GPs hit back over 'rising OOH complaints'
GP leaders have hit back over the soaring number of complaints by patients over out-of-hours care – and have warned that they are under a much more demanding workload than ever.
The new GPC chair Dr Laurence Buckman spoke out after both the Medical Defence Union (MDU) and Medical Protection Society (MPS) revealed that complaints against GPs which related to out of hours cases had jumped since the introduction of the new GP contract in April 2004.
The number of complaints referred to the MDU over out-of-hours contacts has increased from 120 in 2002 to 182 in 2006 – a rise of 52%, according to its head of risk management and underwriting Dr Stephen Green.
The MPS recorded 77 complaints between 1996 and 2000. In 2003, the last year before GPs were able to opt out, it dealt with 30 new complaints. In 2006, that figure rose to 100.
Dr Green said many visiting doctors lacked access to crucial medical data on the patients they saw out-of-hours and had little knowledge of their history.
Saying that the problem could be mitigated in future by access to computerised records on the NHS spine, he stressed that accurate records were never more vital than when dealing with patients out-of-hours.
And he added: "It's also vital for patient safety that there are reliable and consistent communication links between GPs and the out-of-hours service."
The MPS revealed that out of hours complaint cases have tripled since the new contract kicked in three years ago. Its figures show that its officials began dealing with 30 new cases in the UK in 2003 but by 2006 that had risen to 100.
But Dr Buckman said this could partly be explained by patients not being able to see their regular GP.
'I think this is more likely to make them complain about the care they receive,' he said.
He stressed: 'It doesn't mean that the care is worse but I do think doctors could improve their communication with patients. We have to remember that these people are often anxious and not well and need to feel reassured.'
Dr Buckman said a practice workload survey had shown that the average length of a consultation had risen from 8.4 minutes to 11.7 minutes since 1992/3.
'What has changed is the way we work. Intensity has rocketed. Patient care that used to routinely take place in a hospital setting – such as diabetic care, cardiac care and asthma care – is now done routinely in general practice,' he said.
Dr Buckman said family doctors were now working under 'much greater pressure' and were being much more closely scrutinised than before.
Dr Mary Church, a GPC member and GP in Glasgow, said: 'Out of hours was hugely under-funded before the new contract and survived only because of GPs' goodwill. So, surprise surprise, what's replaced it appears to be struggling. The constant undermining of the quality and quantity of GPs in hours work, the complaint culture and ever-increasing demand and expectations of the public have all contributed to the loss of that goodwill. If you want a high-quality service, then fund it properly and let GPs work acceptable hours like everyone else.'
Dr Peter Fellows, a GP in Lydney, Gloucestershire. said it was the responsibility of PCTs to organise and staff out-of-hours services. 'GPs were never properly paid for out-of-hours. GPs had had to run co-operatives to provide god cover,' he said.
A DoH spokesman said the new contract, which allowed GPs to opt out of responsibility after 6.30 p.m, was an improvement on the old system which had put an unacceptable burden on family doctors.Dr Laurence Buckman: GPs are working harder than ever Dr Laurence Buckman: GPs are working harder than ever