November 2022 Newsletter

Dear PRASIS Member

The PRASIS Board wish all members and their families a happy, safe and peaceful forthcoming festive season and 2023.

We would also like to extend our thanks to you for your loyalty in remaining a PRASIS member.

We are here to help members with any enquiries. The quickest way to get through to a Board member is to contact the PRASIS Board Secretary, Helen Roberts, via email or mobile phone (see below), and she will ensure your query is forwarded to the correct member of the team.

With Best Wishes

The PRASIS Board

Chair:

T Yeoman

Clinical Board:

Steve Hamilton

Mark Henley (Advisor)

Graham Offer

Jim Kirkpatrick

J Srinivasan (Srinivas)

Ruth Waters

Legal Advisor:

Nicky Collins, Lawyer at Harper James, Former PRASIS Chair

PRASIS Board Secretary:

Helen Roberts:

Email: helen.roberts@prasis.org

Mobile: 07930509646

Twitter: @PRASIS_UK

Instagram: prasis_uk

CHANGES TO THE CLINICAL BOARD

Mr Steve Hamilton and Mr Graham Offer are just completing their six years’ terms as members of the Clinical Board, and we are very grateful to them for their long service and commitment to PRASIS.

Their replacements will be appointed at the AGM in December 2022

PRASIS, MIC, CFC and KEOGHS

Please find attached an Infographic, summarising the interplay between these different professional groups for PRASIS.

TRAINEE MEMBERS

Trainee membership is available through MIC, our broker, who can advise you of the benefits available to trainee members. A key element of the policy is that it is insurance, not discretionary and allows you to assist, under supervision, in a far more flexible way than Medical Defence Organisation cover. You can also add in some private practice for procedures, such as Botox and fillers for an additional premium.

We are pleased to report increasing numbers of trainees joining PRASIS over the last year.

Trainees considering joining may be directed to the following links:

Trainee policy key facts:

https://www.prasis.co.uk/trainees/trainee_indemnity_scheme/keyfacts.aspx

How trainees can join PRASIS:

https://www.prasis.co.uk/trainees/trainee_indemnity_scheme/how_to_join.aspx

THEMES OF CLAIMS

Based on her recent experiences in contact with our members, Emily Borhan, Medico-legal Adviser to PRASIS and MIC writes:

“Is Treatment Always the Right Option, and How Do You Manage Expectations?

Plastic surgeons are often driven by a desire to help people – to improve appearances and to make people feel good and confident in themselves.

But of course, trying to achieve ‘the image in the magazine’ is rarely realistic and it is your responsibility as the treating surgeon to ensure that the patient is fully aware of the limitations of surgery prior to carrying out any surgery and, if surgery is in your judgment inappropriate, explaining to the patient why that is.

Where surgery is an option for a patient, it is important, especially during the early consultations, to make sure they have a detailed understanding of the risks involved, and the likely outcomes. It is impossible to predict the exact outcome of surgery as each individual body may react in a different way, and this should always be explained to patients. However, if thorough discussions have been had with the patient about potential outcomes, methods of surgery, surgical risks and the achievable results, and the patient consents to the surgery on this basis, then the patient is consenting to the surgery with all the necessary information and will be making an informed choice. It is also important to document everything that has been discussed, and to provide the patient with a copy for them to review in their own time.

There will be occasions where you may be faced with a patient who will challenge your medical opinion, and may not agree with your medical assessment of the risks, methods or outcomes of the surgery. Talking to your patient and explaining how and why you have drawn your conclusions can often make a difference to how they listen to your advice. In some cases, however, you may just feel uncomfortable carrying out the surgery. This could be because you feel the risks are too high, or simply that the desired outcome is not achievable. In these cases, your primary duty remains to ensure the welfare of your patient, and it is important to stand by your advice. If you do not feel comfortable carrying out any medical treatment, whether it is for clinical reasons or because you are worried about the psychological welfare of the patient, then do not proceed. In these situations, your gut feeling is often right, and by going against it, it could put the patient at risk of harm or lead to a complaint with financial repercussions.

