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Article title index

This index lists all the case histories in the library. Just click on the links to read the case history.

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Advice Articles

  • A burning issue - 27 February 2003

    Recent analysis by the DDU has revealed some common adverse incidents that have caused harm to patients and led to a complaint or even a negligence claim. We look at some of these and at ways of managing risk and learning from mistakes.

  • A doctor’s criminal conviction is never spent - 17 July 2008

    News that an A-grade student had an offer of a place at medical school withdrawn, apparently because of a spent criminal conviction received widespread media attention recently.

  • A guide to guidelines - 1 March 2004

    They are everywhere - local guidelines, national guidelines, guidelines from the Royal Colleges, NHS screening programme guidelines, GMC guidelines, guidelines from NICE the national service frameworks as part of clinical governance. We answer some typical questions from members on the subject.

  • A passage to India - 1 April 2002

    Katie Wright spent her elective at a teaching hospital in Bangalore where the rules were strict - including a ban on tender coconuts.

  • A review of out of hours complaints and claims in primary care - 1 June 2007

    Since the introduction of the new GP contract in April 2004 the provision of out-of-hours primary medical care has changed radically. Here we highlight some of the factors peculiar to out-of-hours care that can lead to complaints and claims.

  • A student dental elective in Vietnam - 1 December 2008

    King's College London dental student Aliza Jesani traveled to Vietnam to experience at first-hand dental practice in a community where dental hygiene is not top priority for the local inhabitants.

  • Abbreviations should be avoided in medical records - 13 January 2006

    The MDU was recently asked whether it is alright to use abbreviations in medical notes in order to save time. The doctor concerned felt that the time constraints of modern medicine meant that it is difficult to avoid these shortcuts.

  • Access to Health Records Act 1990 - 17 March 2002

    Since the introduction of Data Protection Act 1998, the Access to Health Records Act only applies to the records of deceased patients. There are still however important points you need to know.

  • Access to Medical Reports Act 1988 - 22 March 2002

    The Access to Medical Reports Act 1988 covers reports provided for employment or insurance purposes and has implications for doctors.

  • Accessibility for all on the web - 1 August 2006

    More and more dental practices are setting up their own websites. The Disability Discrimination Act 1999 (DDA) makes it compulsory for services provided to the public to be accessible for all. Specialist web consultancy tmg looks at the Act's implications for websites.

  • Accompanying group foreign travel - 1 April 2003

    Increasing numbers of doctors are asked to accompany groups travelling abroad. We are often asked about the medico-legal issues involved. Dr Paul Colbrook, medico-legal adviser looks at the regulations that need to be adhered to and the implications for members.

  • Acronyms – avoid using them - 10 September 2003

    Recent research reveals that annotating patient notes with insulting or demeaning acronyms is dying out.

  • Addressing complaints about private treatment - 19 May 2006

    The GDC has created a scheme, the Dental Complaints Service (DCS), to consider complaints from patients who are not satisfied with the outcome of local resolution of a complaint about private dental treatment. This article explains both stages of the complaints procedure.

  • Adults with Incapacity (Scotland) Act 2000 - 18 July 2002

    The Act will have a significant impact on the management of patients in Scotland who are unable to consent to treatment. It introduces Welfare Attourneys who can consent on behalf of incapacitated adults and also introduces the need for a Certificate of Incapacity to be issued before any such patient is treated.

  • Advanced restorative treatment - 1 April 2002

    John Cunningham offers DDU members some risk management advice to help improve patient care, and avoid complaints and claims.

  • Adverse drug reactions - 28 June 2007

    Doctors are reminded to exercise caution when managing patients requiring methotrexate after it is reported that 19 people are suspected to have died in the last three years after suffering an adverse reaction to the drug when it was prescribed to treat their rheumatoid arthritis.

  • Adverse incident medication errors - 6 October 2006

    An analysis of adverse incidents reported by MDU members working in primary care over a recent six-month period reveals that 43 incidents related to a problem with medication. These incidents were reported at an early stage, before any other action had been taken e.g. a complaint from the patient.

  • Adverse incident reporting - 12 July 2002

    The MDU's clinical risk managers regularly undertake workshops for PCTs, aimed at all members of the primary healthcare team. These are designed at helping practices control or eliminate risks to patients and staff in the surgery. This is a taster of one of the most requested workshops - Adverse Incident Reporting.

  • Adverse Incident Reporting – the MDU's guide - 9 January 2003

    This is a pdf version of the new practical guide aimed at helping GPs to establish a mechanism for reporting and analysing adverse incidents and near misses in their practice.

  • Advice for GPs seeking inclusion on GMS supplementary lists - 31 May 2002

    The National Health Service (General Medical Services Supplementary List) Regulations 2001 provide that all non-principals providing GMS must be on a supplementary list by 1 June 2002 but what information must you provide?

  • Advice for National Smile Month - 11 April 2007

    National Smile Month (13 May - 12 June 2007) is a time when many dentists organise events to help educate patients and potential patients about good oral hygiene.

  • Afraid of the dentist? - 10 September 2003

    For many people a visit to the dentist is a stressful experience. How you deal with these patients can make a major difference to their view of dentistry and the potential dento-legal ramifications following their treatment.

  • An elective in Australia - 15 November 2005

    Gemma Penford is planning her elective in Australia, thanks in part to winning £1500 in the MDU Electives Competition.

  • An elective in Bangladesh - 19 April 2002

    Amina Rahman is a fifth year medical student at Manchester University. This is her account of her elective in Bangladesh.

  • An elective in Jamaica - 11 March 2003

    Karen Shelbrooke found that Kingston Public Hospital was a world away from the palm-fringed beaches in the tourist brochures.

