Cookie policy notice

By continuing to use this site you agree to our cookies policy below:
Since 26 May 2011, the law now states that cookies on websites can ony be used with your specific consent. Cookies allow us to ensure that you enjoy the best browsing experience.

This site is intended for health professionals only

At the heart of general practice since 1960

GPs more compelled to seek legal advice after patient suicide due to increased scrutiny

The number of doctors seeking legal advice in the wake of a patient’s suicide has more than doubled in the last decade, despite an overall decline in suicide rates, the Medical Defence Union has found.

The MDU was contacted about patient suicides 259 times in 2013, compared with 113 in 2004. It has already been contacted 180 times so far in 2014, of which more than half of contacts - 56% - have been from GPs.

Legal experts say the growth in requests for guidance may be a result of increasing scrutiny doctors are under in the wake of a death.

MDU medico-legal adviser Dr Richenda Tisdale said: ‘When a suicide occurs, relatives usually ask what steps healthcare professionals took to help their loved one. There will also be an inquest, at which the deceased’s doctor may be asked to give evidence.’

‘The increase we are seeing in MDU members wanting support and guidance in this area may be because doctors are coming under closer scrutiny when a patient commits suicide.’

Dr Tisdale added managing mental health conditions in particular can be difficult for doctors, saying: ‘GPs in particular are on the front line for the identification and management of mental illness. Of the 180 cases notified to the MDU so far in 2014, over half (56%) were from GPs. Around a third (29%) came from psychiatrists, and the remainder from other specialties.’

The MDU have issued guidance on avoiding common pitfalls when treating patients with depression, including:

  • Be alert to the possibility of depression in patients with a history of mental illness, chronic health conditions and vulnerable groups such as the elderly or young.
  • If it isn’t possible to discuss all of a patient’s mental health concerns in one short appointment then ask the patient to come back for a longer appointment and book this straightaway.
  • Document discussions with patients carefully. If they are seen by a colleague at the next appointment, it should be clear from the notes that the patient has had depressive symptoms or suicidal thoughts.
  • If the patient fails to attend a follow-up appointment, it is advisable to try to contact them to find out why. The MDU is aware of cases where opportunities may have been missed to review a patient.
  • Encourage the patient to allow you to involve close family members or friends who may be able to offer additional support. Bear in mind your duty of confidentiality although it is not a breach of confidentiality to listen to the concerns of a relative or friend.

 

Readers' comments (6)

  • In the 20yrs that I was Deputy Coroner for the City of London and Inner West London I never once found it necessary to call a GP to give evidence." A field day for lawyers"?

    Unsuitable or offensive? Report this comment

  • "If it isn’t possible to discuss all of a patient’s mental health concerns in one short appointment then ask the patient to come back for a longer appointment."

    I have also heard advice not to do this as it encourages unrealistic expectations in the patient:

    In truth, a GP will typically have ten minutes to deal with any given patient on any given occasion. If we set up a pattern of leisurely 40min end-of-surgery chats on a Friday afternoon, we are encouraging an consultation pattern which does not help doctor or patient to make best use of their time.

    Unsuitable or offensive? Report this comment

  • What about the GMC and their role in GP suicides.
    I trust that for openess and transparency they are scrutinised .

    Unsuitable or offensive? Report this comment

  • "If the patient fails to attend a follow-up appointment, it is advisable to try to contact them to find out why. The MDU is aware of cases where opportunities may have been missed to review a patient."

    Whilst I appreciate the logic in this, MDU is acting in self defense rather then providing a practical advice. I (and local mental health trust) have freq DNAs, especially from small potion of patients. I simply don't have the luxury of time to do this. This will also encourage certain patients to DNA only to be called up and given another appointment whilst other patients are struggling to get an appointment for their illness.

    I'm afraid this kind of defensive pampering is what got us into our current plight.

    Unsuitable or offensive? Report this comment

  • SIMPLY ASK PT IF HE HAD THOUGHTS ONLY OR PLAN. ADD ON PHQ9 IF ANSWER IS "NO PLAN ". ASK PT TO SIGN IT.
    ASK PATIENT TO MAKE APPOINTMENT IN 2 WEEKS AT RECEPTION. THIS PROVES HE HAD NO INTENTION OF SELF HARM.
    IF HE STILL GOES AHEAD THEN THERE IS LITTLE ELSE ONE CAN DO.

    Unsuitable or offensive? Report this comment

  • So sadly in spite of our best efforts, this problem will arise. Inspite of repeated attendances, counselling and medication, some people still kill themselves.
    There is so much increased depression in this economic culture of cuts.
    We GPs have to deal with so many, many things way beyond our expertise because of cuts in services. But we will get the blame for this, never the person[s] who took away funding.
    Consider Mid-Staffs where 300 frontline staff were removed; it fell from 5* to horror purely due to funding cuts. But here is the true terror, Francis points his finger at the overworked remaining staff for not caring.
    The moral of this story is this. As long as GPs cling to list size rather than an appointment system of pay, we will have more and more work dumped on us.
    Why do you think all the older GPs are leaving?

    Unsuitable or offensive? Report this comment

Have your say