When clients come to us for care, they entrust their health, well-being, and their lives to us. 

Definition and legal basis of Duty of Care: In many countries it is implied by law that people in a position of responsibility and in particular health workers have a duty of care to others. This duty can form the basis for a legal claim against the individual.  If you have a duty of care, you have an obligation to try to avoid acts or omissions, which could be reasonably foreseen to injure, harm or cause distress to other people. This means that you must anticipate risks for your clients and take care to prevent them coming to harm.

MSI’s required Duty of Care Declaration: MSI requires all healthcare providers, whether interim or permanent, employed or contracted, including any consultants, locums, or freelance providers, to read, sign and comply with this document which details how each healthcare provider is required to execute their duty of care to each client they see. 

In addition, where it is found that any healthcare provider has not complied with the terms of this duty of care, they will be subject to a disciplinary, which depending on the severity and/or impact of the breach may lead to dismissal.

The 3 MSI Duty of Care Requirements

All services must be provided in accordance with the technical requirements of MSI’s clinical standards but also importantly in accordance with the following 3 key requirements which you must comply with in order to demonstrate your professional duty of care to your clients: 

Requirement 1:  Knowledge, skills, and performance 

Requirement 2:  Safety and quality 

Requirement 3:  Client centred attitude 

 

Set out below are details as to how you should comply with each of the 3 MSI Duty of Care requirements, which you are required to confirm and sign to demonstrate your acceptance and agreement to ensure compliance.

 

Requirement 1: Knowledge, Skills, and Performance 

Client wellbeing: I confirm that I understand that ensuring clients safety and wellbeing is central to all of my work whether I am preparing to see a client, seeing a client, writing up relevant records or dealing with equipment and other related materials. I will ensure this concern guides all aspects of my work and is the first thing I think about when I have to make a decision.

 

Where I am a Manager: I confirm that I will create an open and transparent culture where staff are encouraged to speak up about safety and care concerns and know they will be supported. Where any concerns are raised by staff, I will take prompt action to respond to them. I will promptly report safety or safeguarding concerns in accordance with the proper reporting channels.  I will make sure that I understand all the organisational policies and processes and ask for help or training where necessary.

 

I confirm that I will:

·       Ensure I understand my safeguarding responsibilities and act in accordance with them

·       Provide good standards of care in accordance with MSI guidelines 

·       Keep my professional knowledge and competences up to date, and maintain my current licence to practice 

·       Recognise and work within the limits of my training and competence (this means that if I am not comfortable or skilled to perform a procedure: it is my duty not to do so, and to ask for further training)

·       Comply with MSI’s competency assessment system

·       Record my work clearly and legibly 

·       Adhere to MSI standards on data privacy and client confidentiality, and ensure I understand what these are.

·       Ensure that where a client consent form is needed for the procedure concerned, it is fully and accurately completed, including ensuring there is a separate witness to a client’s signature where required

 

Requirement 2: Safety and Quality 

 

I confirm that I will:

·       Take prompt action if I think client safety, dignity or comfort is being compromised by me or a colleague or third party including:

o   I will raise concerns if clients do not receive adequate care (this is essential to your duty of care as it enables weaknesses to  be identified and clients kept safe)

·       Protect the health of clients and colleagues including by:

o   Always adhering to infection prevention standards 

o   Raising concerns if I see others not adhering to infection prevention standards

·       Respond to safety risks and:

o   Ensure good pain management including by using vocal local where possible

o   Ensure adequate Medical Emergency Preparedness according to MSI Medical Emergency Guidelines (this includes participating in mandatory training and drills)

·       Contribute to and comply with systems to protect clients including:

o   Internal Audits 

o   QTA  

o   Incident Management System 

o   Where I am involved with obstetrics, I will:

o   Adhere to MSI guidelines taking care not to risk the mother or baby’s health by performing surgical or other interventions that are not clinically indicated

 

Requirement 3: Client-centred attitude

 

Client-centred: I confirm I understand that as a health care worker or staff member my duty is to provide the best experience of healthcare for all my clients, whoever they are and wherever they come from. I will therefore treat all clients, no matter their ethnicity, religion, disability, sexuality, age, profession or needs, with dignity and respect, and will raise concerns where I see others who do not do the same.

 

I confirm that I will:

A.      Work in partnership with clients 

·       Listen to clients and provide methods and care that respond to clients concerns and preferences  

·       Give clients the adequate information they need or want in a way they can understand 

·       If dealing with a child/ young person or person with disability, assess their capacity to consent (in accordance with counselling guidelines) 

·       Respect and support clients’ rights to make their own decisions  

·       Work collaboratively with clients to serve their best interests 

 

I confirm that I will:

B.      Treat clients as individuals and respect their dignity 

·       Respect clients right to privacy and confidentiality 

·       Give client privacy to undress/dress and keep clients covered whilst performing a procedure as much as possible to maintain their dignity 

·       Before conducting an intimate examination or procedure I will: 

·       Explain to the client why the examination/procedure is necessary and give the client an opportunity to ask questions 

·       Explain what the examination/procedure will involve in a way the client can understand, so that the client has a clear idea of what to expect, including any pain or discomfort, and explain what I am going to do before doing it 

·       Get the client’s informed consent, and where indicated record that the client has given it 

·       Before, during or after an examination I will:

·       Stop if the client asks me to

·       Not make personal comments regarding the client

·       I will ensure a chaperone (i.e., a second staff member or government health worker (if providing services in a government clinic)) is offered or present for the below listed examinations/procedures, where I am a different gender to the client.  I understand that the chaperone should be the same gender as the client.  I understand that this both reassures the client and protects me should any complaints or serious concerns arise.

·       All breast examinations

·       All rectal examinations

·       All genital examinations including speculum examinations, bimanual examinations

·       IUD procedures, IUS procedures, cervical cancer screening and treatment

§  All gynaecological examinations/procedures

§  Ultrasound examinations

§  MSP procedures, STP procedures

 

       I understand that:

·       a chaperone is ideally a member of staff, who provides vocal local during the examination and/or procedure but does not have to be a trained healthcare provider

·       Where a chaperone is present, the chaperone must:

·       be sensitive and respect the client’s dignity and confidentiality

·       reassure the client if they show signs of distress/discomfort

·       stay in the room for the whole examination/procedure

·       be prepared to raise concerns if they are worried about the provider’s actions or behaviour

·       A relative/friend of the client is not an impartial observer, so would not usually be a suitable chaperone, but if a client requests to have their relative/friend present during an intimate examination/procedure, where appropriate this may be permitted in addition to a chaperone

·       I will record the name of the chaperone (i.e., second staff member or other service provider) in the client record.

 

I confirm that I will:

 

C.      Maintain trust 

o        Be honest and open and act with integrity 

o        Treat all clients fairly and equitably 

 

I confirm that I will comply with this MSI duty of care. I also confirm that I understand that I am personally accountable for my professional practice and performance.  I will ensure that I am always able to explain and justify my decisions and actions.