  • An elective report from Tokyo - 1 July 2007

    Jennifer Kiggins decided to do her elective at the Jikei University School of Medicine as it was closely based on Guys, Kings and Thomas' medical schools.

  • An insight into opthalmic claims - 1 December 2007

    Over a recent five-year period the MDU opened about 150 files related to ophthalmic conditions reported by members, and many more queries were answered.

  • Anaesthetic breathing systems - 2 August 2002

    Following the news that the CMO is setting up an expert group to investigate why anaesthetic tubing can become blocked, the MDU offers some suggestions on preventing blockages.

  • Answering patients' complaints - 25 September 2002

    Sadly every dental practitioner is likely, at some stage of his or her career, to be the subject of patient complaints. Whatever the nature of the complaint it is clearly in the dentist's and patient's best interests that the matter is resolved swiftly and professionally.

  • Antibiotic prophylaxis - 20 July 2006

    Many dental care professionals will be aware that there is conflicting expert opinion on the need for antibiotic prophylaxis for invasive dental procedures where patients have certain types of cardiac conditions.

  • Anticoagulant alert - 20 April 2007

    Members may recall past warnings from the MDU about the problems that can occur when prescribing anticoagulants.

  • Apologies, offers of treatment and other redress - 1 February 2007

    The Compensation Act 2006 received Royal Assent on 25 July 2006. This includes Section 2, which was not in the original Bill but was added after the Government agreed to an amendment proposed by Lord Hunt of the Wirral.

  • Automated appointment systems - 1 October 2006

    The MDU has been contacted by a number of practices concerned about the potential breach of patient confidentiality when using automated appointment systems.

  • Avoiding complaints puts a smile on your face - 1 August 2003

    Addressing patient complaints can help dentists safeguard patient safety and care. They can be used as a trigger to alert dentists that something may not be working as it should. Learning from complaints can also help to prevent future complaints.

  • Becoming an associate - 1 May 2005

    If you are in vocational training, it may be daunting to consider the next stage in your career but it is well worth considering your options quite early in the VDP year. The DDU has extensive experience in advising and assisting members in choosing their first associate job.

  • Behind the scenes at the MDU – the Legal Department - 1 September 2003

    As a medical defence organisation and provider of medico-legal advice, the MDU relies on a team of in-house legal specialists. Here, Joanne Brundrett, an MDU solicitor, describes the work of the MDU's Legal Department on behalf of members.

  • Behind the scenes of a dental claim - 29 May 2003

    What happens when the DDU assists a member who has received a letter threatening a claim for negligence? Ian McLaren, a DDU lead claims handler, looks at the process of a typical - but fictitious - claim, from the day of the adverse incident through to final settlement.

  • Behind the scenes of a medical claim - 14 August 2003

    What happens when the MDU assists a member who has received a letter threatening a claim for negligence? Dr Matthew Robson, a senior MDU medical claims handler, looks at the process of a typical - but fictitious - claim, from the day of the adverse incident through to final settlement.

  • Beware of wrong tooth extraction - 8 December 2004

    While treating the wrong tooth is a comparatively rare occurrence given the range of treatments carried out by dental professionals, DDU figures show that a significant number of these errors occur each year.

  • Blood transfusions - 5 December 2006

    The National Patient Safety Agency (NPSA) has introduced a safer practice notice designed to improve the safety of blood transfusions.

  • Breaches of confidentiality - 29 October 2004

    Inadvertent breaches of confidentiality are not uncommon, especially when treating patients in the same family. It's vital to remember that any information learned in a professional capacity is confidential.

  • Cardiac consent - 12 July 2005

    A new guide has been launched for cardiac surgeons on obtaining informed consent from adult patients with capacity, undergoing elective cardiac surgery.

  • Caring for drug addicts in the community - 1 March 2001

    There has been a lot of adverse publicity about doctors treating patients who are drug addicts. Using cases from our files, this article looks at some of the important medico-legal issues and offers some risk management advice.

  • Cauda Equina Syndrome: diagnosis delay and litigation risk - 26 August 2004

    Cauda equina syndrome is an acute surgical emergency. Although an uncommon condition, rarely encountered by most clinicians other than a small number of neurological and orthopaedic surgeons, it is not a difficult syndrome to suspect or investigate and this article should be of interest to a wider audience.

  • Caution urged on suicide requests - 31 May 2007

    We have had a few requests for advice from GP members who have been contacted by patients seeking a medical report because they are planning to travel to another country for the purposes of assisted suicide and a report from their treating GP is a prerequisite for assistance from the organisation abroad.

  • Caution when involving patients in Significant Event Audit - 2 June 2002

    Significant Event Audit (SEA) and complaints are, strictly speaking, separate processes. Nevertheless, sharing the findings of SEA with a complainant can provide reassurance and help to resolve the complaint at an early stage but caution needs to be exercised in how information is shared.

  • Cessation of ventilation - 7 May 2004

    A six year old boy is admitted to the paediatric intensive care after a near drowning. The child is unable to support respiration. After being fully resuscitated he is still unable to survive off ventilation. The parents do not want the ventilator switched off. What should you do?

  • Change in law on controlled drugs - 29 July 2003

    Doctors, drug treatment workers and pharmacists will soon be able to supply cleaning items and other equipment to drug abusers. The change in the law is designed to help prevent disease and infection, the Home Office announced recently.

  • Changes to GMC registration for doctors over 65 - 18 June 2008

    It has been announced that doctors who are 65 or over will no longer be exempt from payment of the GMC’s Annual Retention Fee (ARF). Members who decide not to remain on the GMC register can remain with the MDU as retired members.

