Tag: claims management

Freedom of Information Act risks – flawed clinical judgement, discrimination and education refusal

Post date 23 July 2021
Categories In Compliance

The Freedom of Information Act 2000 affords patients, litigants and the scientific community several routes to highlight policy, reveal shortcomings and to enforce lawful clinical and administrative decision-making. It must be noted that the low and/or prejudicial standards of communication and record keeping that are often normalised in this professional field (link) can be revealed…Continue readingFreedom of Information Act risks – flawed clinical judgement, discrimination and education refusal

Compliance

Obligation to procure ME/CFS medical education

Post date 23 July 2021
Categories In Compliance

Educational materials defined by legally demonstrable scientific consensus are of material legal consequence versus liability for clinical outcomes, breaches of duty of care and relevant statutory and policy discrimination frameworks discussed in this document. This lack of medical education is documented empirically, by the UK National Institute of Health and Clinical Excellence and addressed by…Continue readingObligation to procure ME/CFS medical education

Compliance

Knowledge-gap risk and audit trails (examples plus research-market inefficiencies)

Post date 23 July 2021
Categories In Compliance

Liability-generation from elevated probability of unlawful clinical and administrative judgement does not only stem from practitioners’ incorrect beliefs regarding disease aetiology (causes) and pathology (symptoms). Practitioners also generate further excess risk from their knowledge gap versus formal ME/CFS and related diagnostic criteria, which offer 1) rigour and ease of diagnosis and 2) risky diagnostic audit…Continue readingKnowledge-gap risk and audit trails (examples plus research-market inefficiencies)

Compliance

Obligation to not mislead or evade diagnosis and to provide sufficient detail (FND, MUS, PPS, ‘dysregulation model’ and Long Covid examples)

Post date 23 July 2021
Categories In Compliance

Risk generation and unnecessary liability accumulation is commonly exacerbated by low and/or prejudicial standards of communication and/or record keeping in ME/CFS and other post-viral disease contexts. False record taking is commonly experienced in this field. Beyond the statutory contexts, the frequent frontline status quo regularly breaches a range of associated General Medical Council (GMC) and…Continue readingObligation to not mislead or evade diagnosis and to provide sufficient detail (FND, MUS, PPS, ‘dysregulation model’ and Long Covid examples)

Tags BDD, BDS, Best practice, Bodily distress, Book, breaches, Care Quality Commission, CFS, claims management, Clinical judgement, Compliance, compliance risk, Conversion Disorder, Covid, CQC, Diagnosis, diagnosis rebranding, Discrimination, dysregulation model, education, Evidence, expertise risk, FND, Free, Freedom of Information, Functional, Functional Disorder, General Medical Council, GET, GMC, Harm, hydra diagnoses, Influenza, insurance underwriting, intermediation, Judgement, Law, Legal, Liability, Long Covid, ME, ME/CFS, MEA, Medical Education, medical failure, medical norm, Medically Unexplained Symptoms, medico-legal, MUS, Narrative, obligation, occupational health, operational risk, Pandemic, PENE, Persistent Physical Symptoms, PESE, Policy, Post Exertional Malaise, post-viral, PPS, practice management, PSS, PTSD, reinsurance, Risk, Risk management, Somatisation, Somatization, Standards, unlawfulness, vaccination, vaccine

Compliance

Obligation to recognise ME/CFS patient housebound or carer status

Post date 23 July 2021
Categories In Compliance

House bound status Not accounting for the housebound or bed bound status of a patient when determining treatment or eligibility of a patient can add to or substantiate claims of liability, for resultant harm and financial loss, and/or for discrimination claims. It is extremely common that practitioners / their practices fall foul of these obligations,…Continue readingObligation to recognise ME/CFS patient housebound or carer status

Compliance

Obligation to recognise ME/CFS mobility limitations

Post date 23 July 2021
Categories In Compliance

Smear test exampleContinue readingObligation to recognise ME/CFS mobility limitations

Compliance

Evaluating duties of care and unmanaged risk exposures

Post date 23 July 2021
Categories In Compliance

The numbers of people affected by ME/CFS are significant. There are roughly twice as many sufferers as either Crohn’s disease or Lupus, roughly one and half times as many sufferers as HIV/AIDS in the European Union, and similar numbers of sufferers as either multiple sclerosis and Parkinson’s disease. The prevalence rates are significantly greater where…Continue readingEvaluating duties of care and unmanaged risk exposures

Compliance

Compromised indemnification, insurance cover nullification and liability for lost income

Post date 23 July 2021
Categories In Compliance

It is of acute risk management importance to note that any officialised obfuscation or encouragement of unlawful outcomes is not accompanied by implicit indemnification for discrimination, breaches of duties of care or other improper acts. This is in addition to reputational risk and accompanying freedom of information risk. Moreoever, lack/incompleteness of central NHS indemnification in…Continue readingCompromised indemnification, insurance cover nullification and liability for lost income