Hospital Dr News

Doctors vulnerable to investigation over neglect

Police investigations of doctors may become more common following the introduction of the new criminal offence of wilful neglect or ill-treatment, the Medical Defence Union has warned.

From this month, section 20 of the Criminal Justice and Courts Act 2015 applies to individuals such as doctors, dentists and nurses.

It makes it “an offence for an individual who has the care of another individual by virtue of being a care worker to ill-treat or wilfully to neglect that individual.”

Dr Michael Devlin, MDU head of professional standards and liaison said: “No-one would condone any deliberate act or omission by care staff designed to harm or distress a patient. But ethical principles make clear how healthcare professionals should make the care of their patients their primary concern.

“The new legislation is likely to lead to more police investigations if there is any question that a doctor may have wilfully neglected or ill-treated a patient through something they did or didn’t do. Even if a decision is later made not to prosecute the doctor, such investigations can last for months or even years and doctors may also be suspended by their employer and/or referred to the GMC.”

The MDU believes there would need to be a significant or serious departure from acceptable standards for there to be an offence and the Department of Health has explained that the new offence is not designed to penalise doctors who make genuine accidents or errors.

However this may not prevent a rise in the number of police investigations in cases where wilful neglect or ill-treatment is suspected.

Devlin continued: “Doctors will be wondering what they can do to avoid such a stressful investigation. It is vital that they tell patients if there is a significant delay in their treatment or diagnosis.

“Clinicians should explain to patients why the delay has happened, for example because of a waiting list, what they are doing to try to speed things up as well as ensuring the patient understands the need to get urgent medical advice if their condition worsens. Doctors should also explain to patients if any treatment will be painful for them or significantly impact on their dignity.

“Good communication with patients and colleagues, including clear written instructions in the clinical records, are vital to ensure continuity of care, and may also help defend a doctor in the event of a police investigation.

“It’s important that any doctor who is informed they are involved in a police investigation doesn’t panic and contacts their medical defence organisation as soon as possible.”

Cases which might lead to a wilful neglect investigation:

– A junior doctor who assesses a man with abdominal pain and probable appendicitis is called away to deal with another emergency. There is a significant delay in the man being referred to the surgical team and the man suffers a ruptured appendix. The man is finally operated on and makes a full recovery but later complains that the junior doctor neglected to refer him to the surgical team.

– A GP sees a five-year-old boy with a high temperature and diarrhoea. After careful examination the doctor can find nothing of concern and suspects a viral illness, advises the parents accordingly, and tells them to keep an eye on the child and to contact the surgery again if his condition worsens. That child is admitted to hospital 10 hours later with meningitis and suffers brain damage. The understandably distressed parents complain that the GP was rushed and off-hand and was wilfully neglectful in not diagnosing meningitis.

Read the MDU guidance.

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