The MDU in action
Physiotherapy care cover scenario
27.09.24
The following is drawn from the real-life experience of the MDU supporting healthcare organisations during times of crisis. It illustrates the depth of support and guidance available to MDUConnect members.
The scenario
A 48-year old woman consulted a private physiotherapy clinic with pain in her Achilles tendon.
After clinically assessing the woman, the physiotherapist diagnosed Achilles tendinopathy, prescribed various therapies, including an eccentric exercise programme and stretching, and advised the patient to go back to her normal activities once the pain had eased sufficiently.
The patient issued a complaint two weeks later.
She had suffered increasing, debilitating pain following the advice and had attended her local emergency department, where doctors had diagnosed an 80% rupture of the tendon. Her ankle was immobilised and a referral made for an urgent orthopaedic review.
The patient wrote a scathing review on the corporate’s website.
Risks and impacts
In a scenario like this, of course a medical malpractice claim can arise, but there are many other areas to consider, some of which impact the corporate entity itself.
They include:
- Complaint: a common impact that must be dealt with quickly and sensitively
- CQC obligations: there is a need to follow the statutory duty of candour processes
- Digital media: the risks of reputational damage following the patient’s review cannot be underestimated, particularly if the review is shared on social media.
Support from an MDU risk advisory partner
In a scenario like this, an MDU risk advisory partner (RAP) would be able to step in, supporting the business and ensuring that the incident and any fallout are dealt with in an efficient and professional manner. This support could include the following:
- Duty of candour support: advice to the clinic on discharging its duties in accordance with the statutory duty of candour. Timescales for duty of candour notification to the patient are set out in statute and are short (notification is to be made as soon as is practicable).
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Clinical governance review: advice about carrying out a review of the incident to ensure lessons are learned and the risk of future recurrence is reduced.
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Complaint resolution: advice to the corporate on dealing with the patient’s complaint. Most complainants want an apology, explanation, and reassurance that lessons have been learnt. A well-handled complaint often resolves issues without recourse to a claim. The RAP will be aware of the need for an apology and a reflective, complete complaint response.
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Employee disciplinary support: advice (via partner organisation) on disciplinary/employment matters, if needed, relating to the physiotherapist. The (Peninsular) team provides 24-hour employment law and health and safety advice through dedicated consultants with in-depth experience in employment legislation, contractual requirements, and case law precedents. The team also provides phone coaching when managing difficult or complex employee relations and access to a team of specialist solicitors who can advise on contractual matters.
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Reputational risk: advice from the MDU’s media team on how to manage scrutiny on social media, taking into account the need to maintain strict patient confidentiality.
Sarah Jarvis
Risk advisory partner
Sarah has been a full-time medico-legal adviser since 2013, and has wide experience of supporting healthcare companies in dealing with complaints, inquests and general medico-legal queries.
A GP partner and trainer before joining the MDU, she is a team leader in the advisory department, where she also draws on experience gathered from sitting as an MPTS fitness to practise panellist, including chairing the panels.
Oliver Lord
Risk advisory partner
Oliver is part of a specialist advisory team that assists members with disciplinary investigations and has an interest in doctors’ wellbeing.
Before joining the MDU in 2013 Oliver was a consultant psychiatrist in a crisis resolution team. He provides regular talks and courses to members on medico-legal issues, conflict resolution and unconscious bias.
John Dale Skinner
Risk advisory partner
John is a medico-legal adviser and risk advisory partner. John has been with the MDU for the past 10 years, having previously worked as a GP.
He has wide experience as a senior medical claims handler helping MDU members defend clinical negligence claims.
Kathryn Leask
Risk advisory partner
Kathryn has been a medico-legal adviser with the MDU since 2007. She is a team leader and trainer in the medical advisory department.
Before joining the MDU, she worked in paediatrics, gaining her MRCPCH in 2002, and holds a CCT in clinical genetics. Kathryn also holds an MA in Healthcare Ethics and Law, a Bachelor of Law and a Professional Doctorate in Medical Ethics. She is also a fellow of the Faculty of Forensic and Legal Medicine and has previously been an examiner and deputy chief examiner for the faculty.
Kathryn is currently a member of the faculty’s training and education subcommittee and a member of the Royal College of Pathologists (medical examiner).
Jerard Ross
Risk advisory partner
Jerard has been with the MDU for over 10 years, and now works as a risk advisory partner.
Prior to joining the MDU, he was a consultant neurosurgeon balancing a busy NHS practice with private sector work. He is currently the educational lead for the MDU and head of Scottish affairs.
Ed Farnan
Risk advisory partner
Ed has been a medico-legal adviser at the MDU since 2013, and now works as a risk advisory partner. In addition to providing advice and assistance to members. Ed has worked as a clinical risk manager in the underwriting department and as a member of the medical education team.
After qualifying from Queen’s University Belfast in 1995, and as a GP in 2000, he worked as a partner in general practice for around 12 years before joining the MDU.
With an interest in clinical governance, Ed sat on a regional research ethics committee, completed a master’s degree in medical law in 2011 and became a Fellow of the RCGP in 2015.
Ed also writes articles for the MDU and other publications as well as running courses and webinars.
Leo Briggs
Risk advisory partner – dental
Leo is a risk advisory partner specialising in supporting dental practices in dealing with complaints and regulatory matters, as well as general dento-legal queries.
Having qualified from University College Hospital London in 1989, he has worked extensively in the Community Dental Service as well as in general dental practice. Leo also gained an MSc in Periodontology from the Eastman in 1995 and is on the GDC specialist register for Periodontics.
Leo worked part time as a clinical tutor at the School for Professionals Complementary to Dentistry in Portsmouth and started working part time for the DDU in 2005. He has been with the DDU full time since 2009 and became deputy head of the DDU in 2016.
Sarah Ide
Risk advisory partner – dental
Sarah is a risk advisory partner and has been working at the DDU as a dento-legal adviser since 2015, initially combining this work with general practice.
She qualified from Guy's Hospital Dental School in 1992, working there as a house officer before entering general practice as a vocational trainee.
Sarah subsequently worked in independent and private general practice for 25 years and completed an MSc in Aesthetic Dentistry at King’s.
