Being asked to attend an internal investigation meeting at your workplace after something has gone wrong with the care of a patient can be anxiety-inducing whether you feel you have made an error or not. However, it's important not to jump to conclusions about the purpose of the meeting.

Remember, you have a professional duty to be open and honest when things go wrong, and to learn lessons from any incident. Your organisation also has a duty to be open and transparent and will need your cooperation to investigate.

Establish the purpose

The first step is to clarify the purpose of the meeting. Is it part of a disciplinary process, or a significant incident (SI) investigation or similar process? The distinction is important, as SI processes are not designed to find fault or apportion blame, but rather to identify learning to inform future practice and prevent recurrence.

If you're told the meeting relates to conduct, capability, performance concerns or disciplinary proceedings, then it's likely the meeting may be part of a formal investigation process.

On the other hand, you may be reassured that the point of the meeting is to identify missed opportunities, system processes, and lessons to be learned, with no intention to attribute blame to individual staff members. Fact finding meetings like this often form part of adverse incident or significant event investigations.

Whatever the purpose of the meeting, it's advisable to contact the MDU for advice.

Adverse incident meeting checklist

The checklist below will help you to prepare in advance. It's important to do this, even if there are no obvious concerns about your role in the incident.

Establish what process or policy is being followed, who will be present at the meeting and if you can bring a trusted colleague for support.
If you do feel that your care could have been better, then be prepared to demonstrate that you recognise this and what remediation you have undertaken (or plan to) to address this. Including mention of reflection and remediation in adverse incident statements or at meetings is not always necessary, but it can help you pre-empt any recommendation about steps you should take to improve your practice.
Ensure you've seen the relevant medical records where applicable so you're familiar with the original documentation about the event in question.
Consider drafting a statement, even if one has not been formally requested. Aim to create an aide memoire for the meeting that includes a full chronology and everything you would want to say about your role in events. This way, you're less likely to leave the meeting feeling that key points were omitted from your evidence or that you didn't make yourself clear. You can find our guide on writing reports here.
Listen carefully to each question, and only answer if you fully understand. You can ask for clarification if the question is unclear.
Take your time and consider your answer before speaking.
When you have answered a question, it is appropriate to stop talking and wait for the next question. Don't be tempted to fill any silences.
If you don't know something, it is fine to say so.
Do not speculate about what might have, should have, or could have happened, or not happened.
Do not comment on the actions or omissions of other people or go outside of your own area of expertise.
If the questioning at any point appears to shift towards those trying to attribute blame to you, it is appropriate to ask that you take those questions away and get advice before you answer them. You can offer to reply to these in writing later.
Be mindful of the relevant GMC guidance (paras 86-96) when answering questions. It is important to be honest, take reasonable steps to check any information is accurate and that no relevant information is omitted.

Your account will be relied on, so try to give an accurate report of your involvement in the incident. While the information will primarily be used for the relevant internal investigation, you should be aware that it could be used in other processes, like a coroner's inquiry or GMC investigation.

Scenario

A cardiology trainee contacted the MDU for advice after he was called to a meeting at his Trust following an adverse incident involving a medication error. He was understandably concerned about the purpose of this meeting and how best to approach it.

He drafted a full chronological account of his role of the event based upon the relevant records and his recollection. With the assistance of the MDU medico-legal adviser, he reviewed relevant NICE guidance and was able to refine this document, which he then relied upon during the meeting. He noted learning points from the incident in his appraisal.

The meeting went smoothly and he was thanked for his contribution to the investigation. He asked to have sight of the investigation report when it was ready so he could learn any lessons from the incident. He also shared this with the MDU medico-legal adviser who agreed it did not contain any criticism of the member.

How to prepare for an internal meeting after an adverse incident

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