Audio-recording your consultations with NHS doctors

[nolegion]

See you in court.

 

Here's an interesting story from last Tuesday's Guardian:-

 

http://www.theguardian.com/uk-news/2014/oct/07/bullied-student-video-sunglasses-private-court-case

[nolegion]

Here's today's PHSO response (with commentary from enquirer) to a FOI request raised in consequence of some observations earlier in this thread:-

 

"…we do hold a legal briefing note to PHSO staff about the use of audio and video recordings as evidence. As you will see from the note, PHSO can and does consider relevant evidence of this kind in coming to a decision on a case."

 

See:-

 

https://www.whatdotheyknow.com/request/audio_recorded_evidence_of_medic#comment-54252

 

Of course, what is actually happening in practice may be quite another story. But I hope Shirli and others won't give up trying to make sure their recordings are properly considered. The law here is on our side.

[SHIRLI]

Here's today's PHSO response (with commentary from enquirer) to a FOI request raised in consequence of some observations earlier in this thread:-

 

"…we do hold a legal briefing note to PHSO staff about the use of audio and video recordings as evidence. As you will see from the note, PHSO can and does consider relevant evidence of this kind in coming to a decision on a case."

 

See:-

 

https://www.whatdotheyknow.com/request/audio_recorded_evidence_of_medic#comment-54252

 

Of course, what is actually happening in practice may be quite another story. But I hope Shirli and others won't give up trying to make sure their recordings are properly considered. The law here is on our side.

 

 

GOOD AFTERNOON

 

 

you can be assured I will never give up and am now appealing to the p.h.s.o on the grounds that I have recordings of the barbaric attack by the nurse during my smear test, also recordings of 3 separate incidents when telling my gp about the attack I was so distressed she even offered me counselling on the first occasion that part is in my medical records. last month she looked me straight in the eye and told me she had no recollection of these discussions or she would have noted them on my medical records, I trusted this dr for 17 years and am shocked that this dr is simply lying through her teeth.

my only wish was for the nurse to explain to me why she did this to me.

but the practice manager and the gp have aided and abetted this nurse and now will all be implicated in this incident, even after two years I am very very angry, It has affected my life being unable to have any intimate relations and will never allow any gynocological examinations.

[SHIRLI]

I am still very very angry after two years and have become very bitter with revenge on my mind, I WOULD LOVE TO PUBLICALLY NAME AND SHAME THE SADISTIC NURSE AND SURGERY, I would be happy for them to take me to court, the public would then know what I have suffered when my tapes are heard, it would save me a fortune on taking out a private prosecution which seems likely in the end.

although I am appealing to the ombudsman on the grounds of new evidence my recordings I would much rather the recordings are heard in court, maximum exposure for the maximum damage they have caused me which I will never recover

[BazzaS]

I am still very very angry after two years and have become very bitter with revenge on my mind, I WOULD LOVE TO PUBLICALLY NAME AND SHAME THE SADISTIC NURSE AND SURGERY, I would be happy for them to take me to court, the public would then know what I have suffered when my tapes are heard, it would save me a fortune on taking out a private prosecution which seems likely in the end.

although I am appealing to the ombudsman on the grounds of new evidence my recordings I would much rather the recordings are heard in court, maximum exposure for the maximum damage they have caused me which I will never recover

 

Nothing stopping you "naming and shaming" them : just do so on your own web site, so you aren't exposing someone else's website to the risk of legal action.

For example, CAG posting guidelines forbid "name & shame" on CAG to protect CAG.

 

Why not create your own site to name & shame. I assume you can then post a link to it here, as long as it is only the link, not the name(s) / surgery name.

[SHIRLI]

Nothing stopping you "naming and shaming" them : just do so on your own web site, so you aren't exposing someone else's website to the risk of legal action.

For example, CAG posting guidelines forbid "name & shame" on CAG to protect CAG.

 

Why not create your own site to name & shame. I assume you can then post a link to it here, as long as it is only the link, not the name(s) / surgery name.

