The regulations are also designed to monitor the practice of cosmetic surgery and to avoid possible abuse.
]]>This paper describes the types of psychological risk associated with specific procedures, and the psychiatric conditions most commonly found in the cosmetic surgery population.
Clinical guidelines are given for both patient and practitioner. Prospective patients are give advice on how to reduce their exposure to psychological risk, and practitioners are given guidelines on the selection of patients for procedures, and ways of developing referral pathways to mental health services where appropriate.
]]>There are distinctive risks in cosmetic surgery. The focus is on an individual surgeon, rather than a system of institutional care delivery. The surgeon's assessment and selection of patients is crucial to the avoidance of subsequent dissatisfaction. Mainstream surgical training concentrates on the acquisition of knowledge and technical competencies: the cosmetic surgeon's armamentarium must include in addition superlative communication skills and a degree of psychological awareness which will allow exclusion of those patients for whom it is unlikely that satisfaction can be achieved. It may circumvent disaster for the surgeon to say ‘no’.
Awareness of inherent clinical risks and the ability to manage them are crucial to successful practice, as is the surgeon's commitment to support and encourage the patient throughout the entire process. There is, however, the potential for extremely high levels of satisfaction for both surgeon and patient if pitfalls are avoided, and risks are managed appropriately within a positive doctor–patient relationship.
]]>Review the existing Conditional Fee Agreement (CFA) and ATE insurance funding landscape for clinical negligence claims worth less than £60,000;
Explore the potential impact on access to justice for Claimants if partial costs shifting is introduced;
Suggest some alternative ways of controlling costs.
To undertake an in-depth analysis of all complaints over a 12-month period in an orthopaedic department in the NHS.
Department of Orthopaedics in a UK NHS Trust.
Sixteen complaints files and associated patient case-notes were retrospectively reviewed by an independent consultant orthopaedic surgeon and members of the research team.
There were some common themes in the adverse events reported. For example, failure to obtain adequately informed consent and lack of information given to patients were the most common adverse events that were identified by the review process. There were 36 adverse events/complications in the sample, 30 were adverse events and six were complications. Half of the complaints reviewed (18/36) related directly to adverse events. The majority of the adverse events that were identified by this study and review of complaints (27/36) were covered by the adverse event list and should have triggered an incident report.
Adverse events are not being acknowledged and there is a need for more openness with patients. As such, a larger study is needed to explore the extent of these issues.