................. 8

2 SCOPE ......................................................................................................................... 9

2.1 Purpose .................................................................................................................. 9

2.2 Scope ..................................................................................................................... 9

3 DEFINITIONS ............................................................................................................... 9

4 DUTIES ...................................................................................................................... 10

4.1 The Chief Executive and Trust Board ................................................................... 10

4.2 Quality and Safety Committee .............................................................................. 10

4.3 The Deputy Chief Executive/ Director of Nursing .................................................. 10

4.4 Serious Incident Lead & Complaints and Litigation Manager ............................... 10

4.5 Human Resources and Specialist Advisers .......................................................... 11

4.6 Heads of Operations/ Service Managers .............................................................. 11

4.7 Managers Responsible For Managing an Adverse Event (Including Senior Staff Responsible For Immediate Management of an Incident) .................................... 11

4.8 Line Managers ...................................................................................................... 12

4.9 Occupational Health ............................................................................................. 13

4.10 All staff ............................................................................................................... 13

4.11 Medical Staff ...................................................................................................... 13

4.12 Flowchart: Supporting Staff – Managers Responsibilities .................................. 14

5 PROCESS FOR SUPPORTING STAFF INVOLVED IN TRAUMATIC/STRESSFUL EVENTS (INCORPORATING INCIDENTS, COMPLAINTS AND CLAIMS) ............... 15

5.1 Support for staff involved in Incidents, Complaints, Allegations of Negligence or Claims ................................................................................................................... 15

5.1.1 Immediate Support Offered to Staff ................................................................ 15

5.1.2 Treatment ....................................................................................................... 15

5.1.3 Support........................................................................................................... 15

5.2 Ongoing Support Offered To Staff ........................................................................ 16

5.2.1 Additional Forms of Support (Including Internal and External Support) .......... 17

of 43

5.2.2 Actions to Be Taken If Staff Members Experience Difficulties Associated With the Event at a Later Date ............................................................................... 17

5.3 Delays in Concluding Investigations and Processes ............................................. 18

6 INVESTIGATION PROCESSES AND STAFF SUPPORT .......................................... 18

6.1 Introduction ........................................................................................................... 18

6.2 Internal Trust Investigations .................................................................................. 18

6.3 External Investigation Processes .......................................................................... 19

7 SUPPORT AND ADVICE AVAILABLE FOR STAFF IN THE EVENT OF BEING CALLED AS A WITNESS ........................................................................................... 19

7.1 Introduction ........................................................................................................... 19

7.2 Witness Statements .............................................................................................. 19

7.3 Internal Advice ...................................................................................................... 19

7.4 Attendance at Court / Inquests ............................................................................. 19

7.5 Statements for Court/ Inquests ............................................................................. 20

7.6 Other Circumstances Where Legal Support Is Required ...................................... 20

7.7 Conclusion of the Incident, Investigation, Complaint or Claim .............................. 20

8 RECORD KEEPING AND DOCUMENTATION .......................................................... 20

9 DOCUMENT DEVELOPMENT ................................................................................... 21

10 EQUALITY IMPACT ASSESSMENT .......................................................................... 21

11 TRAINING NEEDS ANALYSIS ................................................................................... 21

12 CONSULTATION, APPROVAL AND RATIFICATION ................................................ 22

12.1 Consultation ...................................................................................................... 22

12.2 Approval ............................................................................................................ 22

12.3 Ratification ......................................................................................................... 22

13 REVIEW ..................................................................................................................... 22

14 DISSEMINATION AND IMPLEMENTATION .............................................................. 22

15 MONITORING COMPLIANCE AND EFFECTIVENESS ............................................. 23

16 REFERENCES ........................................................................................................... 25

17 ASSOCIATED DOCUMENTATION ............................................................................ 25

17.1 Trust Documents ............................................................................................... 26

17.2 Interagency Documents and Processes ............................................................ 26

of 43

18 APPENDIX A: COMPLIANCE CHECKLIST ............................................................... 27

19 APPENDIX B: EQUALITY IMPACT ASSESSMENT ................................................... 29

20 APPENDIX C: GUIDANCE FOR STAFF IN GIVING STATEMENTS AND ATTENDING COURT HEARINGS AND INQUESTS .................................................. 31

20.1 Introduction ........................................................................................................ 31

20.1.1 Inquests ...................................................................................................... 31

20.1.2 Criminal Investigation .................................................................................. 31

20.1.3 Claims Against the Trust ............................................................................. 32

20.1.4 Children Proceedings .................................................................................. 32

20.1.5 Criminal Investigations ................................................................................ 33

20.1.6 Employment Tribunals ................................................................................ 33

20.2 Release of Records ........................................................................................... 33

20.3 Support to Staff ................................................................................................. 33

20.4 Statements and Reports .................................................................................... 34

20.5 Court Etiquette .................................................................................................. 34

21 APPENDIX D: GUIDANCE TO STAFF ON WRITING A STATEMENT ...................... 35

22 APPENDIX E: CONFIDENTIAL REPORT FOR THE CORONER .............................. 37

23 APPENDIX F: A GUIDE FOR WITNESSES CALLED TO GIVE EVIDENCE AT A CORONER’S INQUEST ............................................................................................. 39

23.1 Introduction ........................................................................................................ 39

23.2 A Coroner’s Inquest ........................................................................................... 39

23.3 Common Fears Experienced By Clinical Staff ................................................... 39

23.4 Role of the Serious Incident Team .................................................................... 40

23.5 Prior to the Inquest ............................................................................................ 40

23.6 Day of the Inquest ............................................................................................. 41

23.7 Taking the Witness Stand .................................................................................. 41

23.8 Leaving the Court Room and Taking Care of Yourself ...................................... 42

of 43

1 INTRODUCTION Trust staff are encouraged to report adverse incidents knowing that they will be treated fairly, and that the Trust will try to learn lessons from them. When things go wrong those involved (staff, service users, carers, relatives, visitors or the public), can be affected and sometimes traumatised, and that this can lead to personal and, as a result, organisational difficulties. This document describes the Trust processes for supporting staff involved in or affected by an incident, complaint or claim.

The Trust values its staff and will ensure that adequate and appropriate support is offered to staff to ensure their wellbeing is maintained.

The Trust recognises that counselling and support, generally accessed through the occupational health department, may need to be utilised following traumatic/stressful incidents, complaints or claims.

The organisation is committed to ensuring staff can access support and that all contact will be treated as strictly confidential.

1.1 Why Staff May Need Support Being involved in an adverse event can be a very difficult and stressful experience, especially after a serious incident, or a ‘near miss’ incident where something serious could have happened, or during a complaint or claims investigation.

Staff can sometimes feel very isolated after an adverse event, particularly if they are absent from work or if they do not work within the team where the incident took place; agency staff or students can feel particularly isolated and excluded.

Care should be taken to ensure that those staff who may be affected or traumatised by an incident are identified as soon as possible and every effort made to engage them and offer appropriate support both immediately post incident and in the longer term. The level of support needed may vary according to the:

• Nature and severity of the incident

• Support network around the staff member

• Resilience and personal resources of the people involved.

