Review of NHS Hospitals Complaints Hard-hitting report into the NHS Complaints System with recommendations for change
Nuffield Council on Bioethics Exploring ethical issues in biology and medicine.
Together for Short Lives Leading UK charity - speaks for children with life-threatening & life-limiting conditions.

Links to literature on conflict in paediatrics and the use of mediation

Fassier T, Azoulay E: Conflicts and Communication Gaps in the intensive care unit. Current Opinion in Critical Care (2010) 16: 654-665

“Recent staff surveys also found that job strain was significantly associated with conflict severity. In qualitative studies, ICU workers reported feeling that conflicts were “stressful, distressing, frustrating, time-consuming and exhausting”

 

Brinkert R: A literature review of conflict communication causes, costs, benefits and interventions in nursing. Journal of Nursing Management 2010; 18: 145-156

“Direct costs of conflict included litigation costs, lost management productivity, employee turnover costs…increased care expenditures to handle adverse patient outcomes….Indirect costs of conflict included damaged team morale, lost opportunities to manage future oriented projects, costs to patients, cost to reputation….and emotional costs.”

 

Studdert DM et al: Nature of conflict in the care of pediatric intensive care patients with prolonged stay. Pediatrics 2003; 112 (3) 553-558.

“Few areas of medicine are as emotionally charged for the individuals involved as the care of critically ill children….this volatile environment is conducive to conflict.”

 

Nuffield Council on Bioethics: “Critical decisions in fetal and neonatal medicine”, 2006.

“We consider that there are potential advantages to using mediation in disputes about critical care decisions in neonatal medicine. Mediation will not … provide an answer to every dilemma. It may, however, facilitate better communication, reduce acrimony and narrow down the issues requiring formal adjudication in the courts.”

 

General Medical Council Guidance: “Treatment and Care Towards the End of Life” July 2010.

“If disagreements arise about what course of action would be in a child or young person’s best interests, it is usually possible to resolve them by involving an independent advocate … holding a case conference or ethics consultation or by using local mediation services.”

 

Mulcahy L: Mediating Medical Negligence Claims: University of London 2000 ISBN 0 11 322268 8

“Mediation promises self-determination by allowing the parties to speak for themselves and define the issues at stake.”

This study also reported that the benefits of mediation included a) addressing the real causes of the dispute b) reducing the alienation of the parties and restoring relationships and c) facilitating lasting settlements

 

Meller S and Barclay S: Mediation: an approach to intractable disputes between parents and paediatricians (commissioned editorial). Arch Dis Child 2011;96:619-621

 

Together for Short Lives: The Big Study for Life-limited Children and their Families (An overview). October 2012

“The germ of the idea for the Big Study began at least five years ago at an ACT Board meeting where we were discussing how far children’s palliative care had come since its early days and yet how little we really knew about whether children’s palliative care services were meeting the needs of children and families.”

 

Teuten BJ, Forbat E, Barclay SF: The Conflict Pathway: a model to address conflict in paediatric practise. Plenary Presentation delivered at the RCPCH Annual Conference in Glasglow on 24.05.12.

“Some
 of
 you
 may 
have 
had 
personal 
experience 
of 
conflict
with 
a 
parent 
or 
family 
over
 the 
treatment
 of 
their 
child
 – conflict 
which 
involves 
a 
breakdown 
in 
communication, 
a
 loss 
of 
trust, 
a 
fundamental
 disagreement
 about 
what 
is 
in
 that 
child’s 
best
 interests, 
or
 perhaps
 all
 three”