Response to Clinical Error
Early, routine notification of adverse incidents or near misses can allow issues to be addressed, problems rectified and lessons learned without patients coming to any harm.

Doctors should be familiar with:

  • Clinical governance structures
  • Risk management structures
  • Processes within the organisations for which they work
Doctors are often reluctant to report concerns. The reasons for this include:
  • Fear of potential working tension
  • Not wanting to implicate colleagues
  • It may have a negative career impact

However, the following points should be recognised 10:

  • A doctor's primary duty is to their patients
  • Legal protection against victimisation or dismissal is given via the Public Interest Disclosure Act 1988 7
  • Even if the concern is groundless, as long as it is done in best interests then it will be justified
What to do? 10
  • If you believe a patient is at risk report it via the appropriate channels immediately
  • The first port of call is the Consultant, then the Medical Director/Practice Partner
  • If your concern is about one of these, an appropriate alternative may be the Medical Director or Clinical Governance Lead at your Trust or Health Board
  • Medical students may raise concern with their Dean
  • Each workplace should have a structure in place 8
  • If you are not satisfied with the outcome you may make your concerns public as long as patient confidentiality is not compromised (Note: it is a good idea to contact your defence association when considering this)
The report?
  • Be clear, honest and objective
  • Focus on patient safety
  • Keep a record of concerns and any steps taken
  • GMC: Duties of a Doctor
  • GMC: Valuing Diversity - Guidance for Doctors
  • GMC: Personal Beliefs and Medical Practice (March 2008)
  • Janaway v Salford Health Authority All England Law Rep 1988 Dec 1;[1988] 3:1079-84
  • GMC: Conflicts of Interest (September 2008)
  • Medical Act (1983)
  • Public Interest Disclosure Act (1998)
  • Health Service Circular (1999/198)
  • GMC: Maintaining Boundaries - Guidance for Doctors (November 2006)
  • GMC: Raising Concerns about Patient Safety - Guidance for Doctors (November 2006)
  • Kerr/Haslam Inquiry (2005)