Case report 14/11/2022 Fatal outcome after chest drain error Preview Article Fatal outcome after chest drain error Time to read article: 2 mins Close Preview Mrs A, was admitted for a triple coronary artery bypass graft operation for her NSTEMI. She had a past medical history of thoracic (T9-T10) spinal fusion for fractures secondary to a viral illness more than 20 years ago. Read more Article contains Text Tagged in... General Surgery Medical Records Managing clinical risk
Case report 01/07/2022 Alleged failure to diagnose perforated uterus Preview Article Alleged failure to diagnose perforated uterus Time to read article: 3 mins Close Preview Record keeping plays a major role in the development of this case, which sees GP Dr O receive a clinical negligence claim following the insertion of an IUCD. Read more Article contains Text Tagged in... Consent Medical Records Record keeping Diagnosis
Case report 01/07/2022 The importance of good record keeping Preview Article The importance of good record keeping Time to read article: 4 mins Close Preview Julie Baylis, Case Manager at Medical Protection, looks at a recent High Court case and how it underlined the importance of good quality medical records. Read more Article contains Text Tagged in... GP Stress Medical Records Record keeping Consent
Articles and features 01/07/2022 Reinventing record keeping with GPConsult Preview Article Reinventing record keeping with GPConsult Time to read article: 2 mins Close Preview We all know the importance of keeping good records, and now GPConsult.co.uk makes it easier than ever for doctors to make clear, timely patient notes. GP Dr Rima Aboud talks about her experience with record keeping and how this new resource can help. Read more Article contains Text Tagged in... Medical Records GPConsult Communication Record keeping
Case report 08/06/2021 Missed diagnosis during colonoscopy Preview Article Missed diagnosis during colonoscopy Time to read article: 2 mins Close Preview GP Dr D and consultant gastroenterologist Dr B face a claim after an abandoned colonoscopy fails to pick up the required diagnosis. Medical Protection handles the case. Read more Article contains Text Tagged in... Colonoscopy Missed diagnosis GP Diagnosis Gastroenterology Medical Records
Case report 18/07/2019 Missed critical limb ischaemia Preview Article Missed critical limb ischaemia Time to read article: 3 mins Close Preview Mr S was a 60-year-old lorry driver. He was overweight and smoked, and couldn’t walk far because he suffered with pain in his calves. Read more Article contains Text Tagged in... Casebook General practice Diagnosis Casebook Scotland GP locum Negligence
Factsheet 27/04/2018 The General Data Protection Regulation (GDPR) Preview Article The General Data Protection Regulation (GDPR) Time to read article: 16 mins Close Preview From 25 May 2018, the EU General Data Protection Regulation (GDPR) (1) will come into force and will have a direct effect in every EU country. Read more Article contains Text Tagged in... Scotland Northern Ireland Confidentiality Record keeping Data Protection Wales
Case report 13/04/2018 Failure to review nitrofurantoin: hepatitis and rash Preview Article Failure to review nitrofurantoin: hepatitis and rash Time to read article: 2 mins Close Preview Read more Article contains Text Tagged in... Casebook Scotland Casebook Medical Records Claims Prescribing
Case report 13/04/2018 Delayed diagnosis of Achilles tendon rupture Preview Article Delayed diagnosis of Achilles tendon rupture Time to read article: 2 mins Close Preview Mr E, a 50-year-old accountant, was playing squash with a colleague after work and hurt his left ankle. He couldn’t keep playing but he was able to walk, so he went home. The next day his ankle became quite swollen, so Mr E kept it on ice and took some ibuprofen... Read more Article contains Text Tagged in... Medical Records Diagnosis Sports Medicine Casebook Casebook Scotland
Case report 12/04/2018 Sciatic nerve injury but no negligence Preview Article Sciatic nerve injury but no negligence Time to read article: 3 mins Close Preview Read more Article contains Text Tagged in... Negligence Record keeping Casebook Medical Records Casebook Scotland
Case report 05/09/2017 Wrong drug, no negligence Preview Article Wrong drug, no negligence Time to read article: 3 mins Close Preview Mrs M was a 64-year-old care assistant in a retirement home. She visited her GP with a two-month history of blood in her stools, altered bowel habit, and intermittent lower abdominal discomfort. Read more Article contains Text Tagged in... Casebook Managing clinical risk Record keeping Medical Records
Advice booklet 04/07/2017 An essential guide to medical records Preview Article An essential guide to medical records Time to read article: 7 mins Close Preview This Essential Guide was produced as a resource for Medical Protection members in the UK. It is intended as general guidance only. Read more Article contains Text Tagged in... Patients Medical Records Use Guidelines Managing clinical risk Record keeping
Advice booklet 04/07/2017 GP entry study guide Preview Article GP entry study guide Time to read article: 1 mins Close Preview General Practice remains one of the most popular of all the specialties, with about a quarter of all candidates ranking it as their top choice, and more than half likely to apply for it as one of their choices for specialty training. Read more Article contains Text Tagged in... Managing clinical risk Use Guidelines Medical Records Patients Record keeping
Factsheet 18/05/2016 Consent – The basics - Northern Ireland Preview Article Consent – The basics - Northern Ireland Time to read article: 4 mins Close Preview Respect for patients’ autonomy is expressed in consent law; to impose care or treatment on people without respecting their wishes and right to self-determination is not only unethical, but illegal. The approach to consent in Northern Ireland is currently governed by common law. Read more Article contains Text Tagged in... Managing clinical risk Medical Records Northern Ireland Use Guidelines Consent Issues & conflict management
