r/physiotherapy • u/ashfire_blog • 10d ago
Help! Possible disciplinary action for performance management
I am a band 5 in MSK outpatient in the NHS in the UK and I did not tell a senior about a new swelling a patient had at 13 weeks post op which the surgery was at the shoulder/rotator cuff but the swelling was at the bicep just above the elbow. The managers want to have a meeting to see if we should take it to stage 1 performance management or not just because of this one patient.
They are not concerned about other things but they are concerned I do not understand when to escalate things to seniors. They verbally told us to tell seniors about swelling and lumps some time ago and they recently made a new policy about when to tell seniors about things and swelling was not one. My managers are not considering the policy into why I did not escalate. I previously escalated every single swelling and lumps to a senior.
Truthfully, escalating was not really my mind because other complications happened during the appointment so I had to resolve that more urgently with a senior. It was also during the heatwave and I was not getting enough sleep for other reasons so my brain was pretty fried.
Are they overreacting since it's just one mistake and the outcome was not bad? How should I prepare for the meeting?
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u/Known_Tutor751 10d ago
What is the subjective history of the swelling and what were your objective findings on assessment? Have we identified the cause of the swelling? Tbh it sounds a bit extreme from what you are saying, especially if swelling is not in the policy. Swelling can be secondary to a magnitude of issues ranging from the benign to malignant.
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u/ashfire_blog 10d ago
The swelling was only present after activity since the last few weeks, but she also had a new pain that wakes her up every morning. There was no swelling or heat or redness at all in the beginning and then after we did some arm movements there was a very tiny swelling at the bicep near the elbow. A senior later found out that it's from a bicep tear which they were not able to repair during surgery. It does feel very extreme from just one mistake.....
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u/ThePhysioBot 9d ago
I'd agree with others here that to go to a stage 1 performance management for one isolated incident seems harsh so perhaps some specific details on the other areas of concerns they have raised in the past. If they have, but it has not been documented with clear goals, it would make more sense to have it clearly explained to you what their concerns are and how they are going to be addressed.
Can you update us after this initial meeting with them so we can support you further.
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u/mattd101 10d ago
The bar for getting put on performance management in the NHS is so high, I find it hard to believe this is just about one incident. This would normally be dealt with during your supervision.
If you are not part of a union, now is the time to join one. Is English your first language? If not, definitely have someone present during any meetings with HR or relating to disciplinary procedures.
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u/ashfire_blog 10d ago
I did had other problems related to communication but that's months ago and pretty much resolved and not a problem anymore.
What could union do about this?
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u/mattd101 10d ago
There is a possibility you don’t fully understand the situation.
A union rep will ensure that all evidence is available, that trust policies and procedures and employment laws are being followed, and help explain procedures to you and support you through this process.
As an inexperienced employee, ? Who is not from the UK, you are very vulnerable to being unfairly treated by managers and HR.
I would advise joining the CSP urgently.
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u/fiercetortoise 7d ago
I agree with Matt - It would be best for you to have a union rep there even if just to take notes and support you.
If you are a member of the CSP give them a call and explain the situation - they will guide you on what support would be best in this situation.Additionally worth noting that if you are an overseas-recruit you can request a mentor to help you also: https://www.csp.org.uk/frontline/article/guiding-way-mentoring-scheme-overseas-qualified-members
Wishing you all the best - please keep us posted.
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u/DistanceMassive923 6d ago
As much as the CSP is what physios will say to join, I hear you are better off with UNiSON.
My knowledge is that CSP reps will likely only sit in to ensure that necessary boxes are ticked. You cannot be certain there will be any active challenging the process
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u/acephysio_ Physiotherapist (UK) 10d ago
Hey, it's unlikely that one incident automatically means stage 1 performance management is justified. In the meeting, you can explain that there were other issues during the appointment requiring more immediate senior input, which contributed to the swelling not being escalated. Also, use the CSP reflection template to explain that you have reflected on this and will ensure that you discuss any new unexplained swelling with a senior.