As a GP you can face a series of investigations following a single adverse incident. The idea of just one is enough to set your pulse racing, and relying on state-backed indemnity alone once it's introduced could leave you with an unwanted gap in your defences.
It's not a prospect that anybody would want to face on their own - but with the MDU on your side, you don't have to.
Case study: multiple jeopardy
GPs can be subject to a series of investigations resulting from just one adverse incident, including patient complaints, GMC referrals, Ombudsman investigations, performers' list actions, coroners' inquests and even criminal investigations relating to clinical care of patients.
The MDU can support you throughout multiple investigations, protecting your reputation and your career - something you are unlikely to get from relying on the new state-backed indemnity scheme alone.
The following fictitious case, based on real MDU files, demonstrates how a seemingly simple patient examination can lead to multiple investigations.
A woman saw her local GP with symptoms that required a routine eye examination. As part of his assessment the doctor dimmed the lights and examined the patient's eyes with an ophthalmoscope.
Following the appointment, the patient made a complaint to the police stating that the doctor had sexually assaulted her by pressing his chest against her breasts and that he had done so in a darkened room. The doctor was advised that the police intended to interview him under caution at the local police station as part of a criminal investigation into an alleged assault.
The doctor contacted the MDU, explaining that although a nurse would often be present in the room during examinations, he could not remember whether this was the case on that occasion. There was no record of whether a chaperone was present or offered. The MDU instructed a solicitor to assist the member with the police interview, which was conducted later that week at the police station.
The MDU medico-legal adviser explained to the doctor that the police might notify other bodies about the investigation, such the GMC. The adviser recommended that the doctor begin reflecting on the incident and ensure that there was evidence of professional development and learning relevant to this incident in his portfolio.
A few weeks later the GMC informed the doctor that they were investigating the incident and possible concerns about his fitness to practise. The doctor sought advice from the MDU about how to respond. The medico-legal adviser explained that the GMC would obtain the patient's medical records and an expert opinion on the consultation. The doctor was advised to let that process run its course and not make comments to the GMC while the criminal investigation remained open.
As part of their investigation, the GMC contacted NHS England (NHSE) who in turn began a local performers' list investigation. They asked the doctor to give a voluntary undertaking to use a chaperone for all examinations of female patients whilst their investigation was ongoing.
It was several months before the police confirmed that no further action would be taken. During this time the doctor also attended an interview with the case investigator for NHSE. An MDU medico-legal adviser was present to support the GP. The case investigator concluded that the doctor had conducted an appropriate routine ophthalmological examination and NHSE closed their case.
The MDU then explained to the GMC that the incident had been investigated by the police and NHSE who had decided there was no case to answer. The adviser explained that the GP had since reflected on the consultation as well as the GMC guidance on intimate examinations and the use of chaperones. The adviser also submitted evidence that the doctor had completed communication and record keeping courses.
The GMC obtained an opinion from a GP expert who said that the doctor's examination of the patient was reasonable. The GMC were further reassured that the doctor had learnt from the incident. Therefore, they closed the matter without any adverse outcome on the doctor's registration.
The multiple investigations by the police, NHSE and the GMC caused a great deal of stress and uncertainty for the GP involved over a period of several months. This case highlights some of the issues that doctors can face after an apparently routine consultation and demonstrates how the MDU will be by your side, helping to protect your reputation throughout your career.
Take our quick quiz to see how one incident could set in motion a whole series of investigations.
See our website for more information on the differences between MDU membership and state-backed indemnity.