Health CommitteeWritten evidence from the Medical Protection Society (ETWP 06)

Summary

Poor communication is one of the most common reasons for a patient to make a complaint.

The Medical Protection Society (MPS) is wholly committed to promoting openness between clinicians and their patients. We consistently advise members to be open with their patients when things go wrong.

This area of medical practice is not well understood by practitioners who often think that being open is an admission of legal liability.

We believe a root cause for this misunderstanding is a lack of training, and that where training and education is provided, they form only a small part of the curricula or programme.

Doctors often take a very strategic approach to the way in which they engage with education and training.

The skills gap identified here could be addressed by placing a greater emphasis on the importance of developing these skills, and by more rigorous assessment of their understanding.

The GMC could take responsibility for this by better incentivising doctors to engage in these areas.

Introduction

1. MPS is the leading provider of comprehensive professional indemnity and expert advice to more than 270,000 doctors, dentists and other health professionals around the world. We have nearly 120 years experience and operate in more than 40 countries. In the United Kingdom approximately 180,000 doctors, dentists and other healthcare professionals are members representing around 50% of all doctors and 70% of all dentists.

2. As a mutual, not-for-profit organisation we offer members professional support and expert advice, on a discretionary basis, with legal and ethical problems that arise from their professional practice. This includes clinical negligence claims, disciplinary and professional regulatory investigations, inquests, complaints and general ethical and professional advice.

3. We advocate a culture of openness and provide training in open disclosure and high quality communication for health professionals. In our publications we promote a learning culture, making use of our claims experience to highlight common mistakes and spread awareness of specific risks.

Background

4. In this submission we wish to concentrate on the importance of promoting openness and strengthening communication skills within the education and training curricula, as MPS experience suggests that poor communication is one of the most common reasons for a patient to make a complaint.

5. MPS is wholly committed to promoting openness between healthcare providers and their patients and we consistently advise our members to be open with their patients when something has gone wrong. However, this area of medical practice is not well understood by practitioners, who often express concern that by being open and honest they are admitting legal liability and potentially exposing themselves to litigation.

6. MPS believes the root cause for these misunderstandings arises from a lack of training and development in the advanced communications skills necessary to do this effectively. Furthermore, where education and training in these areas is provided, it is quite often the case that these subjects form only a very small part of the curricula—particularly the undergraduate curricula, and even less for the foundation and specialist training curricula.

7. We believe this could be addressed by placing a much greater emphasis on the importance of developing these skills within the education and training programmes, and by more rigorous assessment of medical students and doctors in training on how they have developed these skills. Our view is that doctors often take a very strategic approach to the way in which they engage with education and training. There is such a lot of material to absorb and unless they perceive a strategic benefit from concentrating on a particular area—ie they will be assessed on it and need to pass that assessment in order to progress to the next level—we believe it is unlikely that they will focus greatly on it.

8. MPS strongly believes the culture of training in relation to these areas need to change and we would recommend the GMC could take a more active role in incentivising doctors to engage in these areas.

December 2011

Prepared 22nd May 2012