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Report Writing Workshop

Report Writing Workshop. Barbara Kuypers & Toni Martin LSA West Midlands 2012. Expected outcomes from the day. Exploration of any issues of concern for you and your team Principles of report writing Summing up your findings for the report Making recommendations to the LSA.

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Report Writing Workshop

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  1. Report Writing Workshop Barbara Kuypers & Toni Martin LSA West Midlands 2012

  2. Expected outcomes from the day • Exploration of any issues of concern for you and your team • Principles of report writing • Summing up your findings for the report • Making recommendations to the LSA

  3. Future Legislation • Changes to Midwives Rules • Changes to the NMC • The impact on SOMs and Midwives

  4. What the NMC expects • Professionals entering and remaining on the register to be of good health and character • Honest and trustworthy • Assessment based on conduct and behaviour of the registrant • Your character must be sufficiently good for you to be capable of safe and effective midwifery practice without supervision • The SOM to be able to handle conflict and achieve consensus ensuring no party feels disadvantaged

  5. Principles of report Writing • Guide to report writing - www.npsa.nhs.uk • Provides good overview and worth examining • Purpose of the report • To convey all necessary information about the incident, the investigation process and the outcome of the investigation • To present a culmination of all the work you have undertaken • Provide a formal record of the process and is a means of sharing learning

  6. Principles of report Writing • The report should explain • What happened, a chronology of events and your investigation • Who it happened to • When • Where • How (what went wrong) • Why (contributory factors • Think of your audience – the midwife, the LSA, the family, the NMC

  7. Writing the investigation report • Section 1 - should have sufficient detail to understand what prompted the investigation. The reader should be able to understand why you decided to investigate. Use of decision tree? • This is a description of the incident and its consequences • Avoid emotional, judgemental language • Section 2 – brief employment and supervisory details of the midwife. Ensure dates are completed

  8. Writing the investigation report • Section 3 – Chronology - ESSENTIAL to begin as soon as possible and keep up to date. • Put as much information as possible in this section as it shows the methodology you followed; the reasons for delays; failure to meet the deadline • This section should be continued to the end of the investigation including dates report sent to the LSA; final report submission; • Details on when and how the midwife was informed of the findings; • Date the summary report sent to the HOM and ideally date the developmental support/supervised practice programme started

  9. Section 3 – Chronology, Supervisory process and events summarySection 3 – Chronology, Supervisory process and events summarySection 3 – Chronology, Supervisory process and events summarySection 3 – Chronology, Supervisory process and events summarySection 3 – Chronology, Supervisory process and events summarySection 3 – Chronology, Supervisory process and events summaryChronology

  10. Writing the investigation report • Section 4 – • This should contain an analysis of all the information you have seen and heard. It should be structured, analytical, balanced and objective. The reader should have a full understanding of the evidence you have found and what your analysis is based upon • It should come to a conclusion about what your opinion is in relation to the investigation. Facts found or not. Evidence seen or not. • Mitigation – why did she practise in this way? Are there system failures? Rare that there are no mitigating factors

  11. Investigation report- Recommendations Currently under review • Must always show a direct link to the conclusions you have reached in the earlier section. Cannot introduce something new • No action – rare • Local action – reflection with named SOM or similar work. Should be documented by SOM in supervisory file • Developmental support – for minor, non-recurring mistakes. Should have objectives and be time limited. Named SOM undertakes support and notifies investigating SOM of completion of actions

  12. Investigation report- Recommendations • Supervised practice – • Should be used when there are serious concerns about the midwife’s attitude or safety of their practice. • Competence is in question as a result of serious or recurring errors in practice, or a midwife lacks insight into her shortcomings or fails to take action to improve skills and knowledge. • Not the same as intractable lack of competence or misconduct • Referral to the NMC

  13. Summary Report to the HOM/Telling the midwife • Summary report • Why not the full report? • Who ‘owns’ the reports? • Summary report should contain sufficient information that the HOM can understand what happened, why it was investigated, why it happened, and the rationale behind your recommendations • Telling the midwife: • Full report, full explanation of her part in the incident/investigation