  • Changes to GMC's online register - 5 October 2005

    A number of members have been unhappy with the GMC's decision to remove names from the online doctor search facility while it investigates a complaint. We have raised these concerns with the GMC and understand that some changes are due to be made.

  • Changes to the complaints procedure - 9 August 2004

    The Healthcare Commission will take over responsibility for the independent review stage of the NHS complaints procedure from this month.

  • Changes to the GMC's online register - 19 July 2005

    The GMC is making changes to its search facility which enables interested parties such as employers and members of the public to check doctors' registration online.

  • Chaperone policies needed in general practice - 20 December 2004

    The recommendations made by the Ayling inquiry and a recent survey in the BMJ have prompted an increase in requests to the MDU for guidance on the use of chaperones.

  • Chaperones and the community paediatrician - 10 July 2002

    "Mummy a strange man asked me to take off my top today." These are the words that could fill any parent with dread. But what if that "strange man" was a community paediatrician and his request was a totally innocent one made while he attempted to carry out a chest examination on a timid child without the benefit of a chaperone?

  • Checking records - 30 June 2006

    A recent news report claimed that some hospital trusts are seeking to make savings by outsourcing the task of typing doctors' notes.

  • Child protection - 3 July 2006

    While child abuse is an emotive and sensitive issue for any dental professional to deal with, the GDC has made it a requirement for dentists to "find out about local procedures for child protection" and to follow these procedures if they suspect that a child might be at risk because of abuse or neglect.

  • Child protection: medico–legal advice - 19 April 2006

    While to some lay observers it might appear – with the benefit of hindsight – that the issues surrounding child protection cases are quite straightforward, doctors know that such cases are not always clear cut.

  • Children and confidentiality - 1 August 2005

    Confidentiality in the case of children is a potentially confusing area. Legal requirements and GMC guidelines will clarify most cases where consent to disclosure is requested, but GP registrars should be aware of the nuances that can apply if they are to avoid broken promises to their younger patients. Dr Louise Wilson, MDU

  • Civil partnership legislation - 14 December 2005

    The Civil Partnership Act has important implications for doctors when considering questions of consent to treatment and parental responsibility.

  • Clinical complaints may fall under Health Act Irish news - 26 September 2005

    Refroms included in the Health Act 2004 may lead to doctors' clinical judgement falling under the scrutiny of the new complaints procedure, even if this is not the primary matter at issue.

  • Clinical negligence – your response to litigation - 1 January 2004

    What you are facing now may be one of the most stressful times of your professional life. Many doctors who have gone through clinical litigation tell us that coping with personal feelings at the beginning of the process and at other key points is perhaps the most difficult thing.

  • Clinical research - 1 December 2006

    Clinical drug trials have been in the public eye since the terrible outcome of a trial earlier in the year that left six volunteers in intensive care. Doctors who are involved in such trials have an ethical responsibility for ensuring the patient has given their consent.

  • Come join the good samaritans - 28 March 2002

    No matter where you are in the world, would you and should you intervene to help in an unexpected situation? According to the GMC, you may have to.

  • Communication counts - 18 November 2004

    The success of many dentist-patient relationships depends on our ability to communicate. The DDU outlines some practical tips to help you measure your own ability to listen, speak and relate to patients.

  • Communication counts - 24 November 2003

    The success of many doctor–patient relationships depends on our ability to communicate. We provide some practical tips to help you in measuring your own ability to listen, speak and relate to patients.

  • Compensation update - 29 January 2007

    In recent years the number of clinical negligence claims brought against MDU members and settled by us on their behalf has begun to level out, however the size of individual settlement awards continues to increase.

  • Complaint myth–busters - 1 December 2007

    It's an uncomfortable reality that every dental professional is likely, at some stage of his or her career, to receive a patient complaint. While it's natural to feel shock upon receiving a complaint, it's always helpful to have a clear understanding of what has happened and strategies that might be helpful in resolving the complaint.

  • Complaints handling post 1 April 2002 - 3 April 2002

    1 April 2002 has seen the introduction of major structural changes in the NHS with many of the roles of the old Health Authorities being formally taken over by Primary Care Trusts. One such role is the coordination of the NHS complaints process.

  • Complaints myth–busters - 1 December 2007

    It's an uncomfortable reality that every dental professional is likely, at some stage of his or her career, to receive a patient complaint. While it's natural to feel shock upon receiving a complaint, it's always helpful to have a clear understanding of what has happened and strategies that might be helpful in resolving the complaint.

  • Completing cremation certificates - 20 January 2004

    Members should be aware that the Home Office has offered new guidance on completing cremation forms, writes MDU medico-legal adviser Dr Paul Colbrook.

  • Concordat on genetic testing - 24 March 2005

    Doctors will be able to reassure patients that insurance companies will not be able to use genetic test results used to predict future illness to deny them insurance.

  • Confidentiality – introduction and principles - 1 July 2007

    Confidentiality is an essential part of the bond of trust that exists between doctor and patient. Patients must be certain that information they divulge will be kept confidential. Without this assurance, they may be reluctant to reveal private or sensitive information a medical practitioner needs to provide full and appropriate care.

  • Confidentiality – relative values - 1 September 2003

    Working in general practice can expose you to a variety of situations that you may not have met in the hospital context. One such area is conflicting requests for information about your, or your colleagues', patients.

  • Confidentiality and the Quality and Outcomes Framework - 25 October 2004

    The Quality and Outcomes Framework is a mechanism by which GP practices may be rewarded for achieving indicators of good clinical care. As part of this process, GPs will be expected to produce disease registers, which may raise new questions about patient confidentiality.

  • Confidentiality in case of criminality - 1 October 2002

    Members are sometimes concerned about the difficulty of maintaining patient confidentiality in certain circumstances. The MDU asked the GMC for its views on hypothetical cases where moral intuition and ethical duties appear to conflict.