Events that can trigger a response may include:

• Being involved in a traumatic clinical situation or other serious incident

• Having been involved in providing care or treatment to a service user preceding a serious adverse event

• Being involved in the investigation process relating to an adverse event – an incident, allegation, complaint or claim

• Providing witness statements and/or information for Trust investigations into an incident, complaint or claim

of 43

• Appearing as a witness at internal investigations

• Appearing as a witness in the Coroners Court

• Representing the Trust as a witness in a court case

• Being interviewed by the police

• Face-to-face meeting with complainants

• Being part of an investigation team into a serious incident or complaint

• Involvement in allegations of negligence or whistleblowing

• Where a staff member was a witness to an incident, if something has happened to a service user that they were working with (even if they were not directly involved in the incident itself or currently working with that person), or if something has happened to a colleague.

1.2 Which Staff May Need Support? Groups of staff who may be affected and need to be considered include staff:

• Directly involved in an incident

• Members of a team where there has been an incident

• Who have witnessed an incident

• Who have previously worked with a service user who has been harmed

• From an agency or bank, or students who may not usually work with the service

• Involved in providing support to service users and carers following an incident

This document describes what support is available to staff including

a. Immediate and ongoing support and communication for staff involved in an adverse event

b. Advice available to staff required to be interviewed or provide evidence in relation to an external or legal process e.g. as a witness

c. Actions for managers in relation to communicating with and supporting staff following an adverse event

d. Actions for managers if a staff member experiences further difficulties associated with an adverse event

e. Support and training for staff who are involved in investigating adverse events

of 43

2 SCOPE 2.1 Purpose The purpose of this document is to ensure that staff who are involved in or affected by an incident, complaint or claim are provided with appropriate and timely support. It describes the support that the Trust will offer and the process managers will follow in offering this support.

The Trust will ensure that a counselling service is available to staff and will guarantee that adequate and appropriate support is available to meet demand following a traumatic or stressful incident, complaint, or claim.

2.2 Scope This policy applies to all staff with responsibilities relating to managing, investigating and learning from adverse events. It outlines the Trust’s approach to supporting staff following a potentially traumatic or stressful adverse event (originating from an incident, complaint or claim). If an adverse event becomes the subject of a disciplinary investigation the Trust’s disciplinary policy and policies will apply and will supersede this policy.

3 DEFINITIONS This section provides definitions of some of the terms used within the context of this document.

Adverse Event

An unintended and/or unexpected event or a circumstance that actually did lead to, or could have led to, harm, loss or damage to a service user, a member of staff, a visitor/contractor or to property. Harm may be physical or psychological.

Post Incident Review

A semi-structured conversation with an individual or team who has just experienced a stressful or traumatic event. The purpose is to reduce the possibility of psychological harm by allowing individuals to talk about their experiences.

Claim

In this context a claim is defined as a formal or legal claim against the Trust. There are other types of claim - details can be found in the Trust’s Claims Management Policy on the intranet. See also NHSLA.

Complaint

A complaint made to the Trust through the NHS Complaints policies. The NHS complaints regulations define a complaint as an expression of dissatisfaction with care, services or facilities provided by the Trust.

of 43

Incident

An unintended and/or unexpected event or a circumstance that actually did lead to, or could have led to, harm, loss or damage to a service user, a member of staff, a visitor/ contractor or property. Harm may be physical or psychological.

Investigation A thorough, detailed, systematic inquiry, search or examination to discover facts.

Root Cause Analysis

(RCA)

Systematic retrospective review of an adverse event to identify what, how, and why it happened. The analysis is then used to identify areas for change to help minimise the re-occurrence of the incident type in the future.

4 DUTIES The Trust is committed to protecting the health, safety, and welfare of its staff and recognises that workplace adverse events can cause distress.

4.1 The Chief Executive and Trust Board Are responsible for ensuring that effective systems are in place to manage traumatic events and their after effects on the staff involved.

4.2 Quality and Safety Committee The Quality and Safety Committee is responsible for ratifying this policy. It receives the annual report on the monitoring of effectiveness of the policy by the Serious Incident Lead. The Quality and Safety Committee will report to the Trust Board any issues with the implementation of this policy.

4.3 The Deputy Chief Executive/ Director of Nursing Has accountability and responsibility for the development, implementation and review of this policy on behalf of the Chief Executive. Other directors are responsible for implementation of this policy within their Directorates.

They will authorise the use of external agencies to meet demand following a traumatic/stressful incident.

4.4 Serious Incident Lead & Complaints and Litigation Manager Provide, support and advice in relation to the management and investigation of serious incidents, complaints and claims.

• Provide advice and support to staff and their managers regarding this policy.

• Provide support and advice in relation to legal processes and requirements, including providing statements and support with attendance at coroner’s court, tribunals and criminal courts as a witness, in relation to incidents, complaints and claims (but not a claim by them against the Trust).

of 43

• Liaise with each other as necessary in relation to patient safety incidents which are also the subject of a complaint

• Ensure there is a process in place by which staff receives adequate and appropriate communication, including feedback about the outcome of any investigation process.

• Receive reports and statements in draft before they are sent to the Coroner.

• Ensure that staff who are called as witnesses in a clinical negligence claim; employers/public liability claim; coroner’s Inquest; General Medical Council (GMC), or other professional body, hearing; and criminal cases; are provided with support throughout the preposition, actual process, and following conclusion of the case.

4.5 Human Resources and Specialist Advisers

• Provide advice and support to line managers in implementing this policy to ensure that staff are supported.

• Ensure that staff having to attend employment tribunals as witnesses for the organisation are supported in preparation for any hearing, involving the organisation’s solicitors as necessary.

4.6 Heads of Operations/ Service Managers

• Ensure this process is disseminated and implemented within their Directorate or Service

• Following a traumatic or stressful adverse event ensure support and information is offered to those staff affected. This may include giving immediate and ongoing support to staff, such as verbal support; medical help; counselling through the Trust Employee Assistance Programme and the Employee Health and Wellbeing Team; training; and, where appropriate, time off to recover from the incident. This may also involve a referral to an external agency or organisation for further support.

• After an incident where a number of staff have been affected the service manager will ensure that a senior member of staff is nominated to support the staff.

• Ensure staff receive adequate and appropriate communication prior to, during and after investigations and ongoing support.

• Ensure staff receive feedback about the outcome of any investigation process

• Maintain appropriate records of actions taken relating to this process

• Ensure a staff member who has to attend a court hearing or inquest as a witness in relation to a Trust adverse event is appropriately supported in liaison with the Serious Incident Lead and/or the Complaints and Litigation Manager

4.7 Managers Responsible For Managing an Adverse Event (Including Senior Staff Responsible For Immediate Management of an Incident)

Following a potentially traumatic or stressful adverse event, ensure:

• Immediate support and information is offered to those staff affected.

of 43

• Following a traumatic or stressful adverse event ensure support and information is offered to those staff affected

• Witness statements are taken as required

• Actions taken to support staff are recorded on the incident report form

• Relevant staff are given adequate and appropriate information, including considering the needs of staff not on duty at the time.

• Liaison with Human Resources where there are any concerns about staff capability, competence or behaviour

• Liaise with occupational health as appropriate

• Judge the level and type of support to be offered immediately post-incident and ensure that it is delivered in a sensitive and timely manner, to those who need it.

