Case Studies

Case Studies: How HSCAMP Helps Healthcare Providers

Effective complaint resolution is essential for maintaining trust and professionalism in healthcare. HSCAMP’s adjudication services provide healthcare providers with a structured, impartial, and efficient approach to resolving disputes. Our case studies showcase real-world examples of how our process protects providers from unfair claims, ensures regulatory compliance, and prevents complaint escalation.

Explore these case studies to see how HSCAMP supports healthcare professionals in managing complaints with confidence and achieving fair, transparent outcomes.

Adjudication and Legal Implications in an Aesthetic Procedure Complaint

Background

A patient (Mrs R) sought a rhinoplasty at a private aesthetic surgical clinic to address perceived nasal asymmetry and refine the shape of the nasal tip. During the pre-operative consultations, the surgeon discussed the potential limitations of rhinoplasty. The patient gave consent, acknowledging the possibility of minor irregularities, swelling, and the need for revision surgery in certain cases.

Shortly after surgery, the patient began expressing dissatisfaction with the aesthetic results, citing concerns over nasal tip shape and an unexpected contour along the nasal bridge. The clinic maintained regular follow-up appointments to monitor post-operative progress and addressed the patient’s worries about the healing process. However, the patient believed the outcome fell short of the promised expectations and file a complaint. The patient followed the providers two-stage complaint pathway disputing both the aesthetic result and the level of post-operative support provided.

Despite the clinic concluding that the procedure was within acceptable clinical standards the clinic offered a substantial goodwill gesture in the interest of patient satisfaction amounting to a full refund of the procedure or a revision.  The patient declined, choosing to escalate the matter to adjudication.  The provider agreed to waive the HSCAMP £5,000 cap.

Escalation to Adjudication

The dispute proceeded to independent adjudication, where a medical expert reviewed documentation, including operative notes, clinic records, before and after and both parties’ statements. The adjudicator determined that:

• The procedure was performed in a manner consistent with what would be expected by an appropriate body of surgeons trained to the same standard.
• The rhinoplasty result, while unsatisfactory to the patient, was within the expected range for the procedure.
• The patient should receive a goodwill payment, but for a significantly lower sum than the clinic had originally offered.
  
  

Post-Adjudication Developments

Dissatisfied with the adjudicator’s conclusion, the patient sought to accept the original offer, which the provider had already withdrawn in favour of the adjudicator’s final award. The patient then approached a no-win, no-fee solicitor, prompting the clinic to share the patient’s records and the adjudication report.

Soon after, the solicitor withdrew representation, likely due to the robust expert findings confirming that the clinic had acted appropriately, thus undermining any claim of clinical negligence.

• Independent Verification: A qualified, neutral party confirmed the clinic operated within safe and acceptable clinical standards, minimising legal exposure.
• Cost and Time Efficiency: Adjudication short-circuited lengthy legal disputes, allowing for a decisive outcome.
• Risk Mitigation: By providing an objective medical review, adjudication bolstered the clinic’s position against potential litigation, ultimately deterring legal action.
• No impact on the provider’s or performing Doctor’s medical indemnity insurance

This case underscores the strategic value of adjudication in resolving patient complaints. Through expert-led review, providers can demonstrate their adherence to best practices while reducing the likelihood of drawn-out, high-cost legal challenges.

Successful Complaint Resolution in a Multi-Procedure Aesthetic Case

Background

A patient (“Ms. A”) underwent a combined abdominoplasty and breast augmentation at a private surgical clinic. Post-operatively, Ms. A experienced complications that included a suspected infection, prolonged swelling, and the formation of a seroma requiring drainage. She voiced concerns about the timeliness of antibiotic administration, feeling that a raised CRP level should have prompted earlier antibiotic use. Although intravenous antibiotics had been given during surgery, Ms. A believed that additional oral antibiotics should have been prescribed immediately afterward.

Clinic’s Internal Complaint Process

The clinic conducted a thorough two-stage review. Their assessment concluded that the patient’s raised CRP alone was not sufficient evidence of an active infection: indeed, a CRP can be elevated due to inflammation or other factors. Additionally, staff had appropriately administered intravenous antibiotics in line with recognised best practice for multiple cosmetic procedures. Nonetheless, the clinic offered Ms. A a goodwill payment of £2870 to acknowledge her challenging recovery and to settle the complaint amicably. Ms. A, however, remained dissatisfied and considered further escalation.

Why HSCAMP Was Brought In

Because of the value of the goodwill award and the HSCAMP £5,000 liability cap, the provider did not believe that adjudication made financial sense. The only remaining option for Ms. A, short of accepting the goodwill offer, was to pursue a no-win, no-fee solicitor.

Before that could happen, the clinic engaged HSCAMP to facilitate a Complaint Resolution, seeking to avoid the potential costs and complications of legal proceedings.