  • Confidentiality in child protection - 1 October 1998

    This article talks of GPs involved in child abuse cases, and the medico-legal dilemmas where several family members may be patients

  • Confidentiality of electronic records - 1 October 2006

    Many practices have made the move to a paperless patient record system and this raises questions about the storage and security of electronic patient records (EPRs).

  • Conscious sedation - 4 July 2007

    New guidance for dental practitioners on the use of conscious sedation.

  • Consent – a question of judgement - 24 May 2004

    Failing to provide a patient with information about a proposed treatment or examination could be regarded as a breach of your duty of care. But how much information should you provide, and how much does a patient need to give their "informed" consent?

  • Consent and capacity when aged 16 to 18 - 10 November 2006

    Teenage patients, within the 16-18 age group, can represent a challenging area when it comes to consent. While in most cases, a doctor can accept the consent of such a patient; it is important to judge each case on its own merits, seeking advice if necessary from a colleague or your medical defence organisation.

  • Consent and the deceased - 22 October 2002

    The law on possession of a human corpse is complex. Appropriate permissions must be obtained before a hospital post mortem is carried out or before any tissue and organs are removed.

  • Consent for clinical research - 22 October 2002

    There are special problems wih consent for clinical research. The MDU can advise in specific situations.

  • Consent for minor surgery - 24 May 2004

    If you're considering performing minor surgery, you need to understand what information you should provide your patients, and record, in order for them to give their consent.

  • Consent for school dental inspections - 6 July 2006

    The Department of Health (DoH) has warned salaried dentists who carry out dental inspections or epidemiological surveys in schools that it is not sufficient to rely on implied consent (described as "negative consent" in the document) to examine school pupils.

  • Consent to treatment (MDU booklet) - 9 December 2004

    This is a pdf version of our comprehensive guide to consent. It covers key issues surrounding consent including treatment of incompetent adults, minors and consent for clinical research.

  • Consent to treatment and incompetent adults - 22 October 2002

    This is a guide to consent issues that may arise with adults who do not have the capacity to consent including unconscious patients, patients on life-support and those in a permanent vegetative state.

  • Consent to treatment and minors - 20 August 2002

    This is a guide to consent issues affecting minors including "gillick competence", parental responsibilities, pregnancy and children in care.

  • Consent to treatment and pregnancy - 22 October 2002

    This is a guide to consent issues surrounding pregnancy and childbirth including obstetric procedures, surgical intervention, assisted conception and sterilisation.

  • Consumer guidelines on plastic surgery - 8 November 2004

    The British Association of Aesthetic Plastic Surgeons has produced a 10-point checklist to help anyone considering plastic surgery to make an educated decision about any treatment and help them to form a realistic idea of what surgery can and cannot achieve.

  • Continuing Professional Development (CPD) - 10 June 2004

    Dentists who fail to complete 250 hours Continuing Professional Development (CPD) over a five-year period, risk being erased from the dental register.

  • Controlled drugs – update on latest guidance - 24 August 2006

    The DDU is reminding all members to consider whether their drugs protocols need to be revised in the light of guidance from the Department of Health (DoH) about private controlled drugs (CDs) prescriptions and dental prescribing.

  • Controlled drugs interim guidance - 23 March 2006

    The Department of Health (DH) has produced interim guidance for doctors who prescribe controlled drugs (CDs) on private prescriptions and for all healthcare professionals who deal with controlled drugs.

  • Coroners amendment rules - 21 June 2005

    New rules about the retention and disposal of human tissue and other samples by pathologists came into effect on 1st June 2005.

  • Coroners' inquiries – An introduction - 13 February 2006

    An inquest is a fact-finding inquiry and not a trial. It is held by the coroner when he decides that a death may not be due to natural causes. You may be asked to submit statements to the coroner about the care and treatment you have provided to patients and if necessary attend inquests as a witness.

  • Coroners' inquiries – Attending an inquest - 13 February 2006

    The inquest is usually held in court premises, but may be held in some other public place. Witnesses are called by the coroner, and not by interested parties.

  • Coroners' inquiries – the verdict - 14 February 2006

    At the end of a jury hearing, the coroner will sum up the evidence which has been given and direct the jury on any points of law that arise.

  • Coroners' inquiries – Writing a report - 13 February 2006

    Most doctors will have to produce at least one written report for a coroner during their professional career. Writing a good report requires skills which differ substantially from those needed to produce a report for clinical purposes.

  • Corporate dentistry - 1 August 2007

    This summer, the General Dental Council (GDC) is planning to launch a list of corporate bodies "carrying on the business of dentistry". This follows the removal of restrictions on the number of dental bodies corporate (DBCs).

  • Corporate manslaughter and corporate homicide bill - 29 January 2007

    The Corporate Manslaughter and Corporate Homicide Bill returned to the House of Commons for its second reading in December. It is intended to make it easier for organisations, including hospital trusts, to be prosecuted if the way their activities are managed or organised by senior management causes death from a gross breach of duty.

  • Could you cope with an IT systems failure? - 11 August 2006

    With increasing reliance on electronic records, the DDU is advising members to ensure they have a clear recovery plan in place in case of IT failures.

  • Could you cope with an IT systems failure? - 8 August 2006

    With increasing reliance on electronic records, the MDU is advising members to ensure they have a clear recovery plan in place in case of IT failures.

  • Court of Appeal child abuse decision - 10 September 2003

    A recent ruling in the Court of Appeal means that doctors and social workers may owe a common law duty of care to a child when investigating suspected child abuse.

