Posts Tagged ‘Suspended’

Royal Surrey Hospital suspends epilepsy doctor

BBC Health - 23rd July 2011 9:41 am

A hospital doctor has been suspended after concerns were raised about how children with epilepsy were being treated.

Parents of 569 children have been told there will be a review of Dr Nicholas Driver’s methods going back nine years.

The Royal Surrey County Hospital said none of the children had died as a result of the treatment. But medical director Christopher Tibbs did not rule out that some children may have come to harm.

Dr Tibbs said the hospital, in Guildford, received a letter from a paediatric neurologist in February expressing concern about Dr Driver’s methods. Dr Driver was suspended from working with children with epilepsy the next day.

Two weeks later, he was suspended on full pay from all hospital duties, Dr Tibbs said.

Dr Tibbs urged parents not to change their children’s medication without seeking expert advice. He refused to go into specifics but said the concerns were about “the totality of the management of the patient”.

Read BBC Health.

Suspension periods are falling, figures suggest

By Mike Broad - 28th March 2011 8:18 am

Suspension periods for doctors - who have fallen foul of their practices or trusts - are getting shorter, figures reveal.

However, GP suspensions still average about twice the length of exclusions in the hospital and community sector - 39 weeks against 21 weeks in the year to September 2010.

The statistics, from the National Clinical Assessment Service, also show that while two-thirds of GP suspensions involve the GMC, only a quarter of those involving hospital doctors did.

Suspensions are likely to be lengthened by the involvement of a regulator.

Professor Alastair Scotland, director of NCAS, said: “The cost of exclusions to the NHS and to the public has been well recognised for many years and led to the National Audit Office’s report in 2003. However there has been much less scrutiny of suspension in primary care.

“Our figures suggest that concerns about professional practice are late in coming forward in primary care. Late recognition increases the likelihood of regulatory action and therefore lengthens the time for resolution. This is too late to assist the practitioner and means that patients are at greater risk of harm. Performance concerns are best dealt with as early as possible - not only to identify those cases that must involve the regulator, but also to focus on helping those cases where safe practice can be restored effectively.”

The NCAS works with health services to resolve concerns about individual professional practice.

Read the full report.

Overseas doctors more likely to be suspended

By Mike Broad - 17th February 2011 11:35 am

Doctors qualifying outside the UK are more likely to be referred to be excluded or suspended from work than UK medical graduates.

Statistics from the National Clinical Assessment Service reveal higher rates of concern among doctors who qualified elsewhere in the European Economic Area as well as outside Europe, with the highest rates seen amongst non-white doctors.

However, NCAS attributes these differences to place of qualification and training factors at undergraduate level rather than to ethnicity. Levels of concern amongst doctors qualifying in the UK do not differ between white and non-white groups.

Approximately 5,600 NCAS referrals were examined altogether, including 900 in the most recent year, 2009/10. The latest year’s figures show patterns very close to those reported in earlier years.

NCAS, which provides advice to trusts on improving the performance of individual doctors, is calling on the NHS to strengthen induction and support systems for international medical graduates so that levels of concern about professional practice can be reduced.

Professor Alastair Scotland, Director of NCAS, said: “We are not generalising. Most doctors from outside the UK do excellent work for the NHS and the service depends a great deal on them and the skills they bring. But these statistics show clearly that there is a greater likelihood of concerns being raised in some groups than others”.

The analyses also show a strong association between concerns about professional practice and the gender and age of doctors being referred.

Scotland added: “We consistently find higher levels of concern in older age groups, which might be telling us something about the educational needs of doctors at the later stages of their careers. We also find fewer concerns amongst women at all ages. The reasons for that are less clear and it is therefore important we see more research in that area.

“There has been a great deal of discussion in recent years about the influence of ethnicity and place of qualification on concerns about professional practice. NCAS’ statistics have shown consistently that place of primary qualification has a more powerful influence on referral to our services.”

Read the full report - Concerns about professional practice and associations with age, gender, place of qualification and ethnicity - 2009/10.

Scotjunior doesn’t deserve Needham’s rehash

By Bob Bury - 15th February 2011 12:33 pm

While I was writing this blog, a news story on the issue was posted on the site, but I make no apology for the apparent repetition - I think this is important.

Two years ago, a junior hospital doctor caught up in the car crash which was MMC made a posting on the online forum DNUK concerning Dame Carol Black, one of the fiasco’s architects. The posting was rapidly removed at the poster’s own request, but as I recall, it suggested a suitable proctological repository for the MMC/MTAS scheme, using language which was a little intemperate, but nothing that would upset the average Royal Navy stoker or surgeon.

