Clinical Responsibility provides practical legal advice by highlighting real-life healthcare case studies and workplace examples. It looks specifically at the areas of accountability, the legal process, what constitutes a legal claim brought by the patient, and the duty of care and how it is measured. It assists and guides health professionals in understanding their legal and professional obligations and the implications for managing risk.
Foreword. Preface. The high cost of litigation. Accountability. The four areas of accountability. Society. Patient. Employer. Vicarious liability. Professional body. Sanctions. Outside the health professionals duty. Clinical responsibility and the law. The legal system. Legal personnel. Solicitor. Barrister (counsel). Legal executives. Lawyers. Sources of law. Statute. Common law. The court system. The adversarial and inquisitorial process. Coroners court. Death of a patient. Deaths that have to be reported to the coroner. Post mortems.The inquest. Purpose of the inquest. Who should attend an inquest? Criminal courts. Investigation and decision to prosecute. The Crown Prosecution Service (CPS). The witness. Magistrates court. Summary offences. Either-way offences. Indictable-only offences. Crown court. The Old Bailey. Sanctions imposed by the courts. The jury. Burden of proof. Elements of a crime. The case of Harold Shipman. Manslaughter, gross negligence and recklessness r v adamako 1994. Assault and battery. Defences to criminal charge. The absence of mens rea or actus reus. Insanity. Diminished responsibility. Mistake. Necessity. Duress or coercion. Superior orders. Self defence. Corporate Manslaughter and Corporate Homicide Act 2007. The aim of the act. How is a gross duty of care determined?How does the duty of care arise?Who does the act apply to?The NHS, duty of care and public policy decisions. The duty of care and emergencies – the exemption. The emphasis on senior management responsibility. The importance of a health and safety culture. Managing risks. Penalties. Civil courts. County court and high court. Standard of proof. Witness. Public inquiry. Employment tribunal. Civil law and negligence. Civil procedure rules 1998. Time limit. Who can bring a claim?Negligence. Components of a legal claim for compensation. Duty of care.To whom do you owe the duty of care?What constitutes a breach of duty of care? Adverse outcome. Causation: the ‘but for’ principle. Reasonably foreseeable. Too remote. Thin skull rule. Defences to claims for negligence. No defence. 'res ipsa loquitur' - the thing speaks for itself. Consent. Contributory negligence. Compensation/damages. General damages. Special damages. Value of the claim. Where a patient dies. When a patient complains. Informal complaint. Formal complaint. Professional body. Legal advice/claim. The Redress Act 2007. Human rights. Article 2 - ‘Everyone's right to life shall be protected by law’. Article 3 ‘No-one shall be subjected to torture or to inhuman or degrading treatment or punishment’. Article 8 - ‘Everyone has the right to respect for his private and family life, his home and his correspondence’. Consent and human rights. Patients' right to privacy. Risk management. Clinical governance. Skill, ability and authority. Refusing to undertake a task. Balancing the risks. Refusing to undertake training. Continuing education and keeping up-to-date. New and developing practices. Inexperience. Approved practices. Deviation from approved practices. Protocols, policies, procedures and guidelines. Failure by managers to act. Breakdown in communication. Duty to inform the patient of a mistake. System failures. Working long hours. Team decisions. Obeying orders. Acting in an emergency. Major incident. Obeying orders in an emergency. On holiday. Off duty. Lack of resources. Duty of local authority. Obligations on hospital and PCTs. Lack of funding. Cut backs in training. Pressure on managers. Understaffed. Covering more than one ward. Delegating and supervising. Delegating. The records. Accountability and responsibility for delegating. Principles of delegation. Supervising. Countersigning the records. Waiting lists. Excessive waiting time. Inadvertently creating a relationship. Gifts and hospitality. Whistleblowing. The public interest disclosure act 1998 (pida). Good Samaritan – duty to volunteer help. The obligation to stop and assist. What is expected if they stop and assist?Legal implications. Consent. Giving advice. Referrals. Tape recording. The law and midwives. Midwives rules. Liability to the unborn child. Case study. The law and allied health professionals. Allied health professionals. Radiography. Ambulance service. Emergency care practitioner. Outpatient department and walk in centres. Medication and prescribing. The law. Classification of medicines. Prescription only medicines. Pharmacy medicines. General sales list medicines. Controlled drugs. Who can prescribe and what can they prescribe. Sale, supply or administer. Administration. Prescriptions.Responsibility. Vicarious liability. Independent and supplementary prescribers. Independent prescriber. Supplementary prescribers. Administering drugs. Acting in an emergency. Conflict with the prescriber. Illegible writing. Calculation errors. Intravenous. Telephone advice. Patient group directives. The checklist. Unlicensed medicines. Types of unlicensed medicines and unlicensed use. Strict product liability (liability without fault). Medication and lack of resources. Glossary.