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GPs buried under trusts' workload dump

GPs blame admin failures for their clinical mistakes

GPs find it 'cathartic' to report their own mistakes but tend to blame their clinical errors on administrative or organisational failures, research reveals.

The findings emerged after the Government's National Patient Safety Agency revealed plans to 'encourage' GPs who make errors to identify themselves to their primary care organisation.

The agency said PCTs should be able to identify GPs for 'local learning and action'. But a spokesman stressed that its national database of NHS adverse events ­ due to be rolled out from November ­ would only store anonymous and untraceable data.

Dr Aneez Esmail, who presented findings of his pilot study of 61 GP adverse event reports to a joint agency and RCGP conference earlier this month, warned that GPs would cover up their errors if they could be identified.

Dr Esmail, medical adviser to the Shipman inquiry and a senior lecturer in general practice at the University of Manchester, said two-thirds of GPs who reported mistakes blamed administrative or organisational failures. In contrast, insurance claims suggested the 'large majority' of GP errors were clinical.

'The truth probably lies in between,' said Dr Esmail. 'The proportion of errors down to clinical knowledge and skills is probably higher than we think.'

Martin Fletcher, the agency's assistant director of patient safety (north), told the conference GPs were deterred from owning up to mistakes by a 'culture of secrecy' and the fear of 'dobbing in mates'.

GPs also felt pressure to be 'infallible' and feared damage to their reputation, he added.

But Dr Maureen Baker, director of primary care at the agency and honorary secretary of the RCGP, said the agency's own reporting pilot suggested most GPs would be willing to identify themselves.

She added: 'Ultimately you get most learning where people can very openly discuss an incident when something's gone wrong. But changing a culture doesn't happen overnight.'

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