The posting was seen by a senior medical educationalist, who took offence on behalf of Dame Carol and alerted Professor Gillian Needham, the postgraduate dean responsible for the training of the doctor in question. The end result was that the young doctor (who was rapidly granted the cyberspace nom de plume of ‘Scotjunior’) was suspended from his job. As you can imagine, there was considerable reaction to this series of events, not least on the DNUK forums. It was perhaps unfortunate that the three leading protagonists arrayed against and/or targeted by the doctor were ladies, a fact which led to much use of the C-word (no - ‘coven’, not the other one).

Any link to the admittedly scatalogical coverage of the affair by the admirable Dr Rant would no doubt be removed by this site’s lawyers, but the curious reader might find that googling ‘jobbygate’ brings up some lively contemporary comment, revealing that incoherent anger was not a rare commodity at the time. Indeed, you could suggest that Scotjunior was simply reflecting the junior doctor zeitgeist.

Scotjunior was eventually allowed to return to work, and there the matter might have rested. But then, last weekend, Prof Needham published a personal view in the BMJ re-hashing the whole affair, justifying her actions and asking us to sympathise with her concerning the adverse personal comment resulting from her role in it (the link will only allow you to see the abstract of her article unless you subscribe, but you can read the electronic responses, of which more below).

The result has been predictable - a second flurry of highly critical responses. You (well, some of you) will be able to read the whole article, but in it Needham makes much of the fact that she was prevented from responding to criticism the first time round because of her professional responsibility to Scotjunior, and also because he clearly ‘needed help’. I don’t know if he is still working in the same deanery; presumably not, as Needham seems to feel that her duty of care towards him has expired.

The renewed criticism centres on the fact that her article has drawn attention to the affair yet again, in a public forum, and intimated that she had concerns for the mental stability of the doctor concerned (yes - I know that ‘needed help’ could mean all sorts of things, but it would be disingenuous in the extreme to suggest that use of that particular phrase would mean anything else to readers of the article). The identity of Scotjunior will already be known to those who followed the initial events, and can be readily ascertained by anyone whose curiosity is piqued by the BMJ’s raking over of the ashes.

If Needham was hoping to elicit sympathy for her plight, a quick viewing of the internet traffic will be very disappointing for her, and she may eventually feel that the maintenance of a dignified silence would have served her interests better. But my reason for drawing attention to this in what is normally a lighthearted blog has nothing to do with the professor personally. More important is the lack of insight demonstrated in the article.

It suggests that some senior medical educators still fail to grasp the degree of distress and genuine hardship caused to a whole generation of junior doctors by the ill-conceived imposition of MTAS. Instead of griping about the language used by some of the victims, Needham and her colleagues should be asking themselves just how they came to acquiesce in the introduction of the scheme, despite repeated contemporary warnings that they were courting disaster.

And secondly, why did the BMJ publish the article? Most of us stopped regarding it as a ‘proper’ scientific journal when it began to view the generation of tabloid headlines as the true measure of its success. Even so, the publication of an article which appears to treat the confidentiality of a trainee so lightly calls into question its editorial judgement.

Incidentally, if it turns out that Scotjunior gave his permission for publication, we would need to ask just how valid that consent could be, when it was being sought for an article written by a postgraduate dean who had already allowed him to be suspended once.

I suspect there may have been some soul-searching within the BMJ editorial department over the weekend, because I can’t help noticing that, despite an immediate influx of rapid responses (some of them probably completely unpublishable in a family journal), the more measured replies only began to appear on their website several days after the article which prompted them. This may just reflect the fact that the editorial team all go home at the weekend, but since then, several of the responses seem to have disappeared and then re-appeared. Not surprisingly, all of them are, at the time of writing, highly critical of both the content of the article and the BMJ.

Not that the doctor at the centre of the affair will be finding any satisfaction in the negative reaction to Needham’s article. From the outset, he made it clear that he did not wish to become a cause celebre; having apologised and withdrawn his online comments, he just wanted to keep his head down and get on with his career. He should have been allowed to do so.

Consultant “didn’t break data protection rules”

By Francesca Robinson - 28th August 2010 8:20 am

A senior diabetes consultant who was sacked for gross misconduct after faxing patient records from her hospital to a community clinic has been exonerated by the GMC.

The South Warwickshire General Hospitals Trust (SWGHT) accused Dr Shirine Boardman of breaching patient confidentiality when she sent the names and contact details of more than 80 diabetes patients to her secretary at the Apnee Sehat NHS clinic in Leamington Spa.