 

 

GOOD EVENING bazzas

 

 

thanks for that advise, you are right I could create my own website to name and shame then create links, I realise now that CAG does not allow naming and shaming although I have been successful on other sites. would the nurse and clinic dare to take legal action " BRING IT ON "

[BazzaS]

GOOD EVENING bazzas

 

 

thanks for that advise, you are right I could create my own website to name and shame then create links, I realise now that CAG does not allow naming and shaming although I have been successful on other sites. would the nurse and clinic dare to take legal action " BRING IT ON "

 

You "realise now"?

1) I understand it is in the posting guidelines, which you agree to before being able to post.

2) The site team has asked you not to do so, on numerous threads, a number of times ....... I'm just trying to find a solution that means I don't have to keep reporting your posts for naming the nurse / surgery / practice manager! (as it may leave CAG in a precarious legal position).

[SHIRLI]

You "realise now"?

1) I understand it is in the posting guidelines, which you agree to before being able to post.

2) The site team has asked you not to do so, on numerous threads, a number of times ....... I'm just trying to find a solution that means I don't have to keep reporting your posts for naming the nurse / surgery / practice manager! (as it may leave CAG in a precarious legal position).

 

 

 

GOOD MORNING bazzaS

 

 

I thank you yet again, I did quickly browse through the posting guidelines when I first joined but must have overlooked the naming and shaming guidelines. i apologise to this forum and all its members for putting them in a precarious legal position. I have decided to set up my own website that way only I have to answer any legal questions.

[nolegion]

Going back to the posts of 6th and 7th October here, there is news about the CQC and the 'guidance' document it expected to be publishing by the end of this month.

 

Basically, that now certainly isn't going happen by the end of this month. And, having watched online the carnage at the CQC's board meeting last Wednesday (15 10 2014), I think one might well question whether it will happen by the end of this year.

 

Non-executive board members had significant criticisms to level at the two executives in charge of the proposed publication. Since we can't see the documentation they were criticising - although some text was read out - it's difficult to judge quite how justified the comments were. Nevertheless, a clear message was conveyed, in my analysis, that the board wanted a more definite, positive and proactive approach to the whole concept.

 

At the same time, I am glad to say, Sali's point about the possibility of the CQC sitting back and letting e.g. the families of vulnerable people do the work for them was specifically addressed. It was at least strongly claimed by the executives concerned that camera recordings would only ever be seen as an additional option for consideration and never as a replacement for any of the range of supervisory work currently undertaken and proposed by the CQC.

 

Conversely, the same executives emphasised that the CQC would most certainly be prepared to consider covertly recorded evidence submitted to it e.g. by members of the public. And that is a point which sits well with the similar confirmation recently extracted from the PHSO by FoI request.

 

So, apart from the delay and expense of a year's worth of consultation and planning leading to launch-pad failure, it's not necessarily, so far, a bad result for the recording patient, in my view.

 

Those with stamina might muster a wry smile by comparing the upbeat further announcement (15 10 14) from Andrea Sutcliffe of the CQC here:-

 

http://www.cqc.org.uk/content/covert-and-overt-surveillance-next-steps-publishing-information-public-and-providers

 

with the extent to which her proposals had just been courteously rubbished, which you can see here:-

 

 

Note, as indicated in the youtube details ("show more") the part of the meeting dealing with camera surveillance starts 1hr 12 mins into the recording. If you then get through the 45 mins odd, it's worth listening to "Questions from the floor as well" whence further commentary on the subject arises.

[Clear33]

With details I have mentioned in another thread, I have recently been diagnosed with a condition which was always likely, the net said, to lead to 'leeching'.

 

I try not to use terms like blood-sucking and leeching too much when consulting with clinicians - they must be sooo entertained by such purported jocularity - but leeching it is, all the same! Basically, they swipe as much blood as they can from you, as often as they dare, and throw it away.

 

So, in any event, when I tipped up on my tod for my first leeching a little while ago, I was not particularly bothered. Predicted and standard procedure, and needles and squeamishness don't muster amongst my many problems.

