Negligence in General Practice – a Liddy’s White Paper
Published: 4th November 2016
In 1948 the National Health Service was born. It gave every citizen the right to be registered with an NHS General Practitioner and to be consulted free of charge. It also provided that in other emergencies, patients could consult hospital based specialists by being referred by their GP. As a result about 90% of NHS consultations take place in front of a GP.
A GP is required to try to identify the need, if any, for treatment or further investigation, including referral of the patient to specialists. GP’s refer patients when they are:
- Ill with conditions which recovery is generally expected
- Terminally ill
- Suffering from chronic disease
The care that is given must be done so in a timely manner, and with reasonable skill and care. When it is not a patient may have grounds for a negligence case
The first test for negligence is to look at whether the GP has used the level of reasonable skill and care that would be expected of the average GP. GP’s sometimes contract out some of their duties to receptionists, nurses or locums. However it is no defence against a charge of negligence that a receptionist or other member of staff failed to convey relevant information or that a locum failed to undertake a home visit when they needed to.
There are common grounds of claims against GPs. These include:
- Failing to visit a patient at home when requested e.g. for a fever or a nonspecific illness where the patient’s history suggests upon possible serious cause.
- GPs not acting on communications from hospitals such as Letter of Discharge or test results e.g. smears, or failing to treat infected wounds or failing to carry out treatments suggested by specialists.
- Failing to refer to a specialist in a timely manner or errors in drug treatment, for example not clarifying any drug allergies.
- Failing to keep adequate notes. The Medical Protection Society provides a checklist as to what constitutes good medical notes. These include things like:
- All consultations and telephone conversations should be recorded in detail.
- Notes should be made as detailed, and as similar the consultation to which these refer, as possible.
- Manual records should ensure sufficient information at the top of each page.
- Records should contain results of physical assessment, including relevant history.
- Records should clearly set out clinical findings and diagnosis, treatment given, advice given about drug side effects, results of investigations and actions taken, signed consent forms and key elements on discussions with patients.
- The most common source of claims against the GP relate to failure or delay in diagnosis, often of malignant disease or surgical conditions.
- Prescribing mistakes including failing to recognise or monitor adverse medication reactions. It is very common (in some studies, as high as 25%) for patients receiving a new drug to experience an adverse drug event when as much as half of those were preventable. Some studies have shown that over half of hospital admissions are caused by drug related problems. Many are due to GP or pharmacy failure.
- A failure to refer to hospital admission, refer to a specialist, to maintain adequate medical records and consult medical records and to act on the result.
If you feel you have fallen victim to any of the above then you may have grounds to make a claim for medical negligence. If this is the case then simply call us on 01226 731 314 to have a chat about it.