Boardman’s aim was to invite the patients to a structured education programme to help them manage their diabetes. She was acting in according with NICE guidance. At the time all trusts had a statutory requirement to provide this patient education.

The award winning Apnee Sehat clinic (meaning “our health” in Punjabi) was a pilot service set up by Warwickshire Primary Care Trust to provide clinical care and help to disadvantaged members of the Asian community. Boardman led the establishment of the project in 2007 as part of her employment contract with Warwick Hospital.

But the SWGHT complained that Boardman made an unauthorised transfer of confidential data from the trust in breach of GMC guidance, the Data Protection Act and the trust’s data protection policy.

The case was sent to the Information Commissioner for an alleged criminal breach of the Data Protection Act in July 2008. Shortly afterwards Boardman was sacked. The decision was later upheld by an employment tribunal.

But the Information Commissioner dropped the case and the GMC has now scrapped a fitness to practise hearing saying that Boardman acted “solely to benefit patients”.

Dr Keith Brent, deputy chairman of the BMA’s consultants committee, said: “There seems never to have been any question that Dr Boardman was anything other than a good clinician providing good care to her patients.”

Dr Sue Roberts, former government diabetes tsar, comented: “The dismissal of Dr Boardman was fundamentally unreasonable in that it disregarded good medical practice in the treatment of diabetes.”

Boardman, who has four clinical excellence awards and has won four national awards for her work, said she had been shocked by the speed with which she had been sacked.

It has taken her two years to do the research to understand the NHS data protection laws, to obtain information from the trust through Freedom of Information requests and to get the right legal experts and witnesses to help her fight her case.

“I don’t think in medical school or specialist training anybody ever told me the kind of trouble we could get into as doctors. The minute something goes wrong it’s enormously important to get the right advice from the right people because a lot could have been done to save me before I was dismissed,” she said.

Peter Bottomley, the Conservative MP for Worthing West, has raised Boardman’s case in Parliament and is calling for the individuals at SWGHT who made the complaint to account for their actions. If this does not happen he says he will be pressing health secretary Andrew Lansley to conduct a review.

He would also like the case to be investigated by the Equalities Commission. He said: “It is now clear Dr Boardman was right and they were wrong and their allegations and smears were unjustified. In my experience no male or no white consultant has ever been treated like this.”

A trust spokesman said: “The trust’s actions were in the best interests of patients as the breach of patients’ confidential information is a serious matter and one which patients themselves also take very seriously.”

Pressure to improve support for whistleblowers

By Francesca Robinson - 4th April 2010 9:31 am

Health secretary Andy Burnham is coming under pressure to investigate the unfair treatment of NHS whistleblowers. 

More than 2,000 people have signed a petition calling on Burnham to explain why suspended consultant pediatrician Dr Kim Holt, who was vindicated by an investigation after she criticised the clinic which sent Baby P home to die, has not been reinstated. 

Holt has spent the last three years on paid “special leave” after warning - more than a year before Baby P came to the clinic in Haringey - that she and other doctors there were dangerously overworked and a child would die unless action was taken.

In December 2009, her employer, Great Ormond Street Hospital, promised to reach a “swift and amicable solution” and implement the recommendations of an NHS London report. One of these was that Holt had done nothing wrong and should be reinstated. 

At one point the trust offered her £120,000 if she would sign a statement saying all her concerns had been addressed, an offer she rejected on the grounds that it would have be “fraudulent” of her to do so.

The petition, organised by a group of doctors, calls for Holt to be reinstated and urges Burnham to explain why a service that is stretched to dangerous levels has been denied the skills of an experience paediatrician at great public expense. 

 

It also asks him to explain why professionals who attempt to raise concerns about systemic failures in the NHS continue to be treated so negatively. The group has also sent a letter The Lancet asking why Holt should not be reinstated when the GMC code of conduct obliges doctors to raise concerns about patient safety.

Holt’s case follows that of Ramon Niekrash who won an employment tribunal case against Queen Elizabeth Hospital, Woolwich, after he was victimised for raising concerns about cost cutting 

In another whistleblowing scandal, in February, an inquiry into the Stafford Hospital scandal heard that medical staff who tried to warn of failings at the trust were threatened into silence by NHS managers.

Holt’s MP Lynne Featherstone, Liberal Democrat MP for Hornsey and Wood Green, has also challenged Burnham by tabling some parliamentary questions asking why Holt has not been reinstated.

She said: “It is an appalling waste of public money not to allow Kim back to work. The investigation found she was an exemplary pediatrician with a flawless track record who should be reinstated with mediation.

“The NHS London report was quite damming.  It said there were management failures but non of the recommendations addressed those issues, they only applied to getting Kim back to work. I thought this was a cop out. 

