full article by Alicia Clegg in the FT

At the start of the pandemic, trainee GP Kaveri Jalundhwala was working on a hospital placement. By the end of March, she had become infected with Covid-19, which then developed into long Covid and forced her to pause her training. With stories emerging of how healthcare workers in makeshift masks and gowns — and sometimes no protection at all — were paying for failures to provide adequate personal protective equipment (PPE) with their health, Jalundhwala looked for a way to support her colleagues.  She joined Doctors’ Association UK (DAUK), a grassroots lobbying group. And rather than “just get angry at home”, Jalundhwala got involved with their “Protect the frontline” campaign. Its aims include to inform the public about conditions in the fight against Covid and press the government to give healthcare workers appropriate PPE and support.

The DAUK grew from doctors joining together to support a junior paediatrician, Hadiza Bawa-Garba. In 2015, Bawa-Garba was convicted of manslaughter by gross negligence after the death of six-year-old patient and was then struck off by the General Medical Council. But many medical professionals did not see a doctor who had failed, rather an overstretched colleague who was put in an unsafe situation and scapegoated. “Any one of us could be Bawa-Garba,” says Jalundhwala. It often feels that doctors are “a faceless number on a rota where [our] individual voice does not matter to the people who make decisions,” she adds. Bawa-Garba has since returned to medical practice, while the DAUK developed its “Learn not blame” campaign to improve the culture of the NHS so it can learn from mistakes “in a constructive and fair manner”.

When the pandemic hit, DAUK started its “Protect the frontline” campaign. As part of this, it broke the story of NHS staff being warned not to discuss PPE problems on social media or speak to the press. It also created an app that enables doctors and GPs to report on PPE supplies. In April 2020, DAUK also led calls for an independent public inquiry into healthcare worker deaths and PPE supplies, with its petition gathering more than 100,000 signatures. When this received no formal response from government, DAUK started legal proceedings with the Good Law Project.

“When something needs doing, we do not sit on it,” says Pushpo Hossain, who joined DAUK to amplify the voice of doctors working in the UK who qualified abroad.

In May, when a DAUK member heard about a plan to upload all NHS patients’ medical records to a central database that could be shared with third parties, the organisation joined forces with Foxglove, a digital rights campaign group, to help force a delay. “In less than a week we had decided to take legal action [later paused],” says Rosie Shire, a GP who led DAUK’s response to the plans. The scheme has now been postponed to allow time for more consultation with no new date for implementation.

Read the full piece by following the above link

Hadiza Bawa-Garba has been allowed to practise again without restrictions, 10 years after a 6 year old boy in her care died of septic shock following a mistaken diagnosis of gastroenteritis.

A well regarded trainee paediatrician at the time Jack Adcock died in 2011, Bawa-Garba was later found guilty of gross negligence manslaughter. Many doctors saw her as a scapegoat for an overstretched and underfunded NHS.

An investigation at Leicester Royal Infirmary found numerous system failures on the 12 hour shift when she was working under extreme pressure, covering several wards without adequate supervision and with IT problems. 

Read the full article here

MANCHESTER—A doctor who received a suspended jail sentence over the death of a 6-year-old boy can return to unrestricted practice, a medical tribunal has ruled.

Dr Hadiza Bawa-Garba returned to work last November for the first time in 5 years after a raft of conditions were imposed on her registration.

In November 2015 a jury convicted her of gross negligence manslaughter in her treatment of Jack Adcock, who developed sepsis and died of cardiac arrest at Leicester Royal Infirmary in February 2011.

A month later she was sentenced to 2 years in jail, suspended for the same period.

Conditions ‘Not in the Public Interest’

On Friday, she was informed at a Medical Practitioners Tribunal Service (MPTS) hearing there were no longer any outstanding concerns over her clinical practice, and it was not in the public interest to maintain the conditions.

Among her failures in Jack’s treatment were making an incorrect diagnosis of gastroenteritis on initial examination of the youngster – who had Down’s syndrome and a heart condition – and not acting on a clinical reading which “ought to have been a clear indicator”.

The doctor was “on the cusp” of becoming a consultant before the incident, as a specialist registrar.

Dr Bawa-Garba was barred from practice for 12 months before the General Medical Council (GMC) took the case to the High Court to appeal against the sanction, saying it was “not sufficient”, and Dr Bawa-Garba was struck off in January 2018.

Later, the Court of Appeal ruled her name should be restored to the medical register and her case sent back to the MPTS.

Read the full article here.