  • Cryotherapy caution - 1 December 2006

    Claims frequently result from routine minor surgical procedures including the use of cryotherapy.

  • Dangers of inaccurately transcribed records - 19 February 2007

    Medical records are important. They should give a clear, accurate picture of patient care and treatment, so aiding communication between doctors and their colleagues and reminding doctors of the care they provided.

  • Data published on adverse incidents - 2 October 2006

    The National Patient Safety Agency (NPSA) has recently published an audit of serious and untoward events, adverse incidents and near misses reported to its national reporting and learning system (NRLS) by health workers in the NHS.

  • DDU claims checklist - 1 December 2000

    Download and use this pdf checklist when writing to notify us of a claim

  • Defibrillators in GP surgeries - 5 March 2002

    A number of GPs are concerned that they might be found negligent if they do not provide a defibrillator in the surgery in case a patient suffers a myocardial infarction. Is there a legal duty?

  • Delay in diagnosing Lyme disease - 4 June 2007

    The MDU is warning its members to ensure they consider a diagnosis of Lyme disease, which is most common in Spring and Summer.

  • Delay in diagnosing malaria - 16 June 2006

    With the peak holiday season now approaching, and increasing numbers of people travelling to malaria endemic destinations, the MDU advises doctors to ensure they exclude the diagnosis of malaria in patients returning from countries where the disease is prevalent.

  • Delayed diagnosis – meningitis and infections - 22 August 2006

    The very nature of the work of a GP means that diagnoses will occasionally be missed or seemingly delayed, which means that GPs inevitably live with a degree of uncertainty. Understandably, if a delay or missed diagnosis occurs patients need an explanation particularly if the outcome is poor or unexpected.

  • Delayed diagnosis in general practice of trauma and orthopaedic conditions - 5 September 2006

    A new analysis of 620 MDU GP claims files relating to delay or failure in diagnosis settled in a recent five-year period shows that trauma and orthopaedic problems were the third most frequent cause of delayed diagnosis claims against GPs – only surpassed by failure or delay in diagnosing malignancy or infection.

  • Delayed diagnosis in primary care - 1 August 2007

    The very nature of the work of a GP means that GPs inevitably live with a degree of uncertainty and diagnoses will occasionally be missed or seemingly delayed. Understandably, if something goes wrong and a delay or missed diagnosis occurs patients may need an explanation, particularly if the outcome is poor or unexpected.

  • Delegating tasks to DCPs - 1 October 2007

    In July 2006, the list of "permitted duties" for dental hygienists and dental therapists, which set out what these groups could and could not do, was abolished under amendments to the Dentists Act 1984, one of a number of changes to the way dentistry was regulated in the UK.

  • Delegation and referral - 27 February 2008

    At first glance, delegating tasks to more junior members of the hospital team may seem straightforward. However, the MDU regularly receives queries from consultants about their responsibilities in this area.

  • Dental advertising - 10 July 2006

    Advertising your practice can be an ethical and legal minefield and is regularly the subject of calls to the DDU advisory helpline.

  • Dental recall intervals – a matter of clinical need - 8 January 2007

    Members have contacted us for advice about the recommended interval between dental check-ups and in what circumstances the responsibility for setting recall intervals can be delegated to another member of the dental team.

  • Dental treatment overseas - 23 January 2008

    As more patients travel overseas for dental treatment, what advice should be given to them?

  • Dentists under scrutiny - 3 November 2004

    Dental professionals are subject to more regulation than ever before - from patient and consumber organisations, government, and increasingly from the media. We examine how this affects dental professionals.

  • Dentists who fail to meet CPD requirements may face erasure - 12 December 2006

    The first dentists to join the GDC's compulsory Continuing Professional Development (CPD) scheme in 2002 are now approaching the end of their first five-year CPD cycle and may soon be asked to provide evidence that they have complied with the scheme.

  • Diabetes, hypoglycaemia and driving - 23 August 2007

    Members are reminded of the importance of ensuring that patients with diabetes are advised appropriately about driving and their responsibilities regarding the DVLA.

  • Disclosing patient information to third parties - 16 October 2007

    To disclose or not to disclose patient information? That is a question which is frequently put to DDU dento-legal advisers, particularly when the information is requested by a Primary Care Organisation (PCO), NHS Business Services Authority (NHSBSA) or private funding scheme such as Denplan.

  • Disclosure of children's medical records - 22 March 2002

    When disclosing children's records there are a number of considerations including the age of the child, whether they understand the implications and also the marital status of the parents.

  • Disclosure of medical records for court proceedings - 22 March 2002

    Where a patient wants disclosure of medical records for a court case there are likely to be two scenarios - one where the action is against a third party and one where the doctor is the defendent.

  • Disposing of patient records - 2 April 2008

    The recent discovery of over 3000 patient records on a landfill site illustrates the risks associated with the disposal of confidential records

  • Do disclaimers work? - 1 December 2007

    Before you read this article, please study the following disclaimer: The writer recommends that readers select a comfortable chair in which to read this article. The writer cannot be held liable for any aches or pains resulting from any reader's decision to read the article in a chair without a proper back support.

  • Doctor in defence – a member's diary - 1 September 2003

    Defending a claim of medical negligence can be a gruelling affair striking at the very heart of a doctor's professionalism. In this unique anonymised diary, chronicling a seven-day hearing, an MDU member gives a defendant's-eye view of the emotional switchback of the courtroom proceedings.

  • Doctor's signatures - 4 August 2004

    Doctors are being reassured by the MDU that their signatures on documents that have legal status do not necessarily have to be legible to be valid. If their signature is not legible however, then it is sensible to print their name underneath.

  • Doctors as managers - 5 July 2001

    Members increasingly seek advice about their dual roles as clinicians and managers. Dr Rupert Lee, one of the MDU's clinical risk managers, gives the MDU's view.