 

"Simply floyin' out of you," the absolutely charming, kindly Irish nurse told me. Not long later, as we disengaged the cannula, I said I was glad to be saving on parking charges, and my Irish friend went to fetch me a drink.

 

I remember very little of the next 25 minutes because I was unconscious for most of them.

 

On coming at least half-way back round, I discovered I was blessed with two fresh cannulas, one in each arm with saline drips at the other end of them. The drip on the left depended from a medic holding the bag as high above their head as possible; on the right there appeared to be a problem maintaining security of tenure for the needle, because, as my blood pressure had plummeted, I had turned so clammy none of their sticky stuff would stay stuck.

.

It happens to some patients occasionally, was the message I began to absorb through dense nausea. I'll get a saline drip in advance, next time: unlikely to happen again. (And it indeed it hasn't. I get the 'advance saline' for 20 mins, and then we are away).

 

I was treated with every courtesy and care, and I had and have every confidence in returning to that medical team for my ongoing treatment.

 

What impressed me was not only the cheerful, considerate and efficient way I was treated while able to converse, but that exactly the same respectful, kindly and purposeful attitude was applied to me, at every stage, by the doctor summoned and the small team he calmly and succinctly directed, while I was 'out'. Plus the very prompt reaction from Ireland which summoned the extra attention within milliseconds of my 'losing it'.

 

Now, how would I know all that?

 

 

Hi Nolegion!

 

Enjoying your thread still.

 

Very sorry to hear of your medical condition. Your body will have gone through some trauma there.

 

But elated to read of your good, prompt, respectful treatment. It most certainly is genuine too when it continued even though you were out for the count. Good to know.

 

Take good care of yourself!

[My Turn]

you can be assured I will never give up and am now appealing to the p.h.s.o on the grounds that I have recordings of the barbaric attack by the nurse during my smear test, also recordings of 3 separate incidents when telling my gp about the attack I was so distressed she even offered me counselling on the first occasion that part is in my medical records. last month she looked me straight in the eye and told me she had no recollection of these discussions or she would have noted them on my medical records, I trusted this dr for 17 years and am shocked that this dr is simply lying through her teeth.

 

my only wish was for the nurse to explain to me why she did this to me. but the practice manager and the gp have aided and abetted this nurse and now will all be implicated in this incident, even after two years I am very very angry, It has affected my life being unable to have any intimate relations and will never allow any gynocological examinations.

 

Hello Shirli. Unfortunately I don't think it is unusual to find that the doctor in whom you placed your trust and your own health for so many years later turns out to be hostile. When this occurs it can be a big shock especially as you have confided so much in them over the years.

 

From what you write about what was or was not said at the time, it may be worth getting hold of a copy of your medical notes before any entries mysteriously get lost.

 

Needless to say, it may be worth recording any encounters (clinical or otherwise) you have with any member of your GP's practise. I would also be inclined to bring a friend along to any consultation.

[SHIRLI]

Hello Shirli. Unfortunately I don't think it is unusual to find that the doctor in whom you placed your trust and your own health for so many years later turns out to be hostile. When this occurs it can be a big shock especially as you have confided so much in them over the years.

 

From what you write about what was or was not said at the time, it may be worth getting hold of a copy of your medical notes before any entries mysteriously get lost.

 

Needless to say, it may be worth recording any encounters (clinical or otherwise) you have with any member of your GP's practise. I would also be inclined to bring a friend along to any consultation.

 

 

 

 

GOOD EVENiNG my turn

I have already obtained my complete medical notes cost me £50 but was worth it, I would rather record my meetings than take a friend which I have done for over 2 years and will continue to do so. the p.h.s,o has been informed of the recordings in my appeal I have already informed my gp that all our consultations were recorded. I am trying to name and shame this nurse, and the clinic on social media and any website that will allow me. if the n.h.s take legal action against me all I have to proof is I am telling the truth and will reveal my recordings in court.

