October 2025 Newsletter

Dear PRASIS Member

Welcome to the Autumn 2025 PRASIS bulletin, and thank you for your ongoing loyalty to PRASIS.

UPDATES

PRASIS underwriter, CFC have introduced a new Streamlined Renewal process. You should find the process of renewing your cover much less onerous from now, but we always value feedback and are constantly seeking ways to improve.
Please consider attending our AGM in December in Belfast to be held in the Belfast Hilton hotel, next door to the BAPRAS conference venue. At the AGM, we will consider proposed amendments to the constitution which will broaden and better define our membership criteria, amongst other things.
The Clinical Board has approved the adoption of a new strap line for use in a variety of media – “Comprehensive Indemnity, Trusted and Supported by Surgeons”
We continue to support and work alongside BAPRAS, BAAPS, PLASTA, PRASSA, CBS and BAM
We continue to deliver webinars of interests to our membership in collaboration with CBS and Chase de Vere
Our social media enagement continues to grow across multiple platforms – please like and follow!
Jo Skillman is set to join the Clinical Board from 2026, and Hiroshi Nishikawa has agreed to serve a second term.
The Medico-legal Helpline is seeing increased use, which is a good thing to help manage issues at an earlier point.

PRASIS Case Study: How the helpline assisted with a ‘Never Event’

Background

A PRASIS member called to inform us that one of his patients had lost a finger due to the failure to remove the tourniquet during surgery.

The patient saw the surgeon as she needed to have surgery on the tip of her finger. The surgery went ahead uneventfully and the patient was discharged.

One week post-surgery the patient returned to the clinic for her post operative review. She said that she had reduced sensation in her finger and felt some discomfort. On removing the dressing, it became apparent that the tourniquet had not been removed during the procedure. Due to the extended period of time without blood flow, the finger had become necrotic and had to be amputated.

This is a very unfortunate situation that has left the patient with a permanent disability. It is important that the next steps are carried out appropriately in order to ensure that the patient is getting the treatment she needs. It is also important that the surgeon protects himself from any potential litigation, or regulatory vulnerability.

While ‘never events’ are, of course, rare, they can and do happen. When they occur – tell us. We are here to help ensure you follow a prudent process to mitigate any further risks to you and to the patient.

If you find yourself in a similar position, what should you do?

Firstly, is important to make sure that you have fully informed the patient. That includes:

providing details of the clinical issue;
explaining the steps you need to take and why; and
explaining why and how the incident happened.

As a doctor, you have a duty of candour, meaning that you must be open and honest with patients when things go wrong.

The GMC states that you must provide the patient with a “clear and honest explanation of what happened, you must provide an apology, and provide them with information about the short- and long-term effects”.

Secondly, it is important to notify the hospital. There will be a process for serious incidents such as this. There will also need to be an investigation in order to work out why the incident happened, and what steps need to be put in place to prevent the incident occurring again. The whole theatre team will need to be questioned.

Thirdly, you will need to contact your indemnifier to notify the incident under the policy. There is an increased chance of litigation or regulatory complaint following a ‘never event’, and therefore it is important that you protect yourself and notify your insurer immediately.

How can PRASIS help in a situation like this?

You should call the medico-legal helpline to report the incident and to seek advice as soon as possible. During your call with PRASIS, we will have a conversation and discuss the facts and the events of the incident.

We would advise you on the steps that you need to take (as mentioned above), and we would notify the Insures immediately to protect your position under the policy.

We would ensure that you have taken clear and complete notes summarising what happened. The summary will include a chronology of events and some comments on the situation, both clinically and about what steps have been taken.

A clinic letter will need to be sent to the patient, and we encourage members to send us a draft of the letter before it is sent so that we can ensure your position is protected.

We ask that any correspondence that is received is sent to us for review before it is responded to.

Conclusion

Sometimes, in your job, incidents will happen. This may be due to something out of your control and even with all due care and diligence cannot always be avoided.

When these situations occur, it is important that the correct procedures are followed both to help the patient, and to protect your position.

Please call the PRASIS helpline for any further advice on 03332408979, or email emily.borhan@m-i-c.co.uk

LATEST WEBSITE ARTICLES

Reflections from a Plastic Surgeon – Personal Perspectives Following a Fatal Critical Incident

Read in full

Writing a Duty of Candour Letter

Indemnity: Insurance based cover OR Medical Defence Organisations?

See full article

THE CONFEDERATION FOR BRITISH SURGERY (CBS)

CBS is an official trade union dedicated to supporting surgeons and their teams, complementing but distinct from associations, colleges, and indemnity schemes. Representing a relatively small but vital part of the UK medical workforce, CBS advocates for members’ professional and employment interests while promoting safe, well-resourced environments that improve patient outcomes.

Benefits include expert surgical advice, guidance on indemnity cover, flexible membership, partner discounts, and a
strong collective voice for change.

Founded by surgeons, for surgeons, CBS ensures members are supported, represented, and heard. Membership starts from just £15 per month for consultants and £7 for trainee surgeons.

Why not join today?

CBS application form

To find out more about the Confederation of British Surgery or to join please visit our website www.cbsgb.co.uk or email admin@cbsbg.co.uk

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.

The Insurance market remains challenging with ongoing reduced capacity affecting 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 Broking and Underwriting 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 (e.g. their premium).

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:

helen.roberts@prasis.org or 07930509646

Helen will ensure your query is forwarded to the correct member of the team.

In addition to this and as outlined above PRASIS supports educational activities and opportunities for its members for their benefit, 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.

The PRASIS Board

Chair:

Rob Winterton

Clinical Board:

Ben Baker

James Haeney

James Henderson

Mark Henley

Hiroshi Nishikawa

Legal Advisor and Board Member:

Nicky Collins

PRASIS Board Secretary: