This slide is about the challenges in general practice. GPs won’t send off patients for brain CT or MR scans. Red flag symptoms will result in prompt referral, but a substantial amount of early presentation of sinister illness will not necessarily have red flags.
The problem arises when there is a perception on the patient’s part that when they first presented with headache the doctor should have suspected the possibility of a tumour and arranged investigations or referral. It is this mis-match between patient expectation and what is clinically deliverable that can be a potent driver of claims. So in this example there may be no discernable clinical error or patient safety incident but the poor outcome coupled with an early symptom that was possibly attributable to it may be sufficient to drive a claim.
Patient safety initiatives are unlikely to have any impact on this type of claim because they may be unrealistic or unachievable – you cannot CT scan everyone with a headache or refer them to secondary care.
Furthermore, the assessment of the patient by the GP may have been reasonable and professional – there may be no features associated with this doctor that would correlate with a future claim. This is a further problem with GP indemnity – claims can arise out of the blue against practitioners who practise safely – and they can arise decades after the event. Indemnity payments have to take account of these uncertainties.
The existence of a huge reservoir of injuries mean that claimant’s solicitors can raise or lower the rate of claims at any given time, depending on the business directions and permissiveness of the legal environment.
Presentatie Judith Clark
Risk – The MDU experience
Dr Judith Clark
Clinical Risk Manager
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