  • Doctors face growing media scrutiny - 20 August 2004

    Doctors are increasingly being approached by journalists for their reaction to patients' allegations about treatment, or for further information about patients' care.

  • Doctors subject to new GMC procedures - 11 November 2004

    The new fitness to practise procedures are a radical overhaul of the old procedures. There are numerous changes, two of which caused the MDU some concern during the consultation stage.

  • Doctors supervising nurses during prescribing training - 19 March 2003

    GPs and hospital doctors must be suitably qualified to supervise the growing number of nurses and midwives who want to train to prescribe from the nurse prescriber’s extended formulary or act as supplementary prescribers.

  • Doctors with managerial roles - 25 June 2002

    In the course of their career some doctors will assume managerial roles either within the NHS or in the private sector. This article looks at some of the questions that the MDU is regularly asked about doctors who take on additional responsibilities.

  • Doctors' SupportLine: Help in a time of need - 21 April 2006

    While many of you view the MDU's 24 hour medico-legal advisory helpline as a vital doctors' support line, there is another valuable advice resource available, offering doctors a chance to talk to someone about a range of concerns such as burnout, depression and overload, as well as problems with their personal life.

  • Does NHS indemnity cover good samaritan acts? - 13 August 2002

    An off-duty doctor who tried unsuccessfully to resuscitate a man who had taken a drug overdose contacted the MDU when the dead man's girlfriend complained that he had not done enough to save him. In situations like this what cover does NHS indemnity provide?

  • DoH relaxes rules on background checks - 30 September 2002

    The Department of Health has relaxed the rules to enable healthcare workers to start working with children while full background checks are completed.

  • Draft coroners bill published - 1 December 2006

    A radical reform of the coroner's court system in England and Wales will create a cadre of full-time coroners and allow bereaved people to challenge coroners' decisions via a scheme overseen by a Chief Coroner.

  • Elective in Games City - 1 October 1998

    This articles talks of the experiences of a student undertaking an elective in Malaysia. Interesting cross-cultural comparisons and views.

  • Electives guide – staying healthy abroad - 6 January 2006

    Before you travel, there are a number of precautions you should take in case of sickness. These include getting travel insurance, having the necessary jabs and packing your medical kit.

  • Electives guide – staying healthy abroad - 1 January 2006

    Before you travel, there are a number of precautions you should take in case of sickness. These include getting travel insurance, having the necessary jabs and packing your medical kit.

  • Electronic signatures - 4 February 2003

    Members should exercise caution when using computerised "e-signatures" to sign documents where the signature may need to be authenticated at a later date. Certificates, prescriptions and wills for example, may need to be signed by hand.

  • Endodontics in Iowa City - 1 April 2000

    Giles Round set off for his elective in the States expecting a peaceful period of research into root canal treatment. But the Iowa weather turned out to be more than he bargained for.

  • Epilepsy driving bans - 30 July 2003

    According to a recent news story, US researchers are questioning whether epilepsy patients need to wait for a year after a seizure to reapply for a driving license. However this does not alter current DVLA guidance.

  • Ethical and legal implications of new GP contract - 26 April 2004

    While many of the debates about the new GP contract have focused on the financial implications, there are also professional, ethical and legal implications which GPs need to be aware of.

  • Ethics in practice - 24 June 2003

    Mark G Brennan, Lecturer in Medical and Dental Education at the University of Wales College of Medicine, takes a closer look at the GMC's "Duties of a Doctor" and asks a group of registrars for their opinions.

  • Explaining fees - 1 December 2000

    This article talks about the importance of the agreement with patients over fees, and the responsibility of explaining the fees. Also offers a case history and risk management advice

  • Extended nurse prescribing – what you need to know - 1 December 2007

    As the pressure increases on primary care to provide wider ranging and more diverse medical services, the role of the practice nurse has also changed and many now find themselves carrying out a wider range of clinical duties, including prescribing.

  • Faculty launches guidance on latex allergy - 13 December 2004

    Dental healthcare workers should be made aware of natural rubber latex (NRL) allergy so they can take steps to protect themselves and are able to manage the patients who suffer from this condition.

  • False or misleading sick notes - 2 June 2004

    A recent court case has highlighted the dilemma GPs face when writing sick notes. The case involved a city trader who claimed damages from her employers reportedly for the stress caused by her job.

  • Female circumcision - 28 August 2001

    Female circumcision in the United Kingdom is illegal and any doctor involved in referral for or actual operative procedure risks criminal charges, warns the MDU

  • Fitness to practise - 1 February 2007

    The General Dental Council (GDC) has recently introduced new rules to govern how it regulates the dental profession. This article explores the main changes and explains how the new rules will work in practice.

  • Five good practice tips that may help to avoid complaints - 6 January 2006

    Most GPs will receive at least a couple of complaints in a professional lifetime. But there are aspects of good practice that may help avoid a complaint and, when a complaint is received GPs can learn from it to try to prevent the same issue being cause for complaint more than once.

  • Flu vaccine dilemmas - 24 October 2005

    With the flu jab season in full swing and public sensitivities heightened by the on-going concerns over H5N1 avian influenza being passed to humans, MDU members have sought our advice on flu vaccination.

  • For the record - 12 July 2006

    Clear, accurate, legible and contemporaneous – the GMC Guidelines on patient records are simple and self-explanatory. Even so, there is ample scope for omission or misinterpretation and this may only come to light some time later if a complaint or claim is made.

  • Freedom of Information (Scotland) Act 2002 - 23 December 2003

    The Scottish Freedom of Information legislation may affect members based in Scotland. Further information is expected from the Scottish Executive Health Department and the Scottish Information Commissioner.

