Policy for Supporting Staff Involved in an Incident, Complaint Or Claim

POLICY FOR SUPPORTING STAFF INVOLVED IN AN INCIDENT, COMPLAINT OR CLAIM

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CONTENTS

QUICK REFERENCE GUIDE

1.INTRODUCTION

2.PURPOSE

3.SCOPE

4.DEFINITIONS

5.DUTIES AND RESPONSIBILITIES

6.PROCESS

7.TRAINING REQUIREMENTS

8.REFERENCES AND ASSOCIATED DOCUMENTATION

9.EQUALITY IMPACT STATEMENT

10.MONITORING COMPLIANCE WITH PROCEDURAL DOCUMENTS

APPENDIX 1: STAFF SUPPORT CHECKLIST

APPENDIX 2: Helping Agencies

EQUALITY IMPACT SCREENING TOOL

QUICK REFERENCE GUIDE

For quick reference the guide below is a summary of actions required. This does not negate the need for the document author and others involved in the process to be aware of and follow the detail of this policy.

1. This policy is to ensure that adequate support systems are in place for staff who have been involved with, or directly affected by incidents, complaints or claims, and provides guidance about the types and availability of support both internally and externally (see Appendix 2).

1. The policy applies to all staff, including agency and locum workers, volunteers, apprentices and those on work experience.

1. A Staff Support Checklist is included (see Appendix 1). The checklist should be completed by the manager and retained until the matter is at an end; the intention is to ensure all staff are provided with timely and appropriate support.

1. Where a manager becomes aware that one or more of their staff are or has been involved in an incident, complaint or claim, immediate support and reassurance should be offered to them and the details of appropriate internal or external resources provided.

1. Ongoing support should be provided by offering debriefings at various stages in the process and by ensuring staff have been offered access to appropriate sources of internal and external support.

1.INTRODUCTION

1.1Portsmouth Hospitals NHS Trust (“the Trust”) has a duty of care to look after the psychological and physical well being of staff, who have been exposed to a traumatic incident to ensure that they are appropriately managed. When a traumatic event occurs, staff need to be aware of exactly what support is available to them both internally and externally, and in the short and longer term.

1.3The principles of providing support to staff detailed in this policy also extend to staff who may experience challenging situations when appearing as a witness, be it at an internal hearing or in a court of law; including an employment tribunal or Coroners Court (Inquest).

1.4Involvement in anincident, complaint or claim can have profound consequences on those staff members involved, who may experience a range of reactions from stress and depression to shame and guilt. The high personal and professional standards of most clinicians and other NHS staff may make them particularly vulnerable to these experiences. It should also be recognised in applying this policy that different individuals will have differing responses to the same incident, complaint or claim and will therefore require different levels or types of support.

2.PURPOSE

The purpose of the policy is to Clarify the availability of support to staff, both internally and externally, in the event of them being involved in a traumatic or stressful incident, complaint or claim. Provide managers with guidance on supporting staff in these situations; andProvide staff with details of how to access the support available regardless of the extent of their involvement or of whether any blame may exist.

2.1The policy isdesigned to ensure guidance is provided to all staff requiring support who have been involved in an incident, complaint and/or claim. The policy aims to reduce the risk of staff failing to receive or being offered adequate support, and will also offer a means of sign-posting staff to both internal and external support mechanisms.

3.SCOPE

This policy will apply to all staff employed within the Trust, including bank, agency and locum workers, volunteers and those on work experience.

The policy outlines the guidance and support available for all staff who have been involved with, or directly affected by incidents, complaints or claims, regardless of the extent of their involvement. This will also include being involved in cases of safeguarding children or adults, harassment or bullying, violence and aggression.

In the event of an epidemic infection outbreak, flu pandemic or major incident, the Trust recognises that it may not be possible to adhere to all aspects of this document. In such circumstances, staff should take advice from their manager and all possible action must be taken to maintain ongoing patient and staff safety.

4.DEFINITIONS

A traumatic or stressful event that invokes unusually strong emotions, overcoming normal coping abilities.

Examples of such incidents may include the following, although the list is not intended to be exhaustive:

• Serious Incidents/Complaints/Claims
• Allegations of negligence
• Dealing with a major incident
• Involvement in cases of safeguarding children or adults
• Cases of harassment and/or bullying
• Involvement in an incident of violence aggression or verbal abuse, whether as a victim or witness
• Being called as a witness in a Court of Law

Root cause analysis - a well recognised way of investigating incidents, claims and complaints, which offers a framework identifying what, how and why the event happened. Analysis can then be used to identify areas of change, develop recommendations and look for new solutions

Debrief - a semi-structured conversation with an individual who has just experienced a stressful or traumatic event. The purpose of a debriefing is to reduce the possibility of psychological harm by allowing individuals to talk about their experiences.