Encourage Acceptance of the Goodwill Offer – HSCAMP would negotiate with Ms. A to accept the existing sum of £2870, with a modest facilitation fee charged to the clinic.

1. Proceed to Adjudication – An independent third party would review the entire case, potentially resulting in a lower or higher award, plus the added cost of adjudication.
2. Adjudication Followed by Possible Legal Action – While an adjudicator’s decision might reduce the likelihood of legal claims, Ms. A would still retain the right to pursue a solicitor.

The clinic ultimately favoured a proactive resolution through direct mediation, which would avoid the uncertainty and additional costs of adjudication or litigation.

Resolution

HSCAMP carefully explained to Ms. A that on assessing the case, the management was carried out appropriately. The standards expected were met and the procedure was performed in manner consistent with an able body of surgeons trained to the same standard.

The timely use of intravenous antibiotics, in conjunction with a clinical assessment that did not confirm active infection, aligned with standard medical practice.

HSCAMP highlighted that an external review (if it proceeded to adjudication) would likely uphold the clinic’s position, and any compensation awarded might well be lower than the current goodwill sum.

After negotiations, Ms. A accepted the £2870 offer, signing a formal settlement agreement. This legally ended any potential claim against the clinic and secured a mutually satisfactory conclusion.

Key Takeaways

• Prompt Mediation: Engaging HSCAMP early helped clarify medical misunderstandings, allowing both sides to move toward a reasonable settlement.
• Appropriate Clinical Practice: The clinic’s adherence to standard infection-control measures and informed decision-making supported its defensible position throughout the complaint process.
• Risk Mitigation: By resolving the issue at the Complaint Resolution stage, the clinic avoided the greater financial, reputational, and legal uncertainties associated with adjudication or formal litigation.

This case demonstrates how HSCAMP’s Complaint Resolution approach can help providers navigate complex patient complaints effectively, reducing both legal exposure and costs while preserving patient trust.

Litigation Risk Due to Lack of Adjudication in a Facial Filler Complication

Background

A private aesthetic clinic performed dermal filler treatment on a patient (Ms. T) who sought volume enhancement in her cheeks and lips. The procedure was performed by a qualified practitioner, and the patient signed a consent form acknowledging the risks of temporary swelling, bruising, and potential need for correction.

Shortly after the treatment, Ms. T experienced prolonged swelling and asymmetry, which she claimed resulted from poor technique. She lodged a formal complaint stating that the results did not meet her expectations and demanded a full refund, as well as free correctional treatment.

Clinic’s Response & Lack of Adjudication

The clinic’s internal review concluded that the filler had been administered correctly and within industry standards. However, Ms. T was not satisfied with the clinic’s explanation and escalated her complaint to legal representatives. Since the clinic had not engaged an independent adjudication process, there was no external validation of their decision.

With no clear resolution route other than litigation, Ms. T’s solicitors filed a negligence claim against the clinic. Without adjudication evidence, the clinic had to rely solely on their internal review, which was not as compelling as an independent expert assessment.

Legal & Financial Consequences

• The clinic’s medical indemnity insurer increased premiums by 45% due to the legal dispute.
• The case lasted 18 months, incurring over £30,000 in legal fees, despite eventually settling out of court for £12,000.
• The surgeon’s indemnity provider flagged them as high-risk, requiring additional compliance training.
  
  

Key Takeaways:

• Adjudication could have provided an independent expert review, reducing the chances of litigation.
• If adjudication had ruled in the clinic’s favor, the patient’s lawyers may have withdrawn the case, avoiding unnecessary legal costs.
• Insurance premiums skyrocketed, highlighting the importance of risk mitigation through early intervention.

Avoiding Litigation Through Timely Intervention in a Liposuction Case

Background

A patient, Mr. D, underwent high-definition liposuction at a private cosmetic surgery clinic. Initially satisfied with the results, he later developed contour irregularities, leading to dissatisfaction with the final outcome. He felt that the clinic had failed to manage post-operative swelling properly and had not provided clear aftercare instructions.

Early Complaint & HSCAMP Resolution

Mr. D submitted a formal complaint, demanding revision surgery at no cost or a partial refund. The clinic, recognising the risk of escalation, engaged HSCAMP early in the process for a Complaint Opinion.

• HSCAMP assessed the complaint quickly, advising the clinic to offer additional non-invasive corrective treatments (such as radiofrequency skin tightening) rather than an outright refund.
• Mr. D initially rejected the offer and considered legal action, but the clinic escalated to Complaint Resolution under HSCAMP, facilitating direct negotiation with Mr. D.
• The outcome was a compromise where the clinic covered two sessions of post-procedural treatment (£800 total), which the patient accepted as a fair resolution.
  
  

Key Benefits of Early Resolution

No formal litigation was pursued, avoiding thousands in legal fees. Indemnity premiums remained unchanged since no legal claim was filed. The clinic protected its reputation, as the patient left a neutral rather than negative review.