[Sali]

Ah, Nolegion, are you saying you fainted at the sight of a little blood?

 

I mentioned in another post that I worked with a man who also had your condition - haemochromatosis. The company used to regularly arrange blood-giving clinics. Me, I never attended. Not fond of needles. My colleague did and he had exactly the same reaction as you. However, it wasn't here that he was diagnosed (I think he went on to give more blood), but at a much later date for other weird symptoms (something to do with his tongue). So, why did they throw your blood away? Was it green? Can it not be used because of the haemochromatosis? In which case, are people tested for iron deficiency and iron overload prior to becoming a blood donor?

 

Well at least you had a record of your lost 25 minutes. Did they know you were recording? I know you've said that you openly record.

 

I bet you're looking forward to your next appointment.

[nolegion]

LOL! Family and friends have made it quite clear it will be along time, if ever, before I live that faint down. In vain have I prefixed any account of it with not being squeamish etc…my children think it is hilarious…!

 

Before going any further, welcome back Clear33 and My Turn. Good to hear from you both again.

 

As regards ongoing Draculation, I am due for my 5th appointment at the end of this week - and at half a litre a week, I claim that must be coming up to a complete oil-change. We shall see.

 

To pick up Sali's other points, I don't know whether they test donors for ferritin levels before risking e.g making the recipient of any donation practically magnetic – but I was told very definitely no-one would touch my contributions with a barge-pole. (That's still somehow just so ungrateful of them, I feel.)

 

I have to confess that, determined overt recorder as I claim to be, I also don't know whether those directly involved in my leechings, know of my resolute habit. Now that I follow My Turn's Manoeuvre, with a couple of discreet recording 'sticks', they wouldn't know it to look at me. I had told the doctor I saw at the outset of this course of treatment that I record ALL clinical encounters, and I left it that. Up to her to note it.

 

My reasoning - or excuse – was\is that, since when I told the specialist Registrar that I audio-record she had to 'pop out' for a while to confer with her consultant, if I had to start from scratch with each person I met considerably lower down the medical hierarchy over a prolonged course of treatment, I would need a camp-bed in the hospital outpatients' department.

 

Fair?

[Clear33]

Thanks Nolegion. Lol.

 

Absolubtely fair!

[Sali]

Now I want to know what effect there would be to a patient inadvertently given blood with high ferritin levels as a one-off and whether they do test your blood for iron overload prior to becoming a donor. (In which case why was my colleague's condition not detected). Ask that nice Irish nurse on your next appointment before you fall into unconciousness. The digital recorder will capture her explanation.

 

I wonder how much blood a medicinal leech (or even a mechanical one) could extract and whether it would be a cheaper, more convenient and less stressful (well, maybe not for everyone) method of blood-letting.

 

What actually caused you to faint? Was it a drop in blood pressure because the blood was simply floyin' out of you?

 

Sometimes I think I wonder too much.

[nolegion]

I've been interested in those questions myself. So, at the end of a routine consultation today, I asked about what happens to would-be donors of blood (or their donations) when patients don't know they have haemochromatosis. Who better to ask than a specialist in haematology?

 

She didn't, er, as such know! – but she said she would be happy find out before next time. In the meanwhile, I wonder if there are other viewers here who could advise...

 

And, yes,' tis the sudden loss of blood pressure which reduces oxygen supply to the brain that can cause people, in a number of rare cases (lucky me), to pass out. (But, in case anyone else is in a similar boat and viewing, let me assure you they can fix that with pre-venesection fluids.)

………………………………………………………………………………………..

Now :-

 

http://www.medicalprotection.org/uk/practice-matters/issue-7/digital-dilemmas-patients-recording-consultations

 

As can be seen, this is an October 2014 online publication, and I regret that it is time to say that the MPS, under the name of Dr Nick Clements as the article's author, has completely lost the plot.

 

Clements acknowledges that patients are within their rights to record and that doctors cannot refuse to consult with recording patients, BUT this man now writes that if doctors feel 'uncomfortable' about it they:-

 

" …should express that discomfort and tell the patient that you would prefer the consultation not to be recorded "

 

…leaving patients to 'insist'.