  14. Evidence to support allegations Failure 1 I allege that MW Smith failed to recognise the role of patients and clients as partners in their care and the contribution they can make to it. • Alleged breach of Code • . Evidence • Within the letter from the patient .....(Letter App 1) • The transcript from the parents....(App 2) • MW Smith’s statement of May 20th says that...... (Midwife Smith statement App 3) • MW Smith reiterates the above in her interview of 23 June and that her usual practice is to ....... (Interview notes App 4)

  15. Evidence to support allegations • An audit of MW Smiths records from 10 other cases shows that her usual practice appears to be .....(Records audit summary App 5) • Statements from other midwives/interviews show that....(App 6) • Midwife Smith’s understanding of her accountability as demonstrated in the interview shows that.... • On the balance of probabilities, did it happen.......

  16. Evidence to support allegations Failure 2 I allege that MW Smith failed to provide an appropriate standard of care in labour by not adequately monitoring fetal well being. • Alleged breach of Midwives Rules – Rule 6 • Relevant section of the Code Evidence • Within the notes the fetal heart was not recorded every 15 minutes , specifically at xx, xx and xx hours. (Labour notes App 1) • The Trust policy dated xx states that NICE Guidance should be followed regarding auscultation of the fetal heart. (Policy App 2) • MW Smith’s statement of (Date) says that she did undertake further observations but did not record them (Statement App 3)

  17. Evidence to support allegations • MW Smith reiterates the above in her interview of xx date and that her usual practice is to take and record the fetal heart according to trust guidelines (Interview notes App 4) • An audit of MW Smiths records from 10 other cases shows she does not consistently record fetal observations according to trust policy (Records audit summary App 5) • Midwife Smith’s understanding of her accountability as demonstrated in the interview shows that.... • On the balance of probabilities, did it happen.......

  18. Create some objectives for Midwife Smith

  19. FTP 2010-2011 • 667,072 registrants (March 2010) • Referrals in 2010/11 - 4,211 (2,215 sent for investigation) • This represents 0.6% of registrants • 41% referred from employers • 23% from police • 23% from the public (16% in 2009/10) • 13% other referrals • 2% from other health professionals

  20. Conduct and competence committee outcomes, 2010-11 • 647 cases referred to Conduct & Competence Committee • 246 hearings • Striking off order – 187 (76% of above number of hearings) 0.02% of total register • Caution order 100(40%) • Conditions of practice order – 39 (15%) • Suspension – 89 (36%) • Fitness to practise not impaired - 76 (30%) • Restoration to register - 4 (6%) Please read NMC Annual Fitness to Practise Report 2010-11 for more details on all of this information

  21. Range of issues • Dishonesty – 25% • Patient abuse/inapp relationship – 22% • Lack of competence – 24% • Failure to maintain adequate records – 4% • Other practice related issues (unsafe)– 7% • Drugs (mal-admin/theft) - 2% • Management practices -2% • Failure to collaborate with colleagues/abuse –3% • Accessing porn- 4% • Violence – 4% • Serious motoring offences – 2% • Substance misuse – 3% • Other (convictions)– 5%

  22. Hints and Tips for SOM’s • Ensure that documentation is clear and logical – pages numbers etc. • Accurate evidence, signed by registrant etc • Ensure that standards are followed- if system falls down anywhere it is likely that the panel will notice. It is better to address this at the time than the case be affected. • Examples include limited experience due to quiet clinical area, poor supervision, lack of sensitivity towards supervised midwife, no orientation period in new area.

  23. Academic work- ensure midwife knows how it will be marked, to what level required, that they are able to update study skills, given feedback. • Keep records of ALL communication • Being a witness – behaviour, no collaboration, read statement, be prepared to be contradicted. • Time management at hearings • Media attention

  24. What happened to Midwife Smith?

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