• Ensure that contact is made and maintained with each individual staff member involved in or affected by an incident to establish their possible care and support requirements

• Ensure that a face-to-face meeting with an appropriate person is offered, to discuss the incident and their reaction to it. The choice of contact method and venue for any meeting should be led by the person who is being offered support

• Arrange letters of sympathy or condolence where appropriate

• Keep those affected informed of the Trust investigation (and investigation by the Police or other agencies) and other developments post incident, including the Trust management response and actions taken to reduce the likelihood of a similar incident occurring

• Be sensitive and alert to the difference between a normal and abnormal grief reaction, and allow people time to progress through a normal reaction using their own personal resources as far as is possible

• Assist in accessing further help

• Maintain appropriate records of the process and action taken

• To report any external request for statements to the Operational Head, Serious Incident Lead or the Complaints and Litigation Manager

• To report the matter to the Trusts communications team to ensure any subsequent media coverage is handled appropriately

4.8 Line Managers The line manager should be encouraged to consult with other professionals within the organisation, such as the Serious Incident Lead, the Complaints and Claims manager, trade union support, and professional external bodies, e.g. Royal College of Nursing (RCN) in an attempt to offer the staff member the best support possible.

of 43

4.9 Occupational Health Have a responsibility for

• Receiving referrals for staff potentially affected by a traumatic incident

• Liaising with managers as to whether a member of staff is fit to work following referral to Occupational Health Department

• The Occupational Health Manager should monitor the use and the effectiveness of the counselling service, quality assuring any external agencies used and advising the appropriate director in a timely manner of the need for additional external support.

4.10 All staff

• Should be aware of this policy and be prepared to access a source(s) of support if they are having difficulty

• Have a responsibility for recognising their own distress, stress or changes in their normal life patterns after experiencing an adverse event and notifying their line manager of this

• If contacted directly by a court, Coroners Department, Police or Solicitors for any reason, they must immediately inform their line manager and the Serious Incident Lead and/or Complaints and Litigation Manager

• Cooperate fully with any investigation process

• To keep a copy of any statement given to the Police or the Coroner and to share this with the Serious Incident Lead.

4.11 Medical Staff

• Where a report for the Coroner’s court has been requested ensure the draft is sent to the Medical Director and Serious Incident Lead, so that, where necessary, legal advice may be obtained before it is submitted to the Coroner or agency requesting the report.

of 43

4.12 Flowchart: Supporting Staff – Managers Responsibilities

Adverse event with potential to be traumatic or stressful for staff

Immediate support Responsible senior manager ensures support offered to:

Staff on duty (record details): o Treatment eg A&E o Support & incident review o Practical help eg police

liaison or transport home o Communication o Consider & identify need for

ongoing or personal support o Obtain witness statements

If potential disciplinary issue identified: o If necessary initiate

disciplinary policy o Liaise with HR o Refer to NPSA

Incident Decision Tree

If external process initiated (eg police investigation or claim against Trust) check that staff support process will not interfere with this process

2. Staff not on duty or not directly affected: o Communication & information o Support

Ongoing support Responsible senior manager

ensures appropriate support is offered / provided:

o Team or service de-briefing o Offer of support such as

counselling or practical help o Identifying support networks o Support during investigation and/or

legal process o Monitor support needs over time o Support during lengthy or delayed

processes eg inquest, court case or independent inquiry

o Communication and feedback re processes and outcomes

o Information re lessons learned o Occupational Health referral

of 43

5 PROCESS FOR SUPPORTING STAFF INVOLVED IN TRAUMATIC/STRESSFUL EVENTS (INCORPORATING INCIDENTS, COMPLAINTS AND CLAIMS)

If a disciplinary issue is identified, the Trust’s disciplinary policy is initiated and supersedes this policy.

5.1 Support for staff involved in Incidents, Complaints, Allegations of Negligence or Claims

Examples of traumatic incidents may include assaults, suicide of patients, dealing with a major incident or other situations which a member of staff considers to be of a traumatic nature.

Appropriate support must also be provided to staff where members of the public or patients make complaints or allegations of negligence against the organisation or individuals.

5.1.1 Immediate Support Offered to Staff

The immediate priority after any incident is to ensure that anyone involved in the incident is provided with any necessary treatment and/or other support, and that any further harm is prevented. This will be coordinated by the most senior person on duty at the time. This person will be responsible for ensuring that appropriate support is arranged for affected staff which might include:

5.1.2 Treatment

Staff may need to attend accident and emergency for assessment or treatment. Consideration should be given to providing someone to accompany the staff member. Staff may also be advised to access other external agencies such as their GP.

5.1.3 Support

The manager of the area will be responsible for ensuring that a post incident review, reassurance and appropriate emotional support is offered, both to those staff directly involved, and/or to those who witnessed the incident.

Careful consideration should be given to whether staff should be sent home immediately following an adverse event, or supported to stay at work. This needs to take account of a range of factors such as, the support that can be available at work, the person’s ability to perform duties, the support available at home, whether they are fit to travel home. It may be necessary to contact the staff member’s family to explain what has happened.

After a more serious incident where a number of staff are affected and support issues are particularly sensitive or complex and likely to be ongoing, the service manager will ensure that a senior member of staff is nominated to ensure staff receive support.

Immediate support may need to be coordinated by a senior manager and involve a senior staff member or an external person. Where there are significant support issues, or there has been a serious incident, a more senior manager will be alerted as soon as possible. This manager will be responsible for ensuring that appropriate support is arranged for affected staff which might include:

of 43

The manager of the area will be responsible for ensuring that a post incident review occurs if not completed already and that support mechanisms are in place for all involved.

After a more serious incident where a number of staff are affected and support issues are particularly sensitive or complex and likely to be ongoing, the service manager will ensure that a senior member of staff is nominated to ensure staff receive support.

The choice of staff support will depend on the circumstances. It may be a senior person from within the local team, but in some cases may need to be someone outside the team or service. To ensure that an independent and objective view can be provided for both processes, this will not be anyone actively involved in the investigation process. The nomination of staff to coordinate support will be confirmed by the appropriate Operational Head. In the case of an incident involving a large number of people or more than one team or service, then it may be necessary to nominate more than one staff.

In some circumstances staff may feel they can be offered sufficient support (immediate and ongoing) through their line manager and colleagues, but sometimes individuals may need personal support to assist them in dealing with what has happened.

Counselling or an opportunity to discuss the issues with a suitably skilled person independent of the service is available, although not all staff may want to take up this offer. The Trust has a counselling service available to staff through the Trust Employee Assistance Programme and the Employee Health and Wellbeing Team;

The manager must also consider discussing with the staff member about arranging an appointment with the occupational health department and facilitate a referral as appropriate

Where members of the public or patients make complaints or allegations of negligence against the organisation or individual staff should be given the opportunity to be supported by a colleague or staff representative at meetings. In some cases it may require accessing the support services within the occupational health department.

5.2 Ongoing Support Offered To Staff Staff may require ongoing support sometime after an adverse event. Managers need to be aware of and alert to this and take actions to identify any problems.

• Regular reviews and direct line management support at one to one meetings must be available to the staff concerned. This will offer support and maintain an accurate understanding of the situation and assess further needs

• After a serious or traumatic incident where a number of staff have been affected, the service manager will ensure that a senior member of staff is nominated to ensure that these staff are offered support.

• Ongoing support could be provided by the line manager, human resources and occupational health department.

Sometimes a reaction to a traumatic event may only surface many weeks or months after the incident, so a manager may consider identifying a supervisor or colleague to offer

of 43

support and monitoring over a period of time. This will be arranged and agreed with the staff member concerned.

If a staff member is experiencing difficulties associated with the event, which have not been resolved following the policies detailed above, further supportive actions should be considered by the line manager in consultation with the member of staff and a Human Resources (HR) Manager. It is vital that the line manager and HR Manager work together to ensure that all supportive measures are explored. This may include identifying external support.

