MDU pays over £30 million in compensation for GP out-of-hours claims
The Medical Defence Union (MDU) has paid out well over £30 million in compensation and legal costs on behalf of GP members working in out-of-hours and unscheduled care settings over a three year period. This included a number of high value cases settling for over £1 million.
The MDU reviewed claims cases to see why this area of GPs’ work carries a higher indemnity risk when compared to care provided by practices to their own patients, and to help GPs to minimise risk to patients.
Dr Pierre Campbell, MDU head of underwriting, said:
“Out-of-hours GP services play a vital role in ensuring people who become ill at weekends or overnight can get access to emergency help. But there are some additional challenges for GPs working in unscheduled care settings which result in claims that are, on average, higher value and more difficult to defend than claims arising from routine care.
“These challenges include assessing unfamiliar patients who are more likely to be suffering from an undiagnosed and potentially deteriorating condition. Often doctors will be trying to make the correct diagnosis based on limited information and little or no access to the patient’s medical records. Added to that, GPs may also be triaging and diagnosing patients over the phone or internet, or supervising other health professionals that are doing so.”
“We are seeing unprecedented increases in the cost of claims from general practice overall. However, nowhere is this more apparent than in the provision of emergency unscheduled care.
“While the Government has set up a Winter Indemnity Scheme to support GPs in England working additional out-of-hours sessions, in the longer term we need root and branch reform of personal injury law to address the rising cost of compensation claims.”
Other findings from the MDU review of claims included:
- The commonest reason for claims was a delay or failure to diagnose a condition which accounted for almost three quarters of cases (71%).
- In 18% of cases, there were allegations about a failure to make a referral or an incorrect referral.
- Claims involving medication issues accounted for 9% of cases, including the wrong drug, dose or regimen prescribed or a failure to appreciate the patient was suffering from known side effects.
- Many cases involved patients with serious and life threatening conditions such as heart attacks, meningitis, septicaemia, appendicitis, cauda equina and testicular torsion. The death of a patient was a feature seen in a quarter of the settled claims reviewed.
- A previous MDU study found that of 15 settled claims for meningitis 40% of cases involved out-of-hours GP consultations
MDU advice for GPs on minimising the risk of out-of-hours consultations includes:
- Put yourself in the best position by reviewing all the patient information available in making a diagnosis. Be prepared to alter this if things change.
- Make sure the patient understands what to expect and watch out for and when to seek further review, and document your management plan and this ‘safety netting’ advice.
- Try to manage patients’ differing expectations and remain polite and professional.
- Record negative findings from the consultation or examination, as well as positive ones.
- Ensure patients are appropriately followed up by secondary care or the patient’s GP practice.
- With telephone/online consultations, be aware of their limitations and be prepared to ask the patient to come in for a consultation if an examination is necessary.
You can find out more about supporting our fair compensation campaign here: www.themdu.com/faircomp
