Impact of Litigations And Complaints on Surgeons ( ILIACS )

Dear Colleagues,

We are all working in a challenging and increasingly litigious environment. The study is designed to evaluate the overall impact on our clinical practice and wellbeing. This survey is completely anonymous. It should not take more than 5 minutes of your valuable time. We hope the results will help understand the issue in depth. We greatly appreciate your help.

Many thanks

Mr Ashok Bohra

Consultant General, Upper GI, Bariatric Surgeon

University Hospitals of Derby and Burton

ashok.bohra@nhs.net

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* 1. Your Grade

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* 2. Please indicate your ethnic origin

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* 3. How many years since you qualified

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* 4. About how many years have you been in your current grade/role?

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* 5. Your speciality (please choose all relevant boxes)

Bariatric Surgery

Breast Surgery

Colorectal Surgery

Endocrine Surgery

General Surgery

Upper GI Surgery

HPB Surgery

Vascular Surgery

Transplant Surgery

Other (please specify)

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* 6. Have you been subject to a complaint (including PALS), litigation, coroner's inquest or other disciplinary procedure? (multiple choices)

Complaint

Litigation

Disciplinary Procedure

Coroner's inquest

None of the above

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* 7. How many Coroner's inquest have you attended in your career?

1 to 5

6 to 10

More than 10

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* 8. How many litigations have you had to respond to or contest in your career?

1 to 2

3 to 5

More than 5

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* 9. How many complaints have you answered in your career

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* 10. How many years after the actual clinical incident did you get notified about the litigation?

0 - 1 year

2 - 3 years

4 - 6 years

7 to 10 years

Longer

Not applicable to me

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* 11. Did you involve your Medical Defence Organisation in the response and proceedings?

Yes

I have not been involved in any proceedings

Not a member of MDO (medical defence organisation)

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* 12. How did you find the support of your Medical Defence Organisation? (multiple choices)

Satisfactory

Excellent

Unsatisfactory

They used their discretion to not defend

I had to employ my own lawyers

I did not need their support

Not a member of MDO

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* 13. Did the litigation proceeding adversely affect your Medical Defence Premium next year? (multiple choices)

Yes, but minimal

Yes, significantly

I struggled to find appropriate cover during renewal

No impact on my cover renewal

I had to stop all private work in that sub-speciality

I had to stop all private work

Not applicable to me

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* 14. Have you been suspended from work as a result of any of the proceedings?

Yes

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* 15. If yes to the above, for how long?

0 to 4 weeks

1 to 6 months

7 -1 2 month

Longer

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* 16. Did the complaint or litigation lead to criminal proceedings?

Yes

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* 17. Did you need to go through a period of retraining / supervision for return to work?

Yes

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* 18. Has the complaint or litigation involving you changed your clinical practice?

Yes, to some extent

Yes, quite significantly

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* 19. If you answered YES to the above question, how has your practice changed (multiple choices)?

My practice has not changed but I am more apprehensive.

I avoid complex or high-risk cases

I increasingly involve other colleagues, including dual operating (surgeons)

I discuss patients in MDT, more often.

I have lower threshold in transferring selective cases to another colleague or centre

I take longer to consent

I personally consent everyone I operate or do a procedure on

I now operate with another colleague in complex cases

I document absolutely everything

I spend more time per patient.

I stopped doing a procedure

I changed my career completely

I never returned to work afterwards

All of the above

Not applicable

Other (please specify)

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* 20. As a result of the proceedings did you suffer financial losses

Yes

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* 21. If Yes to the above, can you give an indication to the amount of losses suffered?

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* 22. Did the complaint, litigation, or other procedures have any impact on your mental health? (multiple choices)

None

Minor (did not need mental health support)

Significant (needed mental health support)

Temporary (3-6 months)

Long term (more than 6 months)

Ongoing

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* 23. Did the proceedings adversely impact your personal life? (multiple choices)

Yes, temporary

Yes, long term

Minor

Significant (e.g break-ups)

Not applicable

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* 24. From your personal experience, please rank the following common causes held responsible for most complaints or litigations

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* 25. Did you find your colleagues supportive and sympathetic during the proceedings?

Yes, I felt supported

No, it was a lonely battle

Some support, but could have been better

Not applicable

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* 26. Do you think better support from colleagues and hospital could have helped you cope with the situation any better?

Yes

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* 27. Would you support the provision of protected time for confidential reflection and support (emotional and pastoral) locally from someone whom you trust via mentoring?

Yes

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* 28. How important do you think the 'no win no fee culture' and opportunity for financial gains is responsible for the rise in litigations?

Somewhat important

Extremely important

Not at all important

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* 29. Do you think the low threshold of complaints and litigations make treatment and care safer for the patients ?

Yes, to some extent

Yes, significantly

It can be detrimental to the care

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* 30. Do you think basic medicolegal teaching and awareness should become part of mandatory training?

Yes

Not Sure

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* 31. What is your perception of the GMC with regards to complaints? Please choose multiple options, if needed.

Supportive

Punitive

Indifferent

Harsh

Fair

Racially biased

There is a culture of "Guilty unless proven otherwise"