5.2.1 Additional Forms of Support (Including Internal and External Support)

Additional forms of support (including internal and external support) which could be considered include:

i. Telephone help lines

ii. External facilitators for support

iii. Occupational Health

iv. Staff counselling service

v. Trust Chaplaincy

vi. Clinical psychology

vii. Professional and trade union organisations

viii. Legal advice

ix. Citizens Advice Bureau

x. Benefit advice

xi. Advocacy Services

xii. Other external sources of help eg police or hospital

xiii. Clinical Supervision

xiv. Management Supervision

xv. Appraisal

5.2.2 Actions to Be Taken If Staff Members Experience Difficulties Associated With the Event at a Later Date

Staff may decide that they do not wish to access support services at the time of the incident or have other support mechanisms they choose to access as an alternative.

However, there is a possibility that it may become apparent at a later date that they need to access the additional support offered. Where this becomes apparent the appropriate manager should ensure that all offers of support as described in Section 5.1 and 5.2

of 43

If a member is experiencing difficulties associated with the event, which have not been resolved following the policies listed above, the following actions must be considered by their line manager, in consultation with the member of staff and a HR Adviser.

• If not already attended, the member of staff should be strongly advised to arrange an occupational health appointment, as they can provide advice on coping strategies.

Other strategies that may be considered on a temporary or permanent basis include:

• Review of working hours in line with Improving Working Lives policy

• Relocation to another ward or department

5.3 Delays in Concluding Investigations and Processes Sometimes the investigations and processes following an adverse event will be lengthy and can go on for a number of years. For example there may be an internal investigation process, but there could also be an external investigation process, a Coroner’s inquest process, a police investigation, a complaint, and a legal process, such as a claim. Support will be available to staff, from management, Serious Incident Lead or Complaints and Claims Manager, throughout these processes, and particularly at the time that a new stage of a process becomes active e.g. when a court proceeding or external investigation begins.

Following the conclusion of the incident review, staff should be given an opportunity for a de-brief.

6 INVESTIGATION PROCESSES AND STAFF SUPPORT 6.1 Introduction The Trust undertakes reviews and investigations of adverse events to collect factual information about what happened and to identify learning and implement change from the event to improve services. In addition there may be external agency investigation processes. This can be a stressful time for staff, who are also important stakeholders in this process. Managers will consider the support staff may need during the investigative process.

6.2 Internal Trust Investigations Following a clear process with open and honest communication can help staff deal with the stress associated with an adverse event and the subsequent investigative process. Staff can be involved in Trust internal review and investigation processes in various ways following an adverse event:

• A properly managed post incident review which outlines what actions the Trust intends to take to address what has happened, including an explanation of investigation processes and any external agency involvement.

• As a witness, through a witness statement and/or interview - to provide factual information or expert knowledge. Staff may be sent a copy of interview notes to agree and sign

• Involvement in a RCA investigation

of 43

• Feedback and discussion of the findings of an investigation and development of an action plan.

6.3 External Investigation Processes External review processes may be undertaken for a number of reasons, either soon after an adverse event or after some time. These can be extremely stressful for staff. Support and communication for staff must be provided as with internal investigations. It is important to ensure communication with and support staff where there has been a time lapse between the internal investigation and an external process eg an independent inquiry process, which can take place two years after the incident.

7 SUPPORT AND ADVICE AVAILABLE FOR STAFF IN THE EVENT OF BEING CALLED AS A WITNESS

7.1 Introduction Increasingly staff are required to attend court or inquests and/or provide a statement in relation to adverse events. This can be a stressful process for staff. The Trust will provide support through the Trust’s Serious Incident Lead, and/or Complaints and Litigation Manager to staff who are required to provide a witness statement, give evidence in court, or attend a Coroner’s Inquest.

In addition if a staff member has to attend an inquest or is asked to give evidence in court for any other reason it is recommended that their line manager or a senior colleague accompanies the staff member to court or to the inquest. Support will be offered by the Serious Incident Team for all Coroner’s Inquests and support may include meeting with the solicitor or counsel representing the Trust prior to the court or inquest hearing.

Staff may also be required to be a witness internally in the Trust

7.2 Witness Statements Witness statements should be completed as soon as possible after an incident to ensure that important information is recorded in an accurately and timely manner.

Guidance and templates for writing witness statements for an internal investigation (incident or complaint), or the Coroner is available in Attachment 1 of this policy.

7.3 Internal Advice Senior Managers, Serious Incident Lead, Complaints and Litigation Manager, Human Resources and Staff Side Representatives may be available to provide support and advice to staff in the event of being called as a witness internally in the Trust for example a disciplinary hearing or Serious Incident investigation interview.

7.4 Attendance at Court / Inquests If there is a Coroner’s Inquest following an incident, affected staff are entitled to access advice and support. This may include legal advice. This will include advice and help prior to the inquest.

of 43

The Serious Incident Lead and/or Complaints and Litigation manager usually receive requests from the court when staff are required to be called as a witness for the Trust eg Coroner’s or in the event of a claim.

If individual staff members are contacted directly by a court or solicitors to appear as a witness they will immediately inform their line manager and the Serious Incident Lead or Complaints and Litigation Manager

The Serious Incident Lead can offer advice for staff that have been called to give evidence at Coroner’s Inquests

The Complaints and Litigation Manager can offer advice for staff that have been called to give evidence in Court as a consequence of a claim

7.5 Statements for Court/ Inquests Following a Trust incident which involved the death of a service user, HM Coroner may commission an inquest and staff may be required to provide statements and appear at the Coroner’s Court.

All staff should ensure that they inform the Serious Incident Lead if they are requested to provide a statement or report for the coroner. The Serious Incident Lead will provide support to staff with making statements and producing reports for the coroner. Additionally medical staff should ensure that the medical director is informed if they are requested to provide a statement or report for the coroner. A copy of the report should be forwarded to Serious Incident Lead.

7.6 Other Circumstances Where Legal Support Is Required There may be other circumstances where Trust staff require support from the Trust in relation to a legal process. Managers should seek advice from the Serious Incident Lead, Complaints and Litigation Team, and/or Human Resources. Professional and trade union organisations may also be able to offer support

7.7 Conclusion of the Incident, Investigation, Complaint or Claim The appropriate line manager / service manager should ensure that staff have the opportunity for a post incident review following the conclusion of the case.

8 RECORD KEEPING AND DOCUMENTATION Documentation and record keeping is important in relation to staff support as in other areas of managing adverse events. It provides a written or electronic record and evidence of what has been done.

• Each adverse event will have an electronic file (incident, complaint or claim file) maintained by the responsible team ie Serious Incident Lead, Risk Management or Complaints and Litigation. This is held separately to any case note or clinical file, although these may also include relevant information.

• Copies of correspondence directly relating to the adverse event e.g. letters requesting witness statements must be kept within the event file

of 43

• Referrals to the Occupational Health Department should be kept by the line manager within the member of staff's personal file.

• Occupational Health will retain the personal and confidential health records of anyone referred to them

• The manager will ensure that details of immediate support offered to affected members of staff are recorded by the web based incident reporting system (IR-e) or on the Incident Report Form (IR1).

• All support offered and given, including ongoing support, should be documented by the appropriate file. This may be recorded in

a. Serious Incident reports

b. Complaints investigation report

c. Staff Personnel file

9 DOCUMENT DEVELOPMENT The Serious Incident Lead is responsible for the development and subsequent review of this policy.

A record of presentation of this policy will be maintained in the Quality and Safety Committee minutes.