Dr Hadiza Bawa-Garba’s application to have her medical licence fully restored was granted today by the Medical Practitioners Tribunal Service (MPTS). The Doctors’ Association UK have supported Dr Bawa-Garba throughout her case and welcome the news that she can now work without supervision

The case of Dr Hadiza Bawa-Garba united the medical profession in fear and anger. A paediatrician in training, with a previously unblemished record, was convicted of gross negligence manslaughter for judgements made whilst doing the jobs of several doctors at once, covering six wards across four floors, responding to numerous paediatric emergencies, without a functioning IT system, and in the absence of a consultant. All when just returning from 14 months of maternity leave.

In 2018, the GMC’s aggressive pursuit of an otherwise highly regarded doctor, against the advice of the Medical Practitioners Tribunal Service (MPTS), prompted widespread outrage amongst doctors. The GMC subsequently launched an independent  review of gross negligence manslaughter led by Mr Leslie Hamilton to promote learning from this case. The Doctors’ Association UK expect them to continue to implement all the recommendations of this review

“We welcome the fact that Dr Hadiza Bawa-Garba has had her licence to practice medicine fully restored today to allow her to work independently. We are pleased that the GMC today opted for a neutral stance.
Healthcare desperately needs an open, transparent, learning culture, where harm is minimised by learning from error and failings. Scandals such as Mid-Staffs, Gosport, and Morecambe Bay repeatedly demonstrate how a culture of defensiveness and denial can escalate into widespread cover-up leaving families fighting for answers.

 
We hope that the GMC works toward full implementation of ALL 29 recommendations of the Independent review into gross negligence manslaughter so that learning can continue. Fear is toxic and blame should not be used as a tool. Jack Adcock should have received better care but this was due to system-wide failure. His death was a tragedy due to this. Our thoughts are also with his family”

Dr Jenny Vaughan, Chair of The Doctors’ Association UK, and Learn Not Blame Campaign Lead

“When the General Medical Council (GMC) appealed for her to be struck off the medical register, it lit the blue touch paper for a whole generation of doctors working in very challenging conditions across the country. Many of these doctors were simply not prepared to accept the High Court’s subsequent verdict in January 2018 that Bawa-Garba should be erased from the medical register. And while the GMC’s appeal was initially successful, its pyrrhic victory was to be short lived. An unprecedented crowdfunding appeal raised more than £350 000 for Bawa-Garba to hire a new legal team and launch an appeal. In August 2018 the appeal court rejected the High Court’s decision to allow the GMC to erase Bawa-Garba’s name from the medical register.”

Read the full article here:

https://blogs.bmj.com/bmj/2019/05/09/jenny-vaughan-the-bawa-garba-case-should-usher-in-a-fairer-culture-in-healthcare/

Today, there is widespread relief amongst the medical profession. However, the verdict is no cause for celebration. At the heart of this case is a child, Jack Adcock, who tragically lost his life to sepsis. Our hearts go out to the Adcock family as they continue to grieve for Jack.

When a child dies it is our duty as doctors to do all we can to prevent the same tragedy from occurring again. We strongly feel that scapegoating an individual doctor or clinician for human errors made whilst whilst working under enormous pressure, does not serve this purpose. Instead, the criminalisation of medical error creates a culture of fear and blame, where clinicians feel afraid to speak up, afraid to reflect, and afraid to learn when things go wrong.1

Therefore, we welcome the verdict of the Medical Tribunal Practitioners Service (MPTS) today, who, after considering all the system failures and the context in which Dr Bawa-Garba made errors, has found her safe to return to medical practice, albeit with conditions on her license. We are especially pleased that the MPTS had accepted Dr Bawa-Garba has “fully remediated”. With widespread support from the medical profession and the Royal Colleges we hope that she will be fully supported in a return to work.

Dr Jenny Vaughan, Law and Policy Officer DAUK and Founder of Manslaughter and Healthcare said:

“I’m a patient, doctor and a mother and I know that Jack Adcock should have received better care. However, Dr Bawa-Garba was working in appalling conditions that day in an NHS hospital and all the evidence of what the hospital actually needed to put right was not heard by the jury. There is a culture of blame in the NHS at the moment which, if left unchecked, will mean patient safety is not what it should be as staff will be too scared to admit their mistakes. The next generation of those who want to care will simply vote with their feet. It’s right that Dr Bawa-Garba is going to be restored to the medical register as the hospital too was at fault and should have provided better care. We are calling for a just culture so that the system here is made safer as locking up individuals achieves nothing.”