National Health Service Litigation Authority- (NHSLA): deals with negligence claims and works to improve risk management practices in the NHS.

Joint Consultative and Negotiating Committee- (JCNC): provides a constructive forum for discussion, consultation and negotiation between Trust management and recognised Trade Unions and Staff-Side representatives.

Doctors and Dentists Negotiating Committee (DDNC) - as JCNC but solely for Medical and Dental staff.

5.DUTIES AND RESPONSIBILITIES

Employees are responsible for:

• Informing there manager if, they are experiencing difficulties associated with the situation or as a result of the requirement to act as a witness, in order to enable their line manager to support them directly;
• Requesting referral to the staff counselling service, Occupational Health or Chaplaincy service if they are experiencing difficulties
• Requesting time away from the workplace to attend any meetings associated with the situation or court proceedings, or, where required, to attend for counselling or support.

Managers/Heads of Department are responsible for;

• Keeping staff Informed of the progress of any incident, complaint or legal investigation in which they have been involved. In particular, staff must be made aware when the investigation has been completed, and the findings, recommendations and any action to be taken should be related to them. They must also be provided with an opportunity to ask any questions they may have.

• Providing immediate and ongoing support to staff who are involved in a stressful or traumatic event.

• Arranging for the de-briefing of staff following traumatic or stressful events and deal with any subsequent absence in a compassionate manner.
• Working through the staff support checklist (see Appendix 1) with any member of staff covered under the scope of this policy, offering support and assistance as required;
• Taking action to refer staff to the Health Safety and Wellbeing Service or counsellors, as appropriate and facilitate
• Ensuring that any recommendations from the Health Safety and Wellbeing Service are followed through
• Ensuring that any support offered is confidential to the individual

Director of Post Graduate Medical and Dental Education are responsible for:

ensuring that processes are in place for all doctors in training, who are involved in a traumatic or stressful events, are supported throughout and receive continued support after the event, if required.

HealthSafety and Wellbeing Services

Provide support and can signpost staff to Aquilis or appropriate external support where this is thought to be more appropriate and/or is requested. Any staff involved in traumatic or stressful events may use this service and can either self refer, be referred by their manager or by occupational health.

Chaplaincy Service

Canprovide confidential, independent and impartial counselling. For those of faith they will ensure that their cultural, spiritual and religious needs are met, putting staff in touch with spiritual advisor of their choice.

Head of Risk Management and Legal Services, Head of Patient and Customer Services are responsible for:

Providing support either to those staff directly involved or by supporting the managers of the staff directly involved in a traumatic or stressful event such as incidents, complaints, claims, inquests or other court proceedings.

Human Resources will:

• Provide advice and guidance where necessary, but managers and employees should refer in the first instance to this policy and guidance referred to herein
• Provide advice to managers on any disciplinary or performance issues which may be commissioned as part of the investigation

6.PROCESS

6.1Immediate support

Immediate debriefing

In all cases, as soon as managers become aware that one of their staff has been involved in a potentially traumatic or stressful event, they should offer immediate support and reassurance to them. Much of the reassurance required by the member of staff can be provided by the manager informing them of the process and referring them to appropriate internal or external resources.

It is very important that the manager provides close support in the immediate aftermath of an event. This is a vital opportunity to help the individual involved in the situation keep the issues in perspective and not feel or become isolated.

The manager should ensure that the:

• Debrief is confidential and takes place in a suitable environment.
• Member(s) of staff is given time to talk and is listened to and feels supported
• Arrangements are put in place for the staff member(s) to receive any required medical assessment or treatment. For example, if they are in shock or suffer from a pre-existing medical condition that may have been exacerbated by the event.
• 24 – 48 hour debrief meeting is discussed and appropriate arrangements put in place.
• Opportunity for referral to other sources of support is discussed and appropriate arrangements commenced, if required.
• Advice is offered concerning any requirement to write a statement. This may be provided by: the manager; a member of the Legal Services or Risk Management Teams; or representatives of the professional body to whom the staff member belongs. Trade Union or staff side may also be able to provide assistance.

Debriefing within 24 – 48 hours

This debriefing provides an opportunity to go over an event in a calm and rational fashion and also provides a further opportunity for the member of staff to explore their concerns.

As with the immediate debrief, this meeting should be used as an opportunity to plan further supportive meetings and to identify any other people with whom the member of staff should discuss the events.

