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, commented, ‘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.’
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 per cent)
- In 18 per cent of cases, there were allegations about a failure to make a referral or an incorrect referral
- Claims involving medication issues accounted for nine per cent 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 equine, and testicular torsion. The death of a patient was a feature seen in a quarter of the settled claims reviewed