“Cardiac Unit Nearing Collapse”. The part (not) played by fact-finding interviews.

(Unreserved acknowledgement to The Times).

Intersol are passionate about the critical part played by fact-finding meetings to inform reliable decision-making and inquiry outputs, a discipline professionally known as investigative interviewing.

In statements reinforcing that message, London coroner Dr Fiona Wilcox was critical of a review into mortality rates at a leading cardiac surgery hospital, a review that has cost our NHS £millions let alone lives, careers, and reputations.

As reported here by The Times, Dr Wilcox labelled the process “less than perfect”. She criticised the review team “throughout this case and the others”,  for not interviewing any of the clinicians involved in the patient’s care.

The coroner apologised to families for the distress caused and in one hearing criticised the “limited” review process that gave a “cursory” three to four hours of assessment for each “complex case”, and registered a series of concerns about the quality of the investigation(s) (reviews).

At the recent inquest into the death of an elderly patient, Dr Wilcox said she made a “finding of fact” that the review carried out by Lewis’s team “was limited by lack of information and evidence”.

She added: “An examination of records of three to four hours compared to the extensive time that this court has spent examining this case both in and out of court is relatively cursory for a complex case.”

Reviewing the report in full it seems that of the 12 panel members, all doubtless expert clinicians and at the top of their game, none were qualified to conduct reliable fact-finding meetings. Combine this with an over-reliance on flawed note-taking and documentation and you witness a toxic mix inevitably leading to unreliable outcomes.

At Intersol we ask whether it’s ‘fair’ to level such criticism at clinicians already hard-pushed to satisfy targets and clinical audits? Is it reasonable or fair to expect them to be investigators? Are they qualified to interview forensically?

We would argue ‘No’, and the  Health Service Investigation Branch (HSIB) certainly take a (justified) view that the inevitable clinician-bias impacts negatively on their ability to investigate impartially.

One solution?

Fuse the excellent clinical skills of the review panel with qualified forensic interviewers to better deliver the professionalism demanded by NHS Improvement under the domain of communication skills.

As scientists, clinicians can make the best investigators, but not without the imperative bolt-on skills.

For more information how the team here at Intersol Global can save lives, careers, reputations, and money contact us at info@intersolglobal.com

Link to full independent mortality review click here.