Factsheet 17/05/2016 Medical records - Northern Ireland Preview Article Medical records - Northern Ireland Time to read article: 3 mins Close Preview Good medical records – whether electronic or handwritten – are essential for the continuity of care of your patients. Adequate medical records enable you or somebody else to reconstruct the essential parts of each patient contact without reference to memory. They should therefore be comprehensive enough to allow a colleague to carry on where you left off. Read more Article contains Text Tagged in... Medical Records Generic Medicine Record keeping Northern Ireland
Factsheet 01/10/2015 Confidentiality – Disclosures relating to patients who are unable to... Preview Article Confidentiality – Disclosures relating to patients who are unable to consent - Wales Time to read article: 4 mins Close Preview You owe a duty of confidentiality to all your patients, past or present, even if they are adults who lack capacity. You may be asked to provide information from the medical records of patients who are incapable of giving consent, are aged under 18, or have died. This factsheet gives you further information about dealing with these circumstances. Read more Article contains Text Tagged in... Consent Medical Records Issues & conflict management Communication Managing clinical risk Generic Medicine
Factsheet 30/09/2015 Medical records - Scotland Preview Article Medical records - Scotland Time to read article: 3 mins Close Preview Good medical records – whether electronic or handwritten – are essential for the continuity of care of your patients. Adequate medical records enable you or somebody else to reconstruct the essential parts of each patient contact without reference to memory. They should therefore be comprehensive enough to allow a colleague to carry on where you left off. Read more Article contains Text Tagged in... Managing clinical risk Record keeping Medical Records Scotland
Factsheet 30/09/2015 Consent – The basics - Scotland Preview Article Consent – The basics - Scotland Time to read article: 3 mins Close Preview Respect for patients’ autonomy is expressed in consent law; to impose care or treatment on people without respecting their wishes and right to self-determination is not only unethical, but illegal. Read more Article contains Text Tagged in... Issues & conflict management Generic Medicine Consent Use Guidelines Communication Scotland
Factsheet 30/09/2015 Consent – The basics - Scotland Preview Article Consent – The basics - Scotland Time to read article: 3 mins Close Preview Respect for patients autonomy is expressed in consent law; to impose care or treatment on people without respecting their wishes and right to self-determination is not only unethical, but illegal. Read more Article contains Text Tagged in... Managing clinical risk Use Guidelines Scotland Consent Generic Medicine Medical Records
Factsheet 20/05/2015 Access to medical reports - England Preview Article Access to medical reports - England Time to read article: 3 mins Close Preview Doctors may, on occasion, receive a request from a patient’s employer for a medical report to be delivered directly to the HR department, without the patient seeing it. However, before any medical report can be provided, you must be satisfied that the patient has given valid consent to the release of the information. This factsheet looks at the issues surrounding medical reports for employers and other organisations, and offers advice to doctors who are asked to write reports. Read more Article contains Text Tagged in... Medical Records Generic Medicine GP locum England Managing clinical risk Data Protection
Case report 05/05/2015 A malignant lesion Preview Article A malignant lesion Time to read article: 3 mins Close Preview Mr M, a 44-year-old architect, attended his GP, Dr C, for a skin check. Dr C diagnosed a papilloma on his right chest wall as well as a seborrhoeic keratosis skin lesion of the upper left arm. Read more Article contains Text Tagged in... Casebook Record keeping Dermatology Scotland Successful Defence Managing clinical risk
Factsheet 01/04/2015 Medical records - Wales Preview Article Medical records - Wales Time to read article: 3 mins Close Preview Good medical records – whether electronic or handwritten – are essential for the continuity of care of your patients. Adequate medical records enable you or somebody else to reconstruct the essential parts of each patient contact without reference to memory. They should therefore be comprehensive enough to allow a colleague to carry on where you left off. Read more Article contains Text Tagged in... Wales Record keeping Medical Records Managing clinical risk CQC compliance Generic Medicine
Factsheet 02/02/2015 Access to health records - Scotland Preview Article Access to health records - Scotland Time to read article: 4 mins Close Preview Providing access to medical records is essentially a confidentiality issue; therefore, the starting point is whether or not the patient has consented to disclosure. If not, access should be denied, unless there is some other clear justification for allowing access. Read more Article contains Text Tagged in... Data Protection Patients Consent Medical Records Ethics Scotland
Factsheet 02/02/2015 Report writing - Scotland Preview Article Report writing - Scotland Time to read article: 3 mins Close Preview One incident can be investigated in a number of different ways – as a complaint, a clinical negligence claim, a criminal case, a disciplinary matter by your employer, a Procurator Fiscal’s FAI or a complaint to the GMC. An important starting point is your written report on the circumstances of the incident. This factsheet gives more information about writing this report. Read more Article contains Text Tagged in... Medical Records GP locum Record keeping Generic Medicine Scotland Communication