 

Frankly, what utterly disgraceful, thoughtless, specious claptrap.

 

I have spent over four years here trying to promote the view that both patients and clinicians would be much better served if the former were handed the confidence to audio-record overtly should they so wish. Clements' advice, apparently being retailed on the MPS telephone advice line as well as in the above article, tries to reverse that approach.

 

I believe that the MPS claims it insures nearly half the doctors in England and Wales. Why (the hell) should any patient wanting to take an audio recording home risk encountering an "MPS doctor's" attitude by declaring they are recording at the outset of a consultation? They won't. They will just record covertly. Is that a good result for a medical insurer? Or a doctor? Or a patient? Congratulations, Dr Clements.

[Sali]

Can't, mustn't, shouldn't always prompt me to 'Why?' I'm much more likely to remember a fact when I know the reason behind it. Maybe she forgot. At least she didn't try blagging you. Respect for that. I once told a nurse that I believed my relative had had an epileptic fit as I was familiar with the after-effects - grogginess, headache etc. The nurse insisted that this was not the case and that the headache (ignoring all the other symptoms) was caused because my relative had not had their daily paracetamol. I was with an off-duty nurse at the time and we were both stunned. This was not the only dangerous ignorance I encountered. I much prefer people to say they don't know, but they'll investigate.

 

***

 

A doctor expressing discomfort and telling a patient that he would prefer the consultation not to be recorded leaves the patient with a dilemma. A doctor may also enforce his wish by stating that it is against hospital policy and may, as we have seen, be able to produce one of these dodgy dossiers. If the patient insists they may risk the ire of the doctor with who knows what consequences. It is the patient who will be left feeling uncomfortable then.

 

And then what subsequently? Will the doctor refuse to see the patient again? Indeed will the hospital put pressure on the patient? Continuity of care could be interrupted with what consequences?

 

Bad advice indeed from Dr Clements. It's a shame because the rest of the article is pretty sound in my view.

[My Turn]

Clements acknowledges that patients are within their rights to record and that doctors cannot refuse to consult with recording patients, BUT this man now writes that if doctors feel 'uncomfortable' about it they:-

 

" …should express that discomfort and tell the patient that you would prefer the consultation not to be recorded "

 

…leaving patients to 'insist'.

 

Frankly, what utterly disgraceful, thoughtless, specious claptrap.

 

Hello Nolegion. In a typical consultation there is a considerable difference in power between the patient and doctor. I seem to recall Prof Glyn Elwyn calls this a power gradient. The patient doesn't have a lot of reason to insist because even if he gets his way, the doctor may subsequently choose not to investigate his medical condition very thoroughly or to give less than first rate care and the poor patient would never know. Such fear would make the patient hesitate to insist.

 

Perhaps Clements is saying this as a sop to doctors who are worried about his general advice to let patients make a recording.

[nolegion]

I think 'sop' is right – for doctors – and, yes, I remember that useful expression 'power gradient' well from the broadcast.

 

The trouble is, of course, from a patient's perspective – at the bottom end of the power gradient - it's bullying.

 

I also think the MPS clearly doesn't dare formally ally itself to any policy to 'ban' (which would certainly be dangerous, and, in my view, in this country, illegal) but is nevertheless now prepared to support doctors in trying to bully patients into not recording.

 

Four years ago, it first suggested that doctors should ask for a copy of the recording. More recently (summer 2014, see post #789) it said that clinicians should 'explore the patient's reasons' and 'discuss any concerns about the recording'. Now it has come right out and said that doctors should tell patients that they don't want them to take an audio-recording home.

 

I suggest that the reasons for this escalation in meddlesome hostility are likely to include reports that the reactions of patients to the first two approaches have extended to the equivalent of mono-verbal phrases ending in 'off'.

 

The current MPS line is in direct conflict with the recommendations of N.I.C.E:-

.