The development has been tracked utilising the approved BDCFT checklist for review and approval of procedural documents.

10 EQUALITY IMPACT ASSESSMENT The Trust has no intent to discriminate and endeavours to develop and implement policies that meet the diverse needs of our workforce and the people we serve, ensuring that none are placed at a disadvantage over others. Our philosophy and commitment to care goes above and beyond our legal duty to enable us to provide high-quality services. Our Equality Analysis and equality monitoring is a core service improvement tool which enables the organisation to address the needs of disadvantaged groups. The aim of Equality analysis is to remove or minimise disadvantages suffered by people because of their protected characteristics.

An impact assessment has been undertaken to consider the need and assess the impact of this policy and is evidenced at Appendix B of this template.

11 TRAINING NEEDS ANALYSIS The Trust is committed to high quality targeted training and effective communication to support this policy. The Trust recognizes that training capacity can fluctuate and will depend on resources available. As such based on an assessment of capacity and risk, the training needs analysis will identify the high priority groups for training. The objective of the training to implement this policy is to meet training to this group over the time frequency stated. The focus of Trust monitoring will be on this group over the agreed period or lifetime of the policy.

of 43

Issues relating to capacity to meet training needs for the high priority group will be escalated by the policy lead to the relevant Director for action to mitigate the risk and inclusion on the appropriate risk register.

For a detailed account of training numbers, costs and action plan please refer to the Trust’s Training and Study Leave Policy.

• Information on staff support is dealt with during Root Cause Analysis training (see Policy for Investigations for Incidents, Complaints and Claims.

• The Serious Incident Lead and Complaints and Litigation Manager can offer individual guidance/support to managers

12 CONSULTATION, APPROVAL AND RATIFICATION 12.1 Consultation This policy will be shared with the following stakeholders for consultation:

Stakeholder Level of involvement

Directors Comment

Operational Heads Comment

Professions Council Comment

Quality and Safety Committee Approval and Ratification

12.2 Approval This document was provided to the Professional Council for approval and was approved on the date set out on its front sheet.

12.3 Ratification This document was provided to the Quality & Safety Committee for ratification and was ratified on the date set out on its front sheet.

13 REVIEW The Serious Incident Lead will undertake a review of this document 3 years following its ratification unless new national policy or statutory guidance is issued in the interim that significantly affects it. It is the duty of Trust staff to ensure that the document author is made cognisant of any such changes they become aware of so that the matter can be dealt with through the policy review process.

14 DISSEMINATION AND IMPLEMENTATION The Supporting Staff Involved in Incidents, Complaints and Claims Policy will be disseminated via the policies pages on Bradford District Care Trust’s ‘Connect’.

of 43

The Serious Incident Lead, Complaints and Claims Manager will provide support to all staff as appropriate in relation to all aspects of this policy.

Responsibilities for dissemination are listed on p.2 of this document and for implementation in the duties section.

15 MONITORING COMPLIANCE AND EFFECTIVENESS Criteria Evidence identified to

indicate compliance with policy

Method of monitoring, i.e. how/where will this

be gathered?

Frequency of monitoring

Lead responsible for monitoring

Duties Incident forms and IRE forms Emails regarding support offered Witness statements Coroners reports Serious Incident, Complaint and Claim reports and files Minutes of feedback to staff meetings Occupational Health referrals Personnel files Support letters Line management meetings Support meeting minutes RCA and complaints training Quality and Safety Committee minutes

Annual Report Annually Serious Incident Lead

Immediate support offered to staff (internally and, if necessary externally)

IRE Forms Complaint files Personnel Files Support meeting Notes SI Reports Referrals to Occupational health Emails regarding support offered Personnel files

Audit Annual report

Annually Serious Incident Lead

of 43

Criteria Evidence identified to indicate compliance

with policy


be gathered?



Support letters Line management meetings Support meeting minutes RCA and complaints training Quality and Safety Committee minutes

Ongoing support offered to staff(internally and, if necessary externally)

Referrals to other agencies Personnel files Emails SI Reports Complaint files Occupational heath referrals Line management meetings Support meeting minutes Minutes of Correspondence with Trust legal team

Audit Annual report


Advice available to staff in the event of their being called as a witness (internally and, if necessary, externally)

Emails / letters detailing support Correspondence with Trust legal team Serious incident reports Witness Statements Coroners reports Minutes of support meetings

Audit Annual report


Action for managers or individuals to take if the staff member is experiencing

Personnel files Referrals to occupational health Line management

Audit Annual report


of 43

Criteria Evidence identified to indicate compliance

with policy


be gathered?



difficulties associated with the event

meetings Support meeting minutes HR meetings

16 REFERENCES The Health and Safety Executive (HSE) website provides further information and resources in relation to stress: www.hse.gov.uk

• ‘Line Manager Competency Indicator Tool’. HSE online tool

• PSP/Stress Programme 2006-07: Health Care. (2006)

• How to tackle work-related stress: A guide for employers on making the Management Standards work. (2009)

• Stress Competency Indicator Tools - How Effective Are You at Preventing and Reducing Stress in Your Staff? (2009)

The National Patient Safety Agency (NPSA) website provides further information and resources in relation to managing patient safety incidents: www.npsa.nhs.uk

• Being open: Saying sorry when things go wrong. (2009)

• Being open: Supporting information. (2009)

• Patient Safety Alert. Being Open: Communicating with patients, their families and carers following a patient safety incident. (2009)

• Department of Health. (2005). The management of health, safety and welfare issues for NHS staff. London: Department of Health. Available at: www.dh.gov.uk

• Department of Health. (2010). The NHS Constitution: The NHS belongs to us all. London: Department of Health. Available at: www.dh.gov.uk

• NHS Employers. (2010). ‘Health and safety essential guide’. NHS Employers website pages. NHS Employers. Available at: www.nhsemployers.org

• Royal College Nursing (RCN). (2005). Managing Your Stress: A guide for nurses. London: RCN. Available at: www.rcn.org.uk

17 ASSOCIATED DOCUMENTATION A full list of current Trust policies, policies and guidelines is available on the Trust intranet system. This is a constantly changing list as policies, policies and related documents are developed and updated to ensure that they reflect current legislation, guidelines, good practice and learning. The list below identifies some of the key related documents. (This list is not exhaustive.)

http://www.hse.gov.uk/

http://www.npsa.nhs.uk/

http://www.dh.gov.uk/

http://www.dh.gov.uk/

http://www.nhsemployers.org/

http://www.rcn.org.uk/

of 43

17.1 Trust Documents

• Being Open policy

• Claims Management Policy

• Complaints Policy

• Incident Management policy

• Serious Incident policy

• Investigation of Incidents, Complaints and Claims policy

• Health and Safety policies, policies and processes

• Human Resources and related policies and procedural documents including:

o Disciplinary policy and policies

o Harassment and bullying policy

o Stress (work related) policy

o Whistle-blowing policy and policies

o Sickness Absence policy

• Information Governance (and Caldicott Guardian) related policies and procedural documents

• Media and Communications – related policies and procedural documents

17.2 Interagency Documents and Processes

• Memorandum of Understanding: Investigating patient safety incidents involving unexpected death or serious untoward harm; a protocol for liaison between the NHS, the Association of Chief police officers and the NHS Health and Safety Executive

• Safeguarding Children – West Yorkshire wide Local Authority Policies (April 2007) - web-based.

