Adviceline: avoiding litigation

Every patient has a legal right to expect a ‘reasonable standard of care’. Patients who have been harmed by sub-standard care may seek compensation. The CSP public liability insurance (PLI) scheme provides insurance cover for such claims. It has paid out millions of pounds as a result of members’ negligent care.

Why are physiotherapists sued? The most common cause is failure to assess and diagnose. Members are sued for failing to refer patients on for diagnostic investigations or specialist opinion quickly enough when timing is critical for proper treatment. Finally members are sued for not applying treatment modalities carefully enough.

The CSP produces ‘Learning from Litigation’ briefings. These highlight to members the common causes of avoidable negligence claims. The briefings are produced in conjunction with a clinical expert physiotherapist and provide a medico legal perspective to practice.

The CSP has produced three Learning from Litigation briefings so far.  

• The ‘Cauda Equina Syndrome’ briefing followed an increase in cases of proven negligence in which physiotherapists failed to manage presentations of this condition properly. As physiotherapists expand into first contact roles in all settings, it is imperative that members can assess, diagnose and refer on people with rare but serious conditions with sufficient urgency.
• ’Burns and Electrophysical Agents’ followed a stream of claims from patients who had been burned by the inappropriate application of electrotherapy. These claims could have been avoided by proper skin testing and caution checking. Physiotherapists who choose to use electrotherapy must ensure they can do so safely.
• The ‘Pneumothorax and Acupuncture/Dry Needling’ briefing highlights the avoidable nature of claims resulting from physiotherapists not using needles correctly. Claims have increased recently in this area from members who are not members of a professional network and where the quality of their training is unknown.

The CSP expects all members to be educated, trained and competent in their areas of work. These briefings allow members to use the clinical negligence experience of the PLI scheme to review their work. Reducing claims means the costs of PLI are contained, which benefits everyone.

• Pip White is a CSP professional adviser