Claims Investigations

A claim is defined as an allegation of clinical negligence and/or demand for compensation made following an adverse clinical incident or adverse incident resulting in personal injury or any clinical incident which carries a significant risk of litigation for Excel EMS.

Claims are handled in accordance with the Civil Procedure Rules, which are the court rules by which civil litigation (including negligence and personal injury claims) are governed.

A claimant has to prove both breach of duty and causation before they are eligible to receive compensation.

Compensation is split into two categories – general damages and special damages.

A Letter of Claim is a summary of the facts on which a claim is based, including the allegation of negligence (breach of duty), the alleged adverse outcome (causation), injuries, condition and prognosis and financial losses incurred.

A Letter of Response is a reasoned answer to the Letter of Claim either admitting or denying all or part of the claim.

Court Proceedings include a Claim Form, Particulars of Claim (setting out allegations of breach of duty and causation), medical evidence in support of the claim and a Schedule of Loss.

The Defence is the response to the Particulars of Claim..

• The patient’s name and date of birth must be recorded on every page in the health record.
• Every entry in the health record is to be made in real time (dated and timed using 24 hour clock) and in chronological order to reflect the continuum of patient care.
• All free text entries must be legible.
• Entries must be clear, relevant and unambiguous when inputting in the free text fields
• An incorrect entry must be “Crossed out" or by an equivalent method
• Attention/Alerts, Allergies, Advance Directives etc must be recorded in the fields provided

Abbreviations

• All entries must be written in full.
• Abbreviations must not be used unless they have first been written in full on the first entry in the content of the document when inputting in the free text fields.

Process For Ensuring A Contemporaneous Complete Record Of Care is Completed

• The person must ensure a chronological record of care is recorded within the patient’s health record.
• Information must be recorded as soon as possible after the episode of care or event and no later than the end of the shift.
• Records must be an accurate record of what took place.
• The time and date that the entry is being made must be clearly documented.
• The time and date that the event occurred must be clearly documented in the content of the entry, so that there is no doubt exactly when the event being documented occurred.