 

Featherstone said the report in particular did not address the fact that management failed to take on board the warnings of four senior consultant paediatricians who signed a letter to saying children were in danger. “The hospital basically turned on the messenger,” she said.

Holt said: ”This is about the quality of children’s services, the fact that people should be able to raise concerns without fear of losing their jobs, the use of money to try and silence people and poor management of people and resources. It is a much bigger issue than just my job now, this has ramifications for the whole of the NHS.

“I am still being victimised and not being allowed to do the job I love. I am currently working on secondment but it is not a proper job. This sends a very bad message to other doctors.” 

A spokesman for GOSH said they were unable to respond to the criticisms: “We don’t feel we can run a process of mediation and debate the fine detail in public at the same time. We are absolutely committed to trying to find a mutually satisfactory resolution to these issues as fast as we can.”

Holt questioned whether the trust were committed to the process with four months having elapsed since the NHS London report, and suggested the recommendations were too vague.

Sacked consultant psychiatrist wins bullying appeal

HSJ - 22nd March 2010 12:18 pm

A leading consultant at top-security Broadmoor Hospital - sacked after complaints of bullying from colleagues, including a former lover - has won his case of unfair dismissal.

Dr Sameer Sarkar had worked at the hospital which houses some of Britain’s most dangerous inmates for six years when he was dismissed for gross misconduct in 2007.

The 46-year-old psychiatrist sued his employers, West London Mental Health NHS Trust. An employment tribunal found in his favour but this was overturned by an employment appeal tribunal.

Three judges at the Court of Appeal restored the original decision, allowing Dr Sarkar, from Wokingham, Berkshire, to bring a case for damages unless the Trust settles.

Lord Justice Mummery, giving the ruling of the appeal court, said the employment tribunal had found the Trust unfairly sacked Dr Sarkar but reduced the compensation by 25% because of his own contributions to his dismissal.

Read more at HSJ.

Whistleblower wins claim after criticising cuts

By Francesca Robinson - 4th February 2010 11:19 pm

A consultant has won a landmark whistleblowing victory against NHS managers who tried to silence him when he spoke out against cuts.

Ramon Niekrash, a consultant urologist at the Queen Elizabeth Hospital in south London, told Hospital Dr he hopes his case will now act as a “big stick” to deter other trusts from bullying their critics.

He has also criticised the amount of taxpayers’ money that the trust wasted in pursuing their vendetta against him.

“Managers used substantial amounts of taxpayers’ money with no accountability to silence a critic who in actual fact was trying to defend and support the patient. The taxpayers’ money hasn’t gone towards medical care it has been spent on silencing me.”

Niekrash was branded a troublemaker and suspended for ten weeks after he repeatedly raised concerns about patient safety.

An industrial tribunal has now ruled that his treatment, specifically his exclusion from the hospital, was in breach of whistleblowing legislation.

In a series of letters from 2005 Niekrash raised concerns about the closure of a urology ward; a cut in the number of specialist urology nurses; hospital acquired infections; the health and safety of patients and the trust’s clinical governance obligations. 

He also complained about his contract and the job planning process and made allegations of widespread bullying and harassment in the surgical directorate in an attempt to achieve cost cuts.

The vast majority of letters received no response which prompted him to write further letters.

When he was suspended the medical staffing committee threatened to hold a vote of no confidence in the management which resulted in Niekrash being reinstated after ten weeks.

The tribunal ruled that letters written by the trust around the time of Niekrash’s whistleblowing were defamatory. It also found he suffered loss of reputation and private practice and injury to health and feelings as a result of his suspension. A separate hearing will decide on the level of compensation he will be awarded.

Niekrash said he had had to pursue the case in order to protect his reputation and because it was his moral duty as a doctor to protect his patients. 

“I genuinely believed there was a moral issue. I did nothing for any pecuniary interest other than that which was genuinely for the benefit of the patient,” he said.

Arpita Dutt, partner at Russell Jones & Walker, who represented Niekrash, said it was difficult for a whistleblower to win a case because the legalities were complex. This meant any successful whistleblowing case was a landmark because it exposed issues in public services that were of wider interest to the general public.

Dutt said: “This case is also is a salient warning because we are in times of public spending cuts and we are seeing A&E departments and wards threatened with closure so there is likely to be an increase in this sort of tension that gives rise to whistleblowing.

“This means we have to be on guard for employers and NHS trusts taking this sort of attitude to whistleblowers. This case certainly sends out a strong message that should resonate throughout all public services.”