  • Freedom of Information Act - 21 August 2003

    By the end of October 2003, dentists carrying out any NHS general dental service (GDS) work will need to publish certain information under the Freedom of Information Act 2000, which applies to England, Wales and Northern Ireland.

  • GDC conduct procedures - 19 November 2003

    Few dentists would have an intimate understanding of how the GDC considers a complaint against a dentist. Tamsin Thomas, an in-house solicitor, gives a detailed explanation of the four stages of the conduct procedures.

  • GDC proposes non–NHS complaints procedure - 7 December 2004

    The General Dental Council is planning to establish a new complaints system for private patients for complaints which cannot be resolved by the practice itself. The proposal formed part of the Department of Health's consultation, Strengthening the GDC: A paper for consultation, which closed at the end of October 2004.

  • Gender Recognition Act - 8 April 2005

    The MDU is advising doctors to be aware of an amendment to The Gender Recognition Act 2004, which came into effect in April 2005, and which sets out the conditions under which doctors can disclose information about a transsexual patient.

  • Generic drugs name change - 14 November 2003

    Hundreds of generic and non-proprietary drugs and medicinal products are having their names changed from December to bring the UK into line with Europe.

  • Georgia on my mind - 2 September 2000

    Negin Shamsian split her US elective between medical journalism at a cable TV station and a real life ER.

  • Gillick competence challenged - 25 May 2004

    The recent case of the 14-year-old girl whose mother complained to the media when she discovered that her daughter had an abortion without her knowledge sparked a national debate about children's rights to confidentiality.

  • Giving patients all the options on fees - 18 October 2007

    A newspaper story claimed that some dental patients are paying more for NHS treatment than they would pay if the same treatment were provided privately. This raises the question should a dentist advise a patient of all treatment options, including private?

  • GMC – Conduct proceedings - 1 August 2001

    This article provides information and function of The Preliminary Proceedings committee and the Professional conduct committee

  • GMC GP register - 21 December 2005

    From April 2006 all doctors who wish to work in NHS general practice must be on a new GMC GP register. The GMC says this is to bring together all the doctors eligible to work in general practice into a single place.

  • GMC guidance on taking up and ending appointments - 23 May 2008

    Junior doctor members who have been applying for specialty training posts, and others planning the next stage of their career, may find it useful to be aware of some new advice which has been published on the GMC website.

  • GMC introduces new rules to dispose of cases - 7 January 2008

    In December 2007 the GMC changed its fitness to practise (FTP) procedures, widening its powers to dispose of cases consensually, at the investigation stage, by agreeing binding undertakings with the doctor, rather than referring for a public hearing.

  • GMC publishes new guidance on treating under 18s - 23 October 2007

    The GMC has published new guidance for doctors treating children. The guidance entitled; 0-18 years: guidance for all doctors, highlights that doctors should always act in the best interests of children and young people and explains how to assess best interests, which may not always be straightforward.

  • Golden rules of medico–legal practice for students - 15 April 2002

    Even as a medical student you should be aware of medico-legal issues that may affect you. This article looks at the rules regarding confidentiality, consent and note taking. It's vital information to help you avoid problems.

  • Good Samaritan doctors - 27 July 2006

    A story reported this week, where an off-duty doctor assisted when an inflatable "air sculpture" tore away from its moorings, shows that a doctor can be called upon at any time to assist. Here we look at the medico-legal position of Good Samaritan acts.

  • GP certificates - 9 July 2003

    When a patient asked for a medical certificate saying he was fit enough for an aromatherapy massage, his GP called the MDU's advisory service to ask if he was obliged to provide one.

  • GP risk management survey - 27 August 2002

    The MDU carried out a survey of risk management systems in 330 general practices. Overall the results were encouraging but the survey highlighted some areas where practices risk failing CHI performance reviews. There were also a number of areas where small improvements may make a big difference to patient care.

  • GPs going to war - 5 March 2003

    The Department of Health has clarified what arrangements should be put into place in the event of GPs being called up to serve in a war with Iraq. It follows enquiries from PCTs about temporary provisions for GPs absent in time of war.

  • GPs providing dental treatment - 5 April 2006

    The MDU is advising its GP members to exercise caution if asked to provide dental treatment out of hours.

  • Guidance on electronic records - 2 May 2007

    In April, the Department of Health published two guidance documents which set out doctors' duties regarding the use of IT equipment and the security of electronic records.

  • Guidelines for good records - 12 July 2002

    Some basic rules for good record keeping including the use of abbreviations, dictation and legible handwriting.

  • Helping members with the media - 1 March 2006

    Widely known as an expert provider of advice, support and legal representation, the MDU also has a dedicated press office.

  • Highlights of the new GMC prescribing advice - 1 December 2006

    Last year, the GMC published its latest advice on prescribing, which – unlike the previous version in question-and-answer format – is in the form of straightforward advice. Here, we highlight some of the new document’s most important points.

  • HIV and confidentiality - 23 May 2005

    A recent newspaper report that an HIV patient, who kept his condition secret and subsequently infected his partner, has been jailed for three years raises an interesting question - can a doctor reveal a patient's HIV status to protect an uninfected partner?

  • HIV and patient confidentiality - 14 May 2003

    In a case widely reported in Australia, a woman whose husband infected her with HIV and hepatitis B, is suing her GPs in the Supreme Court of Australia, in what is reported as a challenge to the legal protection of doctor-patient confidentiality.

  • HIV Positive healthcare workers and confidentiality - 3 December 2001

    Following a change in policy by the Department of Health, patients will no longer be automatically notified if they come into contact with an HIV positive healthcare worker. Instead each case will be assessed individually.

