One year later: Where has my trust gone and when is it coming back? – My reflections on the impact of being a witness in a Fitness to Practise (FtP) hearing:

By Sarah Seddon

What do I feel when I think back to this time last year? Ingrained on my mind, it was the first day of the FtP hearing of my healthcare professional where I was cross examined on the death of my baby.  A year has now gone by: the caution order has expired, the phantom kicks have stopped, the dust has settled and I’m back at work.  The girls have nearly completed another year at school, but there are still people missing.  My memories of Thomas have been tarnished by the actions of my healthcare professional after his death, by the way that his death was investigated and by the way that the FtP hearing was conducted. 

Looking back, it feels like such a blur and an enormous explosion of emotions: terror, panic, sorrow, anger, pain, exhaustion, depersonalisation, loneliness and mistrust… but on the edge of this huge dark cloud was a little shining star of love, support and hope. This was in the form of my husband who was always there (even when he wasn’t physically allowed in the room), family and friends at home (keeping a close eye on our girls) and the Public Support Service who kept me breathing and stopped me shaking.

Some of the long days have now rolled into one in my memory.  But I can still remember every second of some of the hours so clearly: the words that the barrister said to me, the blame, the contempt and the patronising, inaccurate descriptions of what had happened to my baby which I was not permitted to correct.  There are many things that I want to remember. And many things that I can’t forget.  And still so many things that I want to say to the people who were part of my FtP journey:

Dear Regulator CEO,

Thank you for prioritising person-centred regulation over the past year, but there is still so much to be done to ensure that these efforts are not tokenistic and that the people are at the centre of your processes.  Every member of your staff needs to undergo safeguarding training and to appreciate that they are dealing with real people and their lives on a daily basis.  You are still asking too much of your witnesses – asking us to put our lives on hold, re-live our most traumatic moments, step into a brutal, aggressive, cross examination in a public room with no real representation; is this fair and necessary to achieve the right outcome? You still do not formally value the patient story or impact statement and do not encourage mediation.  Yet any professional who provides care should (in my opinion) seek to understand how their actions impact on their patients’ lives and demonstrate reflection on this.  It’s been a year since your organisation ‘disposed of the case’ and effectively disposed of me.  But I want to continue to stand up for the people who don’t have a voice – to remind you that the repercussions of being a witness are still affecting my life now and will be for a long time.  How can I gain trust in regulation again?

Dear Hospital,

Thank you for acknowledging and trying to rectify the things that went wrong in my care and subsequent investigations.  I’m still however left constantly wondering how events may have unfolded if you had allowed me to sit down and talk to my healthcare professional as I requested so many times.  I still believe that mediation could have led to a different (better) resolution for both of us instead of the horrific FtP process which took over 2 years to conclude (and is still very much ‘in-process’ in my head).  I’m still angry that your procedures and systems weren’t robust enough, which had a huge impact on the outcome of the hearing.  It’s now over 3 years since Thomas died and I am still terrified of ever needing to receive treatment from you in future.   I’ve lost that trust.

Dear Healthcare professional,

Everyone is human and makes mistakes, but professionals do not try to cover them up.  I am angry that you allowed your barrister to try to blame me for what happened and to be so vicious in the cross examination.  I’m angry that you brought up personal details about the aftermath of Thomas’ death in a public forum when they bore no relevance to the issues being examined.  You let me down when I was at my most vulnerable and I now find it so difficult to trust people.  Will this trust ever come back?

Dear Defence Barrister,

I can’t find the words to explain how your cross examination affected me and I struggle to understand how anyone could do this for a living.  I’ve stopped having nightmares about you now.  I have learnt that telling the truth is not always enough.