• Safeguarding Adults Policy

• NHS Yorkshire and the Humber Strategic Health Authority

o Policy for the management of Serious Incidents (SIs)

of 43

18 APPENDIX A: COMPLIANCE CHECKLIST To be completed and attached to any document which guides practice when submitted to the appropriate committee for consideration and approval.

Title of document being reviewed: Yes/No/ Unsure Comments

1. Title Is the title clear and unambiguous? Yes Is it clear whether the document is a

guideline, policy, protocol or standard? Yes

2. Rationale Are reasons for development of the

document stated? Yes

3. Development Process Is the method described in brief? Yes Are people involved in the development

identified? Yes

Do you feel a reasonable attempt has been made to ensure relevant expertise has been used?

Yes

Is there evidence of consultation with stakeholders and users?

Yes

Have the requirements of the following been taken into account where applicable: Mental Health Act Mental Capacity Act Care Programme Approach (CPA) Guidance

Yes

4. Content Is the objective of the document clear? Yes Is the target population clear and

unambiguous? Yes

Are the intended outcomes described? Yes Are the statements clear and

unambiguous? Yes

5. Evidence Base Is the type of evidence to support the

document identified explicitly? Yes

Are key references cited? Yes Are the references cited in full? Yes Are supporting documents referenced? Yes 6. Approval Does the document identify which

committee/group will approve it? Yes

If appropriate have the joint Human Resources/staff side committee (or equivalent) approved the document?

Yes

7. Dissemination and Implementation

of 43

Title of document being reviewed: Yes/No/ Unsure Comments

Is there an outline/plan to identify how this will be done?

Yes

Does the plan include the necessary training/support to ensure compliance?

Yes

Is the Training Needs Analysis completed Yes 8. Document Control Does the document identify where it will be

held? Yes

Have archiving arrangements for superseded documents been addressed?

Yes

9. Process to Monitor Compliance and Effectiveness

Are there measurable standards or KPIs to support the monitoring of compliance with and effectiveness of the document?

Yes

Is there a plan to review or audit compliance with the document?

Yes

Does the above plan include the minimum NHSLA monitoring requirements (if applicable)

Yes

10. Review Date Is the review date identified? Yes Is the frequency of review identified? If so

is it acceptable? Yes

11. Overall Responsibility for the Document Is it clear who will be responsible for co-

ordinating the dissemination, implementation and review of the document?

Yes

Individual Approval If you are happy to approve this document, please sign and date it and forward to the chair of the committee/group where it will receive final approval. Name Sharon Lumb

Date 24/09/2015

Signature Committee Approval If the committee is happy to approve this document, please sign and date it and forward copies to the person with responsibility for disseminating and implementing the document and the person who is responsible for maintaining the organisation’s database of approved documents. Name Date Signature

of 43

19 APPENDIX B: EQUALITY IMPACT ASSESSMENT Area Response

Policy Supporting Staff Manager Serious Incident Lead Directorate Specialist Services Date September 2015 Review date September 2018 Purpose of Policy Inform staff of process for supporting staff involved in

incidents, complaints and claims Associated frameworks e.g. national targets NSF’s

Who does it affect All Staff, involved in Serious incidents Consultation process carried out

Professions council members Serious Incident and Complaints Forum members

QA Approved by

Equality protected characteristic

Impact Positive

Impact Negative

Rationale for response

Age Yes There is currently no information that indicates that this document will disadvantage or have a negative impact on this group if implemented and operated in a manner that is laid out within this document.

Disability Yes There is currently no information that indicates that this document will disadvantage or have a negative impact on this group if implemented and operated in a manner that is laid out within this document.

Gender Reassignment

Yes There is currently no information that indicates that this document will disadvantage or have a negative impact on this group if implemented and operated in a manner that is laid out within this document.

Race Yes There is currently no information that indicates that this document will disadvantage or have a negative impact on this group if implemented and operated in a manner that is laid out within this document.

Religion or Belief


Pregnancy & Maternity


of 43

Equality protected characteristic

Impact Positive

Impact Negative

Rationale for response

Sex Yes There is currently no information that indicates that this document will disadvantage or have a negative impact on this group if implemented and operated in a manner that is laid out within this document.

Sexual Orientation


Equality Analysis SIGN - OFF Have any adverse impacts been identified on any equality groups which are both highly significant and illegal?

No

Are you satisfied that the conclusions of the EqIA Screening are accurate? The Trust will publish a summary of the impact analysis carried out to meet the duty and make this available to the public on the Trust Internet site.

Yes

Completed by Manager S Lumb Q A approved September 2015 Director approved Nicola Lees

of 43

20 APPENDIX C: GUIDANCE FOR STAFF IN GIVING STATEMENTS AND ATTENDING COURT HEARINGS AND INQUESTS

20.1 Introduction Staff may be approached to provide statements and/or reports for any of the following reasons:-

Coroners Inquests;

Internal and External Investigations;

Criminal Investigation;

Claims against the Trust;

Children proceedings;

Fraud and any investigations by Inland Revenue or other agencies;

Employment Tribunals; and

Protection of Vulnerable adults.

Statements or reports should not be provided without informing your manager.

20.1.1 Inquests

Staff may be approached by the Coroner’s Officer on behalf of the Coroner, to provide a statement or a report to assist the Coroner in his enquiries. If this is the case, all staff should inform the Serious Incident lead that a request has been received.

In some circumstances, the Coroner will ask the Police to investigate the circumstances of the death and members of staff should co-operate in the same way. Staff may be asked to also attend an inquest though it does not always follow that, by providing a statement or report, the staff member will be required to attend.

For inquests where legal representation is required, this will be provided by the Trust.

In complex, difficult or controversial cases, the Trust may advise using the Trust’s solicitors to assist with ensuring that statements are robust enough to assist HM Coroner.

All statements must be provided to the HM Coroner via the Serious Incident Team.

20.1.2 Criminal Investigation

Staff are most likely to be asked to provide evidence to the Police following a homicide where a current or former service user is a key suspect or the victim. Officers will request statements from directly involved staff very quickly after the incident and evidence is gathered by interviewing the member of staff. Any interviews not held under caution are classed as informal and can be held at the Trust’s premises. The Trust wishes to co-operate as fully as possible with such investigations and urges staff to make themselves available if requested. If however the Police request an interview with a member of staff

of 43

under caution this amounts to a formal interview and it is imperative that legal advice is obtained.

For informal interviews it is permissible for a colleague to be present for support, and depending on the nature of the incident.

Each case can be considered on its own merits. When a request is forthcoming, this issue should be discussed with the Head of Operations or Heads of Service.

Where health professionals belong to a defence union, Trade Union or a professional organisation, they may also wish to consult or obtain their own legal advice.

In all cases it is permissible for members of staff to be given time to gather their thoughts and therefore defer an interview, to allow the member of staff to access the relevant documentation or, for legal representation to be arranged.

For police interviews the usual format is that the Police Officer will have a face to face interview with the member of staff and will handwrite the statement on a standard form which the member of staff will then be asked to read, and make amendments. The amendments are initialled and the member of staff will then be asked to approve the statement and sign the statement of truth at the end of each page of the statement.

It is imperative that the member of staff is content that the handwritten statement as transcribed by the Police Officer is a true reflection of what was said in the interview, as this will stand as that member of staff’s evidence in any forthcoming criminal trial. The Police are often reluctant to permit copies of statements to be kept by the witnesses, but it is permissible to request a copy at the time of signing on the basis that this will be kept confidential.

