Industry Expert View: Paul Whiteing

Paul Whiteing recently celebrated his first year as CEO of Action against Medical Accidents (AvMA), the UK charity for patient safety and justice. Here, Paul reflects on the charity’s work, the growing demand for its services and what healthcare providers should be doing to support patients when things do go wrong.

My background is neither medical nor legal – something my predecessor said was no bad thing – and I like to think that gives me a fresh perspective. I was a financial ombudsman for a number of years, and before that a regulator, and what I do have experience of is helping people who are struggling to get answers from big institutions when they believe that something has gone wrong.

Healthcare is a complex, high risk area and mistakes will occasionally get made, but it’s how they’re handled that can compound the harm. We see it regularly where people start to ask questions of the professionals and the shutters come down. The psychological impact of that is dreadful and it erodes trust in the NHS.

Some patients will need compensation to cover their loss of earnings or pay for treatment or care required as a result of negligence. However, people seldom come to us because they want money but because they want answers and they aren’t getting them. More than anything they just want an acknowledgement that something has gone wrong and a meaningful apology. If medical staff better understood that and were empowered to be open and honest from the start, then I think many of the problems we see would go away. People wouldn’t need us and certainly wouldn’t need a lawyer.

When I started as CEO one of the first things I did was to analyse the AvMA helpline call logs to try and pick out any patterns as I was convinced that there would be many. But it really is quite mixed and difficult to identify obvious patterns and trends. That said, there are perhaps more complaints relating to substandard maternity care and mental health issues than there were previously, and we sometimes see an increase in contacts where a particular issue has been in the news or there has been publicity about it.

We receive about 3,500 enquiries each year and a further 10,000-15,000 people download resources from our website, but I believe we are only just scratching the surface. Some NHS trusts will signpost patients to us, but many don’t. Lawyers signpost people to us if they are unable to help as the bar for what constitutes a viable medical negligence claim is high and set to get even higher.

Many of our helpline volunteers have had some legal training, but if we think that people need to speak to a lawyer then we will give them options from our accredited panel based on their needs and what they seem to be asking for. They will sometimes come back to us and say they spoke to the lawyers and no one would take the case on. I strongly believe that the implementation of fixed recoverable costs will bring a lot more of that challenge for law firms and us.  We are giving a lot of thought as to what we do about this as I believe we need to find a way to help wherever we can.

We’re here to help patients and that also means working closely with healthcare providers. We have a good relationship with NHS Resolution, who I think are genuinely trying to improve their practices and are receptive to talking to us about the things we see and hear. We are currently working with them and the Society of Clinical Injury Lawyers (SCIL) to put in place updated protocols to help improve how litigation cases are progressed and resolved.

We have recently drawn up a new five-year strategy which identifies our four main priorities: to reach more people, particularly in disadvantaged communities, to better empower patients who have been harmed to get the help and support they need, to improve how complaints are handled by healthcare providers, and to ensure AvMA continues to be sustainable financially.

The impending reforms and the unprecedented pressures that the NHS continues to face means our services will be in demand more than ever and it is vital that we make ourselves future fit so we can be there for those who need us as we go forward. We will be talking more about this at our upcoming conference on 21st and 22nd March at the Royal Armouries Museum in Leeds. If you haven’t already booked, details are here. I hope to see you there.


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