I am privileged to be asked to review this book by the author, Giles Eyre

He has recently retired as a Barrister, having become a leading educator for doctors and others in becoming Expert Witnesses, based on a long and illustrious career in the field of personal injury and clinical negligence,

The book is remarkably short – just 135 pages – and can be read within three or four hours. It is beautifully laid out with clear chapters each with a brief introduction followed by logically arranged headings and subheadings. Key points are highlighted in concise text boxes.

Reading this book would benefit all doctors both junior and senior. Why? Because the work of all doctors is inextricably linked with the law. Every time we meet a patient we have a Duty of Care. Every interaction with a patient (whether in person or in writing) might one day be scrutinised in a negligence claim. We have to interact with police enquiries and coroners’ inquests. Some of our patients have issues with mental capacity for which clear legal laws apply. We face issues of consent for transfusion and unconscious patients. General Data Protection Rules are the latest threat to our peace of mind.

Many doctors probably feel threatened or even hostile to the legal profession. Perhaps the doctor fears unfair scrutiny of his work, more for the gain of the lawyer than the patient. This book goes a long way to dispelling this misconception. By reading the book, a doctor will understand the legal context of clinical practice. The book starts with an explanation of how lawyers and the Court examine evidence (be it oral or written) in a tidy, logical and forensic way. By understanding this, a doctor’s record keeping will inevitably improve and will provide a robust defence at a later date were his clinical practice to be questioned. Having read this book, there is no doubt that I will spend more time recording all key clinical findings, more fully explaining consent and to explain explicitly my clinical reasoning for any particular decision or recommendation.

The book also talks the reader through the process followed when things go wrong in clinical practice. Genuine mistakes rather than negligent errors are common; the obligation for Duty of Candour is emphasised-; it does not mean an admission of negligence. If things go properly awry, then the Author explains how to engage with the potential clinical negligence process, Fitness to Practise assessment or disciplinary proceeding.

The book briefly and clearly explains long-standing and also more recent legal judgments such as Bolam, Bolitho, Montgomery, Thefaut and more recently Hassell. With each judgment, a doctors’ obligation to provide clear, logical patient-orientated advice has become more and more established. Whilst this might on the face of it make a doctor feel more insecure, in reality by understanding the simple principles outlined in this book, the doctor should become more immune to legal scrutiny.

Another strength of this book is the repeated emphasis on how established good medical practice as defined by the GMC merely reflects the expectation of the law. Simply by following good medical practice much of the perceived threat of litigation will just fall away.

Even though I have been in consultant practice for over 20 years and an Expert to the Court on medical negligence cases for several years, I found countless wise tips which I will integrate into my practice. These will include routinely recording my logic on every decision, making sure that informed consent is viewed entirely from the patient’s perspective, and writing to the patient in clear non-medical terms rather than to the GP in medical terms after a clinical consultation.

This really is an excellent practical guide and I would recommend it wholeheartedly to all doctors. It is a gentle, easy read and yet so apposite to current practice.

David Warwick
Chair
BOA Medicolegal Committee
Consultant Hand Surgeon, University Hospitals Southampton