20.1.3 Claims Against the Trust

Occasionally staff are contacted direct by a claimants’ legal representative to provide a statement in connection with litigation against the Trust. The member of staff must notify their Service Manager and the Complaints and Litigation Manager immediately of such an approach. The Trust manages litigation in accordance with agreements with the NHS Litigation Authority. On occasions staff may be asked to provide statements for solicitors in relation to matters which do not directly relate to the Trust; again the Service Manager and Complaints and Litigation Manager should be immediately notified before any information is provided.

20.1.4 Children Proceedings

Those members of staff involved in children’s services may be asked to provide statements/reports by a local authority, or a parent, or their legal representatives. These statements require careful and detailed consideration. Child protection issues/critical incidents may be involved. Where parent’s legal representatives are contacting staff, careful consideration must be given by the Safeguarding Children Lead to discuss whether any statement or report should be provided, and whether legal advice should be sought. In local authority court proceedings, it is rarely inappropriate to provide such a statement. It is likely that these statements will need to be provided quickly given timescales by which Courts must hear children’s cases, with all relevant input from health professionals.

of 43

20.1.5 Criminal Investigations

Individuals may be asked to provide a statement or attend court as part of a criminal investigation. This could relate to offences including fraud, theft, assaults or other criminal activity. Investigations can be conducted by a variety of agencies including, the Local Counter Fraud Specialist, Security Management Specialist, HM Revenue and Customs or the police. Employees including non-executive directors, have an obligation to report suspicions of crime as specified in the Fraud and Corruption Policy.

20.1.6 Employment Tribunals

Employment tribunals deal with claims concerning dismissal, redundancy, discrimination, pay, and employment contracts. They are legal bodies which sit in public. A Tribunal consists of a legally-qualified chairman and two lay members – one representative of employers and the other representative of employees.

Staff may be asked to be witnesses, either by the Trust or by the member of staff bringing the Tribunal claim. In some circumstances the Tribunal may issue a Witness Order to require an unwilling witness to attend.

Witnesses normally provide a written statement in advance and are then available in person to be questioned by both parties and by the Tribunal. Witnesses are usually required to give their evidence on oath or affirmation. If you are a witness for the Trust, the Trust’s advocate (usually a solicitor or HR manager) will inform you about the policy. If you are a witness for the member of staff bringing the claim, their representative (often a trade union official) will normally give you a briefing. Witnesses may be called at a preliminary hearing, held to examine a particular issue, as well as at the main hearing.

Many of the issues which are subject of Employment Tribunals will previously have been raised in internal appeals within the Trust, generally with the same witnesses providing statements.

20.2 Release of Records Originals of records must not be released without the agreement of the Information Governance department. In most circumstances, copies must be taken and the Trust must retain the originals. Occasionally the Coroner will request the originals and in these circumstances they can be provided, but a copy set should still be retained by the Trust. Where a legal representative is requesting the original or copy medical records, contact must be made with the Information Governance Department. In particular there may be circumstances (e.g. child protection or vulnerable adult unable to give consent) where medical records may need to be withheld until a court order is received.

If the Police request copies of records, they must provide a Section 29 Document to the Information Governance department detailing the rationale for the request.

20.3 Support to Staff It is recognised that being involved in a serious incident and its subsequent investigation or inquest can be stressful and difficult for staff. The member of staff should contact their Service Manager to agree what support the Trust can provide. This may involve further involvement of the Trust’s solicitors, including prior to the court hearing, arranging for staff to be briefed on the process; and/or having legal representation available; and/or having

of 43

access to Staff Counselling service or Occupational Health. As a minimum the member of staff should be accompanied to court.

20.4 Statements and Reports Statements: are documents recording matters of fact and not opinion (see guidance in this attachment and template A1).

Reports: are documents which are normally requested by the Coroner and will contain matters of opinion and clinical judgement (see template A2).

Reports and statements must be shared with the appropriate Service Manager and Serious Incident Lead in draft before they are sent to the Coroner. Consideration must always be given as to whether the matter should be referred to the Trust’s solicitors.

20.5 Court Etiquette Address a Coroner as “Sir” or if female “Ma’am”.

Address a Judge as “Your Honour” or “Judge”.

All rise when a Judge/Coroner enters/leaves the room.

Witnesses are asked to swear an oath or affirm before giving evidence.

Press can be present throughout inquests.

At inquests, family members or the deceased’s representative may question the witness, in addition to the Coroner.

Dress Code: smart but comfortable.

NB This document is not intended to provide guidance on external inquiries or multi team investigation. There are a range of external enquires all with differing requirements.

of 43

21 APPENDIX D: GUIDANCE TO STAFF ON WRITING A STATEMENT

You may be asked to provide a statement as a result of an incident, complaint or claim. The following guidance aims to assist you in preparing that statement.

1. Do not panic. Don’t feel pressured into providing a statement ”immediately”. You must compose it with due thought, care and with reference to relevant documents. Remember that the statement needs to be as accurate as possible, so try to complete it as soon as you have all the information you need.

2. Make sure you understand the task, if you are unsure about what you are being asked to do, seek guidance from:

Your Service Manager;

Complaints and Litigation Manager;

Serious Incident Lead

Risk Management;

Professional or Trade Union Representative.

3. Your statement must include your:

Full name;

Qualifications and brief details of your relevant experience;

Details of the post you hold and your job location e.g. ward;

State the time you started and finished your duty on the day(s) in question.

4. Be clear about why you are writing the statement, what it is for and who will need to read it. Use of initials is allowed to identify the service use, do not use identifying names in the documentation,

5. Assume the reader knows nothing of the facts, nor of hospital routines. It may be read by a Coroner or jury therefore needs to provide the lay-person with relevant information.

6. Write a factual account only.

7. Always refer to the service users notes to help you.

of 43

8. List the events in the order in which they occurred giving precise dates and times.

9. Quote the relevant reference numbers if associated with a reported SUI or complaint.

10. Write simply and avoid jargon or abbreviation. Write short precise paragraphs.

11. When mentioning policies, describe them carefully.

12. Always refer to the guidelines currently available at the time in question.

13. If normal policies were not followed, state what the normal policies are and why these were not followed.

14. When referring to other people, be precise in their full name and title.

15. Get the final statement typed if possible (otherwise write it neatly in Black Ink).

16. Check your statement thoroughly and keep a copy for reference.

17. Sign and date each page of your statement, print your full name and job title below your signature on the final page. It is good practice for the statement to generally end with: “This statement is true to my knowledge and belief”

of 43

22 APPENDIX E: CONFIDENTIAL REPORT FOR THE CORONER

Statement for HM Coroner Name of Author

Job Title

Place of Work

Name of Patient

Date of Birth

Date of Death

of 43

1. I am [insert full name] I am a (insert job title and speciality) employed by Bradford District Care Trust since (enter date].

At the time of this incident I was employed at BDCT as a (insert role) 2. I have considered the patient’s medical records in the preparation of this report

and (also list any other documents you have referred to e.g IRE forms) 3. I first became involved in the care of [full name of patient] on [insert date

DD/MM/YYYY]. 4. Explain what care and treatment you provided when and why, include your

interventions with the patient, correspondence with other professionals, treatment plans and assessment of risk

[Depending on the individual circumstances, consider referring to the following within your statement:) Personal Family Background Social circumstances Past psychiatric history Diagnosis Personality Physical Condition Medication Risk Assessment Include details of the plan of care, including crisis plan Events leading to the incident Reference to any Trust policies, procedures, protocols or guidance 5. Summary and conclusions I declare that the contents of my statement to be true to the best of my belief. Signed: ………………………… Dated: ……………………. (on each page)

of 43

23 APPENDIX F: A GUIDE FOR WITNESSES CALLED TO GIVE EVIDENCE AT A CORONER’S INQUEST

23.1 Introduction During your professional career you may be involved in the care of a person who dies unexpectedly.

This guidance looks at the practical advice you need in your professional role when you are called as a witness at a Coroner’s Inquest

23.2 A Coroner’s Inquest The Coroner has a duty to investigate those deaths that are reported to the Coroner.

The Coroner is an independent judicial officer appointed to investigate all sudden, violent and unexplained deaths of persons who have either died in, or whose bodies are brought into, the area.