  • HIV tests for healthcare workers - 13 January 2003

    The MDU is calling for tough safeguards to ensure that doctors and other healthcare workers undergoing compulsory HIV, hepatitis B & C or tuberculosis testing retain the same rights of confidentiality as other patients.

  • Hospital disciplinary procedures - 24 March 2005

    The final three parts of new hospital disciplinary framework have now been published and will come in to force on 1 June 2005.

  • House of Lords child abuse decision - 26 April 2005

    The House of Lords recently upheld a Court of Appeal decision that parents wrongly accused of abusing their children cannot sue the doctors or social workers who made the decision.

  • How can the MDU help me to correct misleading information? - 18 October 2005

    MDU members occasionally request advice if misleading information about them has been published or if they think they have been defamed. The offending information may have been published in the press, on the internet or in another public place or document and the member wishes to have some kind of correction published.

  • How MDU subscriptions are set - 1 September 2003

    The MDU provides its members with a level and quality of service and support that is second to none. Here we review the various elements that are taken into account when setting members' yearly subscriptions.

  • How safe are you? - 1 September 2003

    When seeing patients in isolation, such as on home visits there are a number of issues you can take into account to lessen the risk of situations that lead to violence.

  • How safe is my data? - 11 November 2001

    The MDU regularly receives enquiries in relation to patient records stored electronically. Here we look at a few commonly asked questions and the advice we give.

  • How to survive dental education - 1 March 2000

    This article provides tips and hints on how to make the most of dental education. Practical advice on how to solve problems and plan more effective learning experiences.

  • Human rights act 1998 - 1 October 2000

    Charles Dewhurst, head of MDU legal services, gives a guide to the likely effects of the Human Rights Act, which comes into force in October 2000.

  • Human Tissue Act 2004 - 1 December 2006

    The Human Tissue Act 2004, the main provisions of which came into force on 1 September 2006, was developed to rationalise and update the law relating to the use of tissue and organs.

  • Improving patient safety - 30 September 2004

    Two-thirds of doctors, nurses and managers say better communication between staff and patients is priority for improving patient safety according to a new poll.

  • Indemnity for ships doctors - 20 August 2004

    Members working in circumstances that are out of the ordinary - such as on a cruise ship need to ensure that they notify the MDU and are fully covered for clinical indemnity.

  • Infection control in general practice - 6 July 2002

    The MDU's clinical risk managers regularly undertake workshops for PCTs, aimed at all members of the primary healthcare team. These are designed at helping practices control or eliminate risks to patients and staff in the surgery. This articles looks at one of the popular workshops covering Infection Control.

  • Injection errors - 14 March 2006

    The MDU is reminding members about the importance of exercising caution when administering injections following a number of recent cases reported in the media.

  • Irish doctors' new ethical guidelines - 23 April 2004

    The Medical Council's new guidance on ethical conduct and behaviour contains some significant additions to reflect both the growth in the use of modern communication technology and the popularity of complimentary therapies.

  • Is there a dentist on the plane? - 1 April 2008

    A passenger needs urgent medical attention and the airline is looking for someone to offer assistance. Should you as a qualified dentist offer to help?

  • Is your computer secure? - 19 March 2003

    Members are reminded they need to be vigilant in the storage of medical records on computer and in disposing of old equipment.

  • Keeping data confidential - 1 August 2005

    Data is protected, but it is not sacrosanct. There are increasing calls on GPs to disclose patient data for quality monitoring, service improvement and other non-clinical uses. The implications for patient confidentiality are significant.

  • Laser eye surgery - 6 September 2004

    While laser eye surgery is becoming increasingly popular – around 100,000 people undergo the procedure every year – claims related to the procedure now account for a third of all ophthalmology claims on the MDU's files.

  • Last wishes - 4 October 2005

    The GMC makes clear that all doctors must respect the right of patients to be fully involved in decisions about their care.

  • Legal representation - 1 June 2001

    This article gives advice as to when doctors and healthcare workers may need legal representation

  • Legal status of NICE guidelines - 15 April 2002

    MDU members often ask what the legal status of NICE guidelines are and if they are obliged to follow them.

  • Let's communicate - 1 September 2003

    Getting your message across, in the right way, to patients, relatives, colleagues and administrators, is an elusive art but an essential skill for all doctors.

  • Lifestyle and access to treatment - 20 December 2005

    Drinking, smoking and other lifestyle factors may contribute to or exacerbate many of the conditions which doctors see in patients every day. However, while this may be a frustration, it should not influence the patient's access to treatment.

  • Links - 25 September 2007

    You may find these links to third-party websites useful.

  • Lipostabil treatment - 19 July 2005

    Following concerns raised by the Medicines and Healthcare products Regulatory Agency (MHRA) about the subcutaneous use of the drug Lipostabil, the MDU is issuing advice to its members.

  • Long term therapy - failure to monitor - 1 January 1998

    This article provides an outline of a study into GP claims relating to medication and specifically to problems with the monitoring of long term medication

  • Maintaining and disclosing patient records - 2 July 2004

    Patient records are used at every consultation and provide an accurate picture of patient treatment and care. They can also provide vital evidence if the standard of that care is called into question. We look at how long records should be retained and patients right of access and disclosure.

  • Maintaining and disclosing patient records - 2 April 2008

    Patient records are used at every consultation and provide an accurate picture of patient treatment and care. They can also provide vital evidence if the standard of that care is called into question.

  • Making the NHS safer for patients – the NPSA - 1 May 2002

    Professor Rory Shaw, chairman of the National Patient Safety Agency, explains how it aims to improve patient safety by working with other agencies and with staff in all areas of the NHS to reduce the risk of harm through error.