Group debriefings

A group debriefing is sometimes useful when there are several members of staff who would value such a discussion. Such a session requires strong chairmanship to avoid an atmosphere of recrimination or blame. It can usefully be based around a presentation of the case and a reappraisal of the options, judgments and decisions that were made or could have been made. It must have primarily an educational focus. It is particularly helpful for it to take place as soon as possible following the event. Group debriefings do not substitute for individual care and support for the parties concerned.

6.2 Ongoing support

Managers should remember that, in the initial stages following an event, they or a staff member may be unaware of the impact of that event on their well-being or ability to undertake their full range of duties. For this reason, it is essential that on-going support is provided. This should involve a one to one meeting no later than 2 weeks after the event. At the meeting any follow up arrangements, for members of staff still experiencing difficulties should be put in place as a matter of urgency, if this has not already been commenced (section 6.3).

It should be remembered that a complaint, claim or court appearance may arise some considerable time after the actual event occurred. This does not alter the fact that this may be equally traumatic for staff and support may be required at this stage

6.3 Action for managers or individuals to take if the staff member is experiencing difficulties associated with the event

It must be remembered that at any stage, either immediately following an event or in the longer term, staff may find themselves experiencing difficulties. In this case a number of actions may be considered

Referral to Occupational Health

A referral can be made by the manager.The member of staff may also contact occupational health for advice. Occupational Health will assess the fitness of the staff member to continue to undertake their full range of duties and provide relevant advice. It is essential that the manager follows the advice given by Occupational Health.

Referral to Aquilis

Aquilis is the staff counselling service and staff may be referred by Occupational Health , their line manager or may self-refer. If Aquilis deem it is appropriate, a series of counselling sessions will be arranged: if these are to be taken in work time, the manager must ensure the staff member is released to attend.

Change to work environment

It may be that following assessment by the Health Safety and WellbeingService or if the member of staff is finding it challenging to work in the same environment, and/or with others who have been involved in the event, that consideration must be given to temporary redeployment or to a restriction of duties.

Staff responsibilities

A staff member must

• Inform their line manager if they are experiencing difficulties associated with an event, or as a result of being called as a witness, so that direct support can be provided

• Request a referral to Aquilis Counselling Service, Occupational Health or the Chaplaincy Service if they are experiencing difficulties and feel this would be of benefit

• Inform their line manager of any change in the behaviour or conduct of a colleague, even if they were not directly involved in the event, as the change may indicate that support is required

Human Resources

There may be occasions where, as well as Occupational Health, there is a requirement for involvement from the Operational Human Resources team. This may be specifically the case where a member of staff feels they are unable to return to their post. In such cases the following policies may be used:

• Management of Attendance;
• Capability Policy;
• Redeployment Policy;
• Well Being and Stress Policy.

6.4Staff checklist/Helping Agencies

Managers should utilize the staff checklist (Appendix 1) to ensure that all staff are provided with timely, appropriate support; either internally or externally as detailed in Appendix 2. The checklist should be completed and retained by the manager until the matter is at an end. Once finished, the checklist should be forwarded to the Operational HR Team, so that it may be used in the annual audit process (see Section 9 – Monitoring). The checklist can be used either on an individual basis or for a group of staff involved in the same incident, complaint, claim or as a witness.

6.5Advice and support available to staff in the event of being called as a witness

6.6

The prospect of having to give evidence in a court of law or at a tribunal can be extremely daunting and appropriate support is essential, particularly if the staff member has not previously been a witness.

Support provided

From whom support is provided, or by whom the staff member will be accompanied, will be dependent on the event for which the staff member has been called to give evidence. The team who can provide support includes: Trust Solicitor; the Legal Services Manager, a member of the Operational HR Team, a member of the professional body to which the staff member belongs, a line manager or a colleague.

• Prior to the event: a full briefing session will be held with support and advice being provided by one or more of the team described above.

When an inquest has been scheduled, the Legal Services Manager can arrange a prior visit to the Coroner’s Court. This can be undertaken on an individual basis or for a group of staff who are to give evidence at the same inquest. In addition, a meeting may be arranged so that members of staff who have previously attended the Coroner’s Court may recount their own experiences to those who are due to give evidence for the first time.

• During the event: the member of staff will be accompanied at the court or tribunal by one or more of the team described above.

• After the event: a debrief meeting will be held to discuss the events surrounding the court appearance and the outcome. Again, the session may be attended by a member of the team as described above.

Where a member of staff is required to attend court or a tribunal as a witness for the Trust, then the Trust will ensure they receive time off without loss of earnings and payment of reasonable expenses (see Special Leave Policy).

6.6. Staff Support Checklist/Helping Agencies

To ensure staff are provided with timely and appropriate support, both internally and externally, managers should refer to the checklist (Appendix 1) and provide the staff member with information on specialist support as detailed in ‘Helping Agencies’ (Appendix 2).