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CAMHS won't see you now

GPs urged 'step up lung Ca vigilance'

GPs are being unfairly blamed for missed or delayed diagnosis because of 'failures in communication' with patients or grieving relatives, a Government-commissioned study says.

The research leader said GPs sometimes faced legal action even when they had done 'everything right' but could avoid problems by communicating effectively with the bereaved.

Half of medical negligence cases arise from diagnostic problems and another 5 per cent from failure to refer patients, according to the analysis of 3,000 cases from the five main medicolegal databases.

Cancer, pregnancy complications, meningitis and appendicitis were among the diseases most often missed ­ with childhood conditions causing GPs particular problems.

Researchers made recommendations for avoiding claims, including improved communication with patients and other doctors, more careful history taking and use of diagnosis support systems for rare diseases (see box).

The study, published in a National Primary Care Research and Development Centre report, found 5 per cent of cases against GPs involved prescription errors and 5 per cent failure to warn of or recognise side-effects. A fifth involved the death of a patient.

Research leader Professor Aneez Esmail, professor of general practice at the University of Manchester and a GP in the city, said: 'There is something in how we as doctors deal with suffering and loss. Doctors end up in litigation because people feel dissatisfied, things are not explained to them.'

A second study by the Medical Protection Society highlighted paediatric problems as a key area of risk, responsible for 15 per cent of claims. Two-thirds of claims in children involved failed or delayed diagnosis.

Professor Esmail added: 'There are cases where the doctor did everything right yet missed meningitis. Sometimes people die in spite of good doctoring. We have to learn to deal with that.'

How to reduce the

risk of litigation

·Careful history taking, documentation and use of monitoring equipment can prevent problems at early stage of diagnosis

·GPs need diagnostic support for rare diseases and to keep their knowledge up to date

·Better communication with patients and relatives can prevent subsequent claims

·Strong communication systems with other doctors can help prevent errors

·GPs should make careful notes of any deviations from NICE guidelines

·Inexperienced doctors should be able to decline work outside their competency

Source: NPCRDC annual report

By Nerys Hairon

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