The prospect of facing criminal investigations during your career

With the introduction of the new criminal offence of wilful neglect, there are now more criminal sanctions for doctors than ever before. There also seems to be more coverage of cases involving doctors which in my experience has all created a much greater awareness of, and fear about, the potential to end up in front of a judge. These cases dispel the myth that as a trainee you are somehow protected from the same levels of scrutiny as more senior doctors. What these cases also highlight is a willingness on the part of the CPS to prosecute healthcare professionals and an acceptance by society of this.

When I was a house officer the worst thing that I thought could happen to me was to face a complaint or be involved in a claim. Nowadays I advise foundation doctors that they should expect to be involved in significant events, inquests, receive complaints and even be referred to the GMC at some point in their career. As a medicolegal adviser I have to always bear in mind the risks of criminal investigation when advising members. Something as innocuous as being asked to write a report for a trust after an incident could lead to consequences far more significant.

It is not unheard of for doctors involved in inquests to be prosecuted if they are thought to have given untruthful evidence under oath and the Coroner Rules also imposes criminal sanctions should it be shown that a report sent is misleading or lacking in all relevant information. It is therefore imperative that when asked for a statement you ensure you have been through the contemporaneous notes and discussed the case with your education supervisor.

Another concern is the number of allegations of sexual assault made by patients against doctors. Doctors seem to have a false sense of security when performing physical examinations on the ward and often don’t offer chaperones. Although this may seem onerous it is something worth careful consideration, as is recording of when a chaperone is offered.

Last year saw the introduction of the new criminal offence of ‘ill treatment or wilful negelct’ and a statutory duty of candour for healthcare providers in England. Whilst the latter does not apply directly to individual doctors, it is possible that hospital trusts may take action against healthcare professionals who fail to discharge their duty to be open and honest with patients when something goes wrong. The offence of wilful neglect on the other hand does not require harm to the patient and a doctor could potentially face prosecution where decisions taken owing to staffing levels and reasonable clinical judgement are investigated by police.

While the actual numbers of prosecutions remain relatively low and the conviction rate even smaller it does highlight the increasing minefield of modern day practice.