If you are ever in doubt, please contact the medico-legal helpline and we will be able to assist you.”

HIGH PROFILE PATIENTS

Patients who are ‘high profile’ can sometimes present increased jeopardy to the treating surgeon.

When considering treatment of such patients it is vital that any member discusses this at the earliest opportunity with PRASIS so that advice, support and appropriate protection can be provided through our Underwriters prior to undertaking any treatment.

CFC have provided us with the following guidance to help support our members in such instances:

“Please note that these notes are for guidance only regarding information to be provided when making a high profile patient referral and are not be taken as exhaustive.

It should be noted that the earlier a referral can be made the better, as it will allow underwriters to gather all necessary information needed for a full assessment and offer the appropriate advice. It is more than likely that the initial information provided will prompt further questions.

Details with the referral should include:

The occupation of the patient and the level to which/reason why they would be considered high profile e.g. is the patient a Hollywood actor, a social media influencer, a famous pop star, a well-known sports player (please include the sport and level played at)
The age of the patient
The reason the patient is requesting surgery
Considering the above points, what is the surgeon’s opinion of whether surgery is appropriate – what is the rationale for surgery?
Details regarding the procedure being proposed, the level of complexity and whether it is a procedure routinely undertaken by the surgeon
Any other details regarding patient history and any previous consultations – is this revision surgery, are they likely to seek a second opinion, have they had other procedures in the past ?
Has the surgeon considered psychological review/referral and if not, why not?
What the treatment plan looks like, including patient availability for follow-up
How the surgeon proposes to manage patient expectations regarding recovery and returning to work etc.

INDEMNITY PREMIUMS

Simon Downing, Managing Director of our Brokers MIC (Medical Insurance Consultants) writes:

“As private practice activity has recovered for many since the onset of the COVID-19 Pandemic, premiums for indemnity have also increased.

This can be a sore point for some given the way in which some insurers responded to the decline in surgeons’ activity at the height of the Pandemic.

MIC continues to reassure and explain to members how their premium is calculated, and where necessary to review historical premiums to show the value received.

I advise caution when reviewing premiums offered by newly emerging providers who may be trying to capitalise on such adjustments, as prior performance of an insurer or scheme is a key indicator of future longevity and reliability.

This is one of the most important factors for you as a surgeon, because you need to know you can rely on your insurer to protect you whether a claim comes in now or ten years down the line.

Use us a sounding board for any concerns you may have. We are your broker and we are here to provide advice that is best for you.”

FORTHCOMING DERMOSCOPY COURSE

We are delighted to offer this renowned one-day course, delivered by Dr Jonathan Bowling, Consultant Dermatologist from Oxford.

This will be held at Weightmans Offices, St Philips Point, Birmingham on Monday 20th March 2023, and will be free to members.

Numbers are limited to 25, and will be allocated on a first-come first-served basis.

To apply please send an email to the Board Secretary helen.roberts@prasis.org

Please include:

Email address for corresponde
nce if different from the one from which you send the request for a place.
Mobile phone number

Dermoscopy Flyer

OTSIS – PRASIS COMBINED WEBINARS

Following the success of the first combined webinar with our colleagues from the Orthopaedic and Trauma Specialists Indemnity Scheme (OTSIS) the next combined OTSIS-PRASIS will take place third week of January, and notification will be emailed as soon as date is confirmed.

The provisional programme is:

The current political pressures in private practice, and what the future might hold.

Richard Packard, Chairman of FIPO:

The Paterson Enquiry, it’s implications for you as a surgeon.

Charlie Chan, Consultant Breast Surgeon in Oxford, and member of the FIPO Executive Board:

Why do surgeons get sued, and how to avoid it.

Jo Clift, CFC Underwriter:

Registration details will be circulated with the confirmed date.

