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At the heart of general practice since 1960

GPs urged to review procedures for meningitis

By Gareth Iacobucci

GP practices could be liable for millions of pounds in damages unless they revamp their procedures for managing patients with suspected meningitis, the Medical Defence Union has warned.

The advice comes after a review of cases by the MDU found those involving a missed diagnosis of meningitis were the most costly.

This has prompted the MDU to publish new advice on its website for GP members, including a series of risk management questions for GPs to gauge their preparedness to deal with the condition.

Their review found the organisation had paid a staggering £22million to settle just 34 medical negligence claims relating to delays in diagnosing the infection since 1998.

Meningitis and meningococcal septicaemia accounted for only 2% of cases notified by the MDU's GP members, but they amounted to 15% of the payments made to settle claims, reflecting the severe injuries that can result from a delay in diagnosis.

Payments have ranged from £7,000 to £6.8m, with the latter amount paid on behalf of a GP member in 2009 - the MDU's highest ever claim.

The organisation said five further claims have been settled in excess of £1m since 1998, and a further 20 notified claims are currently valued in excess of £1m.

It said children were particularly at risk, with two thirds of cases (22 claims) involving children under eighteen and over a third of cases (13) in patients under five.

Dr Karen Roberts, MDU medico-legal adviser, encouraged GP to take steps to lessen their chances of missing a diagnosis of meningitis.

‘Meningitis is a difficult infection to diagnose, particularly in young children, because patients often present with non-specific symptoms in the early stages.

'Added to this, patients can go downhill quickly so it is important that doctors remain alert to the importance of recognising and treating the illness early on.'

She added: ‘There are also a number of helpful guidelines such as the recently published NICE guidelines on the management of bacterial meningitis and meningococcal septicaemia in children, which includes a checklist of signs and symptoms of the infection.'

Meningitis cases are often in the under-fives Where practices can improve

- Ensure a diagnosis of meningitis is excluded, even if only considered briefly
- Conduct and document a full clinical, or if appropriate, a telephone assessment of the patient
- Listen to patients' and parents' concerns

Source: MDU
- Arrange a reassessment if necessary
- Ensure patients and parents know what to do if a patient becomes more unwell in the meantime

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