A South London Healthcare NHS Trust spokesperson pointed out that the incidents took place prior to the establishment in April 2009 of South London Healthcare NHS Trust, which now manages the Queen Elizabeth Hospital.

She said: “There are lessons to be learned from this case and the new trust absolutely believes in the importance of whistleblowing and encourages any staff members with concerns about patient safety to bring them to the attention of their managers straight away. We now have an environment and the correct processes in place so staff can feel confident that they can raise concerns without any fear. We are assured that the issues which led to this case would not have occurred under the new trust management.”

New safeguarding quango can ban doctors

By Francesca Robinson - 21st December 2009 6:41 pm

The government’s new safeguarding authority - which will have the power to remove doctors from their jobs - is creating an unnecessary and “burdensome” layer of regulation, warns the BMA.

NHS jobs are now covered by the new Vetting and Barring Scheme (VBS) and all children and adults receiving any form of healthcare are categorised as “vulnerable”.

Launched in October, the scheme replaces existing arrangements for spotting potential abusers with much stricter controls for protecting vulnerable people.

The Independent Safeguarding Authority (ISA) which runs the scheme will be able to automatically bar doctors accused of the most serious offences without any right of appeal.

If the concerns are less serious the individual will have the right to make representations as to why the bar should be removed. They will also be able to appeal to an Upper Tribunal but only on the grounds that the ISA has made an error on a point of law or fact in making its decision.

The VBS is the government’s response to the Bichard Inquiry set up after the murders in Soham of Holly Wells and Jessica Chapman by Ian Huntley. It operates in England, Wales and Northern Ireland.

Employers face fines of up to £5,000 if they fail to refer to refer an employee whom they have concerns about.

Doctors must start registering with the VBS from July next year. There will be a one-off fee of £64 for the criminal records and other background checks. Once registered individuals will be continuously monitored. As many as nine million people could be required to undergo the checks.

The scheme has already received widespread criticism for being overly prescriptive because it will extend to parents who transport their friend’s children on behalf of a sports or social club.

Paul Flynn, deputy chairman of the BMA’s consultants committee, said: “One of our concerns is that this scheme will create a whole new dimension of scrutiny of patient safety incidents which are not necessary and it will add considerably to the burden of regulation.

“Another concern is that the ISA will have the power to take away a doctor’s ability to earn a living with no right of appeal. While the GMC and other bodies can question a doctor’s fitness to practise and remove them from their job there is always a right to appeal their decisions.

“This is a very blunt instrument for dealing with a serious problem.”

An ISA spokesman said: “The scheme offers a common sense, proportionate approach to safeguarding and it is what we believe the public would rightly expect.”

Read more on how the new VBS will work

It’s time to start trusting doctors again

By Mike Broad - 17th December 2009 10:41 am

When the murderous school caretaker Ian Huntley lured pupils Holly Wells and Jessica Chapman into his house in Soham in 2002, it was to start a far reaching chain of events.

Just as Shipman led to revalidation, Huntley has generated a new layer of regulation for anyone working with children and vulnerable adults. The ensuing Bichard Inquiry heavily criticised the police for failing to check Huntley’s chequered past enabling him to get a job in a school. 

This year the government set up the Vetting and Barring Scheme in response. Its aims are honourable. As the name suggests, the scheme will attempt to bar unsuitable people from working with children or vulnerable adults, by making it a criminal offence for them to do so, and it will vet those that apply.

The scheme is run by the Independent Safeguarding Authority (ISA) which has significant - and seemingly unaccountable - powers. The growing hysteria surrounding high profile child abuse cases has helped drive these developments.

It currently regards all patients as vulnerable and is urging employers to report any professional whose actions raise concern. This could include doctors innocently involved in medical error cases. Employers face a £5,000 fine for failing to notify ISA of any concerns with staff.

ISA will be able to automatically bar doctors accused of the most serious offences without any right of appeal. Doctors are going to have to register with VBS from July next year and pay for the privilege.

So, while we’re still digesting revalidation - questioning its fitness to practise, let alone our own - we have a new layer of regulation and red tape.

I find the way it’s been rushed in particularly worrying. There’s been minimal negotiation with the professions it affects. And I’ll take a guess that you’ve never heard of it, have no idea how it will make decisions nor understand the sanctions it could take against you and your work.

It also flies in the face of one of the few positive developments being offered by revalidation - namely that the ability to resolve issues locally is being strengthened. Instead we’ll have another body that makes profound decisions, that can affect professional’s lives enormously, from on high.

Of course children and vulnerable adults need to be protected, but that can already be achieved within the current systems. I’m sure my heart won’t be the only one sinking at the level of professional mistrust we are engendering.