"Ask the patient whether they want to be accompanied at consultations by a family member, friend, or advocate, and whether they would like to take notes and/or an audio recording of the consultation."

 

(Guidance from the National Institute for Health and Clinical Excellence ('NICE') of Feb. 2012 entitled "Patient experience in adult NHS services: improving the experience of care for people using adult NHS services." (para.55.) http://www.nice.org.uk/guidance/cg138 )

 

and is doomed to failure.

 

A patient like me would say 'I don't care what you think about it', leaving the doctor to sulk, during a recorded appointment inevitably rendered brittle by the confrontation. Others will simply record covertly.

 

Jolly well done, Clements.

[nolegion]

GP Arun Kumar told a patient in consultation who said she felt suicidal:

 

"You can go and jolly well do it now"…and…"if you don’t know how to do it, it’s on the internet how to do it."

 

It has to be doubted whether matter case would ever have reached the MPTS, if they patient hadn't covertly recorded the consultation – after all the doctor didn't record what he said in the medical notes. But it did, and the recorded evidence was clearly crucial.

 

Nevertheless, in my view, the panel leaned over backwards to make excuses for the GP – who couldn't be bothered to attend the hearing – and dealt out a penalty of risible proportions.

.

Se what you think from the full case report posted at the MPTS website a couple of days ago:-

 

http://www.mpts-uk.org/static/documents/content/Arun_Kumar_Singhal.pdf

[nolegion]

It is perhaps to be doubted whether the first language of the clerk who drafted the 'policy' below could really be english.

 

"Recording devices

The practice may permit recordings (audio, video) of their own consultations with their health professional however its is essential that they should seek the written consent from both the surgery as well as the clinician prior to doing so. If the patient fails to do so this would first and foremost unfortunately damage the mutual trust developed between the patient and practice and not promote therapeutic relationship. It would also be considered an unacceptable behaviour and breach our policy.

 

Due to respecting confidentiality we also ask patients to refrain from using any recording devices (audio, video) within the practice area. This is in case they would inadvertently records personal and intimate information regarding other patients that may be displaced in the waiting area or on the receptionist desk for example. This would again breach the practices policy and equally breach our patients expectation of privacy when they attend or visit the practice."

 

From:

http://www.westgreensurgery.co.uk/dr-haringey-gp-surgery-information/aggressive-violent-unacceptable-behaviour

 

So, at the West Green Surgery in Haringey it is envisaged that a patient who wishes to audio record a consultation must first obtain 'the surgery's ' written consent (when? how?) – which may or may not be given in any event.

 

Then, the patient must also obtain the written consent of each clinician who might be recorded – which may or may not be given in any event.

 

What complete and utter nonsense! This practice is in dire need of a reality check.

 

Patients do NOT need the condescension of any permission in order to record how they are treated behind closed doors. Let alone in duplicate and in writing. Utterly silly, totally self-defeating, officious and offensive claptrap.

 

At this surgery, therefore, patients should definitely record all consultations, covertly and consistently, from start to finish.

 

(And while one is about it, looking at the reviews 'NHS choices' reviews, I would similarly take the precaution of recording any rude and unhelpful reception staff too.)

 

Any further such examples gratefully received.

[think about it]

That page / notice doesn't come across as being written by someone for whom English is a second language, it stinks of 'let's make this sound official by using big words and over complicating matters'. Clearly they've more time than me at work - signed written permission, in advance - please...

 

I'm all for respecting other patients privacy on this, especially in reception if they're getting / giving info to and from the receptionist but there's equal responsibility on the reception to discuss things sensitively if there's any likelihood of an audience.

[nolegion]

Well, I certainly think that an attempt to speak quasi-legalese is 'in the mix' of that policy's composition, t.a.i, and thank you for 'disowning' the ridiculous obstructions it tries to create between patients and their taking an audio-recording of a consultation home.

[nolegion]

Well, there's a funny ol' thing. The Haringey GP practice's 'recording devices' text (post #873) vanished from its website around 9.00am today.