Dear Case Investigators,

I still think about all the times you fobbed me off during the years of investigations and refused to take the time to give me explanations or amend processes to reduce my distress.  The times when you gave me incorrect information or didn’t bother to get back to me as promised, yet didn’t see a need to apologise.  I know that to you I was just a piece of evidence – but I’m actually a person and my child’s death has had a significant impact on my life.  I’m sure you don’t think about my case at all now, but I often think about the way you ‘dealt’ with me.  And I make sure that I don’t ‘deal’ with people in that way.  To gain trust, you need to be compassionate and to treat people with respect.

Dear Panel Members,

Why didn’t you step in and intervene during the cross examination?  Would you allow your loved ones to be treated in this way without speaking up?  And why did you ignore the additional information which came to light and subsequently led to a preventable second investigation? Surely your role is to look at the wider picture?  Why didn’t you apologise when you spelt my son’s name incorrectly? That would have just been the human thing to do.  The decision of FtP panels must stand up to public scrutiny and there should be a clear explanation of how you reviewed the evidence and reached your decision.  But your decision was contradictory – it still does not make sense to me now and no one within the organisation has been able to explain it to me.  So how do I trust that you reached the right decision?

Dear Public Support Service, Friends & Family,

I have nothing to say except “thank you”.  You are all amazing and have brought a little bit of faith, trust and hope back into my life. 

Dear Thomas,

I miss you every day.  But you have taught me so much and I see you in your sisters.  Your life was so short and precious and I hated seeing you reduced to the title of ‘Baby A’, removed from me and discussed as simply a piece of evidence.  My “new year” always starts around now – another year without my baby and I wonder where I will be this time next year.  I want to enjoy every minute with my beautiful family and I want to try to remember you as the little person that you were, with all the things that made you unique.  I want to remember you with love and not with all the fear, distress and broken trust of the FtP proceedings.

If you work in FtP at any point of the process – please, please remember that every action you take or don’t take can have lasting implications for many years following what you may view as the ‘conclusion’ of the case. The sole purpose of FtP is to establish trust. Your role is to ensure that the public can trust the systems in place to make sure their healthcare professional is fit and able to do their job safely and effectively. The trust that we have to invest into the healthcare system is immense as we are all at our most vulnerable when we receive care. Our health goes right to the core of who we are as people and if our health is broken or our trust in healthcare (or its regulators) is broken then the consequences are all-consuming. And I am still unsure whether it is possible to regain that trust. Whoever you are, please prioritise trust and compassion.

About the author

Sarah Seddon is a mum of five children: 3 fabulous girls and two much-missed boys. Her second son (Thomas) was stillborn in May 2017. The lack of candour following Thomas’ death and the conduct of the serious incident investigation impacted significantly on Sarah and her family. The local investigation was followed by a Fitness to Practise (FtP) investigation where Sarah experienced how damaging, dehumanising and traumatic FtP processes can be for patients who are required to be witnesses. Sarah currently works as a clinical pharmacist and has been working with several healthcare regulators over the past few years to promote the importance of compassionate, person-centred regulation.

1 thought on “One year later: Where has my trust gone and when is it coming back? – My reflections on the impact of being a witness in a Fitness to Practise (FtP) hearing:

  1. Andrea Sutcliffe

    Dear Sarah
    Thank you for writing this, for the impact you have had on me personally and on our organisation. Thank you for talking about the impact of the fitness to practise experience on you and for having the courage to share the trauma.
    I’m sorry you feel we have disposed of you – nothing could be further from the truth. I’m sorry for the memories you have to live with and that now we can’t change them.
    I promise you: your experience has helped, and continues to help, with our commitment to learn from past mistakes, change for the better and continually improve. As a professional regulator, I know we have more to do. I’m clear we must embed a culture of kindness that treats people with dignity and respect. Trust is fragile and hard won. You have my word that we’ll work hard to rebuild that.
    Thomas would be so proud of you and everything you’ve done to challenge us to do better – for you, for him and for everyone affected by our work, I’ll make sure we do.
    With my best wishes to you and your lovely family,
    Andrea

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    Reply

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