This can be as a result of a referral from a hospital, GP or in the case of a death in the community, the police.

The coroner will be involved if the death was violent, or death occurred in suspicious circumstances, in prison or police custody, was caused by an industrial disease, while a patient was having an operation, or if the deceased was not previously ill or had not seen a doctor within 14 days before the death, or the cause of death is unknown or uncertain.

An inquest is a hearing where the Coroner hears evidence to decide who is the person who has died, and how, when and where s/he came by his/her death.

It is important to note that an inquest is not a trial. An inquest establishes the identity of the deceased; how, where and when the death occurred but not who (if anyone) was responsible for it. Blame for a death is determined at a trial in the applicable civil or criminal court, not at the inquest.

23.3 Common Fears Experienced By Clinical Staff

• Waiting for the inquest date to be identified by HM Coroner.

o As a guide, HM Coroner’s aim to conclude an inquest within 6 months of the date of death of a service user, however there are circumstances in which this may be delayed. The Serious Incidents team maintains contact with the Coroner’s Office throughout the process and will inform you as soon as an inquest date has been identified.

• Thinking other staff will blame you and worry about what they think of you.

• Fear of another unexpected death.

• Feeling guilty that the patient died.

• Feeling professionally inadequate and that you let the patient or family down.

• Fear of being blamed by the organisation for what has happened.

of 43

• Thinking that you won’t be able to speak in the witness box without becoming emotional.

• Fear of seeing the family in the Court Room

• Being cross examined by the family or their legal representatives.

• Not understanding the legal process.

• Fear of being made to look incompetent.

o The above is a list of thoughts and fears which clinical staff and managers regularly report prior to inquest. It is important that you are well supported throughout the Serious Incident and inquest process.

o Please access the support available - The Serious Incident team, your line manager, and your clinical supervisor may be good sources of support during this time.

o Additionally, the Trust has a clear policy which outlines what support you can expect (the Supporting staff involved in Incidents, Complaints and Claims can be accessed on Connect).

23.4 Role of the Serious Incident Team

• The Serious Incident Department is the nominated contact point in the Trust for the Coroner’s Office and requests for Reports or Statements will be directed there in the first instance.

• In the rare event of the Coroner’s Office contacting you directly please forward all correspondence on to the Serious Incident Department prior to responding and advise the Coroner’s Office to direct any further communication to us in the first instance.

• The Department are available to offer guidance, support and answer any questions prior to the Inquest.

• The Department will ensure that a Pre-Inquest Support meeting is arranged

• The Serious Incident Lead will usually be in attendance at the Inquest.

23.5 Prior to the Inquest

• You will be asked to complete a statement for the Trust as part of the Serious Incident process. This statement may be used as the statement for the coroner and you will be given a copy of this.

• Find out where the location of the Coroner’s Court is and establish how you will get there.

• To get a sense of the procedure at Inquest it is helpful to visit the Coroner’s Court Room.

• You may also wish to consider attending a Coroner’s Inquest yourself to familiarise yourself with the procedure.

of 43

• Plan what you will wear on the day. Remember this is a formal sombre occasion – you should be dressed professionally/formally (men should wear a shirt and tie and women should be dressed smartly).

23.6 Day of the Inquest

• Allow plenty of time to get to the Court.

• Do not be late

• Arrange to meet other colleagues who may be attending and make time to meet up for a coffee in advance

• The Coroner’s Court shares a building with the Magistrates Court, for this reason airport-style security is positioned at the entrance. Security staff will search your bags/belongings and you will need to pass through a metal detector.

• Be prepared to come into contact with family members and media representatives.

• Keep conversation to a minimum and non verbal communications appropriate. Present a professional demeanour as you are representing yourself, the Trust and your profession.

• On entering the court room you may be seated and should remain silent.

• The court will stand when HM Coroner arrives and then be seated.

• HM Coroner will begin the inquest by naming the deceased person and giving the date of their death

• HM Coroner will be voice recording the entire inquest.

• HM Coroner will then go on to ‘set the scene’ in order to describe the purpose of inquest which is to establish how, when and where a person came by his or her death.

• HM Coroner then discloses all evidence he has received in writing. This may include pathology reports, medical or pharmacy reports, clinical records, SI reports from the Trust and witness statements.

• There may be legal representation present at inquest who represent the family or witnesses

• HM Coroner may make available to them any plans or photographs pertaining to the evidence (for example ward layout)

• The Press are usually present and taking notes throughout proceedings.

• Whilst waiting to be called you are in full view of HM Coroner, the family and the press and it is essential to remain silent.

23.7 Taking the Witness Stand

• Speak clearly

• Answer only what is asked.

of 43

• Do not offer information you are not asked about

• Do not be subjective.

• Take your time to respond, considering your response carefully

• The Coroner may ask you to explain your role and what your responsibilities are within your role. You may wish to prepare or rehearse for this question

• Take with you any clinical records or a copy of your witness statement that you may wish to refer to.

• Once in the stand you will be required to take the Oath or Affirmation. You will be provided with a printed card by the Court Usher which you can read.

• Listen carefully to the question being asked

• Ask for the question to be repeated if you need to.

• Address HM Coroner as Sir or Madam accordingly.

• Face HM Coroner as you speak

• Use ordinary language and if you use a professional or technical term offer an explanation of what this is.

• Do not answer questions beyond your scope of practice or those which are more appropriately directed at another professional. Be respectful and state this to HM Coroner.

• If you do not know the answer to a question, then say so clearly.

• Avoid being evasive, angry or upset.

• Do not become argumentative and if you disagree with a statement made to you then do so firmly and repeat your position respectfully.

• You are under Oath of Affirmation so do not exaggerate, TELL THE TRUTH.

• If you make a mistake, apologise to HM Coroner.

• After HM Coroner has finished asking you questions, the family or their legal representative will be invited to ask you questions. You should continue to address answers to these questions to HM Coroner.

• If the family or their legal representative asks an inappropriate question, or a question which asks for your personal opinion (rather than facts or your professional opinion) you should politely not offer a response and clarify with HM Coroner your rationale for this.

23.8 Leaving the Court Room and Taking Care of Yourself

• Remain calm and respectful and minimise any non-verbal or verbal display of emotions.

• If contact has been maintained with the family it may be entirely appropriate to offer your condolences again before respectfully leaving.

of 43

• Do not enter into any discussion with media representatives.

• The Trust will minimise adverse publicity by issuing a formal statement to the media where appropriate to do so.

• Keep all conversation with colleagues to a minimum until you meet up in a private and prearranged venue.

• Recognise that you did the best you could on the day and evaluate your experience with whoever accompanied you to the Inquest.

• At the earliest opportunity on return to work, reflect on what went well, what didn’t go so well and be supported through supervision processes.

• Inquests can be quite emotionally charged and it is wise to consider taking some “time out” afterwards.