Statement Request Guidance Notes

Main Statement Guidance Notes

Please use these points for guidance and carefully consider each one to ensure you form a full and effective main statement for your response:

  • Make sure you reference all the points that have been raised, responding to them individually
  • Make your responses brief but concise
  • Avoid giving opinions, making judgments, and using hearsay and emotion-led responses within your statement
  • Remain as factual as possible. Don’t speculate, elaborate or exaggerate – you may be called as a witness to give oral evidence based on your statement. And you could be challenged on the content of your account
  • Where known, use the initials and job titles of colleagues but keep patients’ and relatives’ identities anonymous. For example, use ‘Patient X’ throughout your statement
  • Follow any professional codes, local policies and confidentiality guidelines
  • Don’t assume that the reader knows anything of the facts of the case, such as a patient’s medical history, your environment, or clinical routines and procedures. Any intelligent lay person should be able to understand the content


Closing Reflective Statement

This final section is an opportunity to acknowledge something went wrong and you have empathy within the situation.

Please use these points for guidance and carefully consider each one to ensure you form a full and effective closing/reflective statement for your response.

Provide an apology, if suitable. Saying sorry doesn’t necessarily mean you’re accepting liability, but it can show that you understand and accept an error/errors have been made.

If a particular error, mistake or bad judgement has been made on your part, you may want to include what you have learnt and what you would do differently moving forward to ensure that this does not happen again.

Considering the above points, here are some lines you may wish to use for the reflective part of your statement:

“On reflection, I can see that my practice and performance was appropriate/lacking in the following areas and ways:”

“In respect of the complaint raised, I have upheld/breached the NMC code in the following ways:”

“Having now had time to reflect on the matter, I can see that I should have done things differently. In future, I will:”

Female Nurse using a digital tablet to check data

Statement Request Form

This form is designed to assist you with creating an appropriate response for the statement that has been requested from you regarding the issue(s) raised/feedback received.

If you need to download it again, it is available here.

Download Statement Request Form