Dr Samantha Batt-Rawden, Chair of The Doctors’ Association UK said:

“Today’s verdict, whilst welcome, is no cause of celebration. There are no winners in this desperately sad case. However, restoring Dr Bawa-Garba to the medical register is the right outcome and will go some way in addressing the current climate of fear and blame in the NHS which is so toxic to patient safety. I have no doubt that Dr Hadiza Bawa-Garba will now be the safest doctor in the hospital, and as a doctor and a mother I would have no hesitation in allowing her to treat my child. ”

Contact

Contact@dauk.org

NOTES TO EDITORS

1. In November 2018 DAUK launched our campaign Learn Not Blame in Parliament, for a just culture in the NHS. DAUK continues to campaign for the decriminalisation of medical error and feels strongly that no clinician should face criminal charges for honest errors. https://www.dauk.org/learnnotblamedauk

The key messages are:

-Healthcare systems should provide an adequate and effective response to patients who have been unintentionally harmed while receiving care

-To improve patient safety we need a greater focus on learning and resolution rather than retribution and blame, recognising the importance of protecting confidential personal reflective practice while encouraging open disclosure and system transparency

-In line with the recommendations from the Williams review, England and Wales should have a higher threshold for criminal prosecution in response to deaths that arise despite conscientious efforts to care for patients under difficult circumstances

-We urgently need to improve the clinical working environment and resourcing for safe functioning of hospitals

Read the full article here: https://www.bmj.com/content/364/bmj.l706

This briefing will be used by Members to inform their line of questioning towards the regulators and other panelists as well as being published.

Dr Samantha Batt-Rawden, Chair of DAUK said, “We thank the Health and Social Care Committee for asking for written evidence from grassroots doctors. The case of Dr Hadiza Bawa-Garba has had a profound impact on doctors, and trainees in particular, who now feel vulnerable that they too may face a criminal conviction for honest mistakes made whilst working under pressure. It is crucial that the HSC hear from doctors, the very people whom the current legislation on gross negligence manslaughter directly affects.”

The DAUK committee are keen to hear your thoughts and keen to represent the views of our members in the briefing. Please get in touch if you have any suggestions as to what to include.

Despite the request coming from the grassroots, disappointingly no doctors or organisations representing doctors have been invited to give evidence. However, the Health Select Committee will be hearing from Charlie Massey.

We have written to the HSC to urgently clarify, and ask them to include representatives from the medical profession, in what is a very important, at the moment incredibly unbalanced, inquiry for us all.

The HSC has given assurances that doctors can attend and observe. Dr Jenny Vaughan will be attending representing DAUK.

DAUK would like to see as many doctors as possible attend. For those who can’t attend the inquiry will be streamed live on Parliament TV and DAUK will keep our members updated.

let us know you can attend

“Adrian has recently been appointed as the media spokesperson for a fledging but already high-profile political lobbying group, The Doctors’ Association, providing the virtual organisation with a GP voice on issues such as Brexit, and the recent Bawa-Garba case.

“We’re an Independent, non-profit, non-partisan political lobbying group for doctors” . Adrian explains, “it was apparent that there was a desire for doctors to become more involved in political campaigning. The foundation of campaign groups nowadays are almost always on the internet and social media, it’s where we come together and have our dialogue. We don’t have a building or an office, we don’t have a pedigree of forefathers, we’ve started this on our own. We’re a small group based all over the country and conversations and planning are online.”

It was Adrian’s outspoken comments on Twitter in support of doctors and nurses at Alder Hey Children’s Hospital (following a high-profile High Court ruling in April) that brought him to the attention of DAUK founder Dr Sammy Batt-Rawden.

“The Alder Hey staff were coming under huge criticism but I agreed with the messages coming out of the hospital. Unbeknownst to me, DAUK we’re saying similar things.”

The case of trainee paediatrician Dr Hadiza Bawa-Garba has given The Doctors’ Association a major platform and Adrian notes ‘our growth has been in parallel with the high profile of the case’.

”We want to move towards a ‘learn not blame’ culture in the NHS, with complete openness and transparency, so that when mistakes happen, tragic as they may be, we acknowledge all the different factors that contibruted to that mistake, and minimise the opportunity for those mistakes to happen again”.

Another big issue for DAUK is Brexit. “The vast majority of NHS workers I’m aware of, in the real world and online, feel that retaining our membership to the EU is the best things for the NHS”.

Read the full article below.