The previous combined OTSIS-PRASIS webinar covered topics of:

Consent in the Modern Era,

How to improve risk: an Underwriter’s perspective, and

How to cut it in the media: pitfalls and actions to take in the face of negative press coverage, social media posts and/or online reviews

The videos for this past webinar can be accessed using the following link:

https://vimeo.com/talkingslides2/download/649435563/5abc49f660

PRASIS SPONSORSHIP

PRASIS continues to support our members and our Specialty through selected sponsorships, including:

The Burns and Plastic Surgery App - BurnsPlastics

https://burnsplastics.com

The BAAPS Annual Conference, September 2022

PLASTA Winter Congress, November 2022

An Educational Partnership with BAPRAS for 2023-2024

THE CONFEDERATION FOR BRITISH SURGERY (CBS)

The Confederation for British Surgery is an official trade union, which is able to provide members of the surgical community with support and resources that the specialty associations, colleges and indemnity schemes, such as PRASIS are unable to offer.

The PRASIS Board is keen to support this development so has arranged funding to give you free membership for your first two years (one year for trainees). You will need to sign up individually to gain this benefit because of the rules regarding trade union membership.

Please follow the link below to join:

https://www.cbsgb.co.uk/membership_application.aspx

Members may also wish to access the video from the CBS' webinar 'A Dummies Guide to Pensions', streamed on 21 September 2022, with contributions from Mark Henley (CBS and PRASIS), and Pensions’ experts from Ballards LLP and Chase de Vere.

https://bapras.eventsair.com/a-dummies-guide-to-nhs-pensions/video/Site/Register

FURTHER EDUCATIONAL AND PROFESSIONAL RESOURCES

We would like again to remind you of the following resources available to all members as part of their membership.

1. EIDO Healthcare

EIDO Healthcare provides members with a Procedure-specific patient information library to support informed consent:

You can download and print your personalised documents by entering your login details provided with your PRASIS membership, at:

https://inform.eidosystems.com

If you need a reminder of log-in details for members’ area, please email; mailto:helen.roberts@prasis.org

These patient information documents (in the ‘Plastics’ section of the ‘Procedure Information’ menu) are:

• endorsed by the Royal College of Surgeons.

• fully referenced and up-to-date.

• Crystal-Marked by the Plain English Campaign.

• certified by the DoH’s Information Standard.

• widely used across the acute NHS and private sectors.

2. Elsevier ClinicalKey in Plastic Surgery

This allows PRASIS members to view the wide range of Elsevier plastic surgery journals (including eg Clinics in Plastic Surgery) and plastic surgery textbooks.

For a list of available journals and textbooks, see: https://store.clinicalkey.com/product/plastic-surgery/.

The subscription for this is normally $749 per annum, but it is accessible without charge via your login to the Members section of the PRASIS website.

https://www.clinicalkey.com/#!/

Elsevier Clinical Key Flyer

SUMMARY BENEFITS OF PRASIS

Stability and security should be the overriding considerations which drive a choice of indemnifier and we believe that our current Underwriters and Broker provide these.

This is particularly the case in such challenging times such as the present, in which Covid-19 has generally reduced capacity in the Insurance market and affected the ability of those left to take on risks, leading to large increases in premiums for some professional groups and great difficulties in securing any cover at all for others.

PRASIS creates and provides a community for plastic surgeons who have shared core values based on their training and working practices, and for this reason PRASIS members are viewed as a safer group, and therefore an attractive risk for insurance companies.

PRASIS is also unique in having a Clinical Board, all of whom are senior plastic surgeons, and who provide their insights and influence to the wider team.

Members of the Clinical Board are always pleased to provide clinical advice to PRASIS members, and when appropriate to act as advocates for them in their dealings with the Brokers and Underwriters of PRASIS. To do this requires the member’s written consent for disclosure to the Clinical Board Member(s) of the full background information relating to the issue in question - be it a clinical matter, or a matter relating to the member’s policy (eg their premium).

In addition to this and as outlined above PRASIS supports educational activities and opportunities for its members for their benefit in particular, and more widely to benefit the Plastic Surgery community as a whole.

PRASIS is an Introducer Appointed Representative of Medical Insurance Consultants Ltd which is Authorised and Regulated by the Financial Conduct Authority and is entered on the Financial Services Register under reference 309026.