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Compensation payouts for poor out-of-hours care top £30m

MDU says claims related to GP out-of-hours and unscheduled care are rising

Mark Gould

Tuesday, 24 January 2017

A doctor's indemnity organisation has paid out well over £30 million in compensation and legal costs on behalf of GPs working in out-of-hours and unscheduled care settings over a three-year period. This included a number of high value cases settled for over £1 million.

The Medical Defence Union (MDU) said the most common reason for a claim 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.

The MDU reviewed its 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 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," he said.

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 Dr Campbell calls for "root and branch reform of personal injury law to address the rising cost of compensation claims".

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