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GPs go forth

GPs must obtain ‘valid consent’ before minor surgery, MDU says

GPs must ensure they have fully informed patients to gain valid consent before carrying out minor surgical procedures, the Medical Defence Union has warned.

The advice came following a routine review, carried out by the MDU, into 112 complaint and claim cases notified by GP members in a recent four-year period.

The most common complaints were related to post-operative complications such as infections, bleeding and scarring, which accounted for 37% of the 112 cases. Delays in diagnosis or referral accounted for 15% of cases, with unsuccessful outcome and scarring accounting for 9% each.

While many of the claims are still active, 18 of the 112 cases were settled by the MDU for compensation fees of just over £410,000, ranging from £500 for a diathermy burn to over £220,000 for post-vasectomy pain.

The advice, which consists of nine key improvement areas, encourages GPs to make sure they have provided patients with the appropriate information about a procedure and follow-up treatments before the procedure takes place.

GPs must also keep their surgical skills up to date and carry out regular audits of minor surgeries, such as clinical outcome, it added.

Medico-legal adviser Dr Ellen O’Dell said: ‘Minor surgery performed in general practice settings will, in most cases, offer patients a quicker and more convenient alternative to seeing a specialist, but occasionally problems can arise which may lead to a complaint or claim.

‘Post-operative complications are a risk in any invasive procedure so careful monitoring is important. In six cases in our study, patients complained that they hadn’t been properly warned about possible complications or scarring. It is important that patients are provided with sufficient warnings as part of the consent discussion and that this is documented in the patient’s notes.’

Readers' comments (4)

  • Vinci Ho

    A matter of interest.
    What is the percentage of GP practices offering vasectomy ??

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  • Can I assume that secondary care surgeons also audit their work?

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  • The need for informed consent for surgery is hardly news. The real news is that GPs are still willing to do minor surgery for a pittance.

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  • Informed consent is not a requirement under UK law as in the US and other Countries (The MDU is canvassing work for the legal profession, as always, by complicating matters). The responsibility lies with the patient. Ethically, because most patients' minds blank out at the sight of a white coat, one should explain profusely and allow a cooling down period.

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