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Consultants are instructing GPs to follow up hospital-ordered test results, BMA finds

There is a trend of hospital doctors instructing GPs to find out hospital test results, which is ‘potentially unsafe’, the GPC and Consultants Committee of the BMA have said.

The warning was included in joint guidance by the two groups on the duty of care for hospital test results, which said that the ‘ultimate responsibility’ of following up results lies with the person ordering the tests.

The guidance stresses that any handover of responsibility has to be a joint consensual decision between the hospital team and the GP.

It states: ‘We are aware that in some areas, some hospital doctors have been instructing GPs to find out the test results which the hospital had ordered. Both the GPC and the Consultants Committee of the BMA agree this practice is potentially unsafe, and that the ultimate responsibility for ensuring that results are acted upon rests with the person requesting the test.

‘If the GP hasn’t accepted that role, the person requesting the test must retain responsibility.’ 

Updated guidance also warns that the issue of drugs recommended from outpatient clinics to patients and their GPs is complex and ‘patient safety can be compromised’.

‘Drugs required for urgent administration should be prescribed by the hospital doctor, and if appropriate dispensed by the hospital,’ states the duty of care.

Readers' comments (23)

  • A consultant holds a CCST in a speciality. I hold a CCT in primary care, ergo, we are of equal status, and I do not work fo ar consultant as a community house officer. Thus any requests to chase results by a consultant are robustly bounced back. It would be nice however not to have to do this bouncinb back 2-3 times a week.

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  • It is a symptom of Consultants ( we clever ) GP's ( you dumb) . It explains why after exposure to this mind set no students want a primary care career.

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  • Yes! This is a daily occurrence. The other variant is getting a scrawled discharge summary with the brief information that a change has been made to the patient's medication while they were an inpatient, or that an abnormality has been found, and the peremptory instruction, "GP to monitor," without any further details of what requires monitoring and why and at what interval and on whose behest, and without so much as a "please". I suspect this is a reflection of time-pressed and undertrained junior hospital doctors and ward staff, so I'm disinclined to bounce these letters back to the discharging consultant, but it's very much not OK.

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  • Community House Officer is an accurate term, discharged from hospital with outstanding tests that Gp should order;colon polyp/gallbladder polyp for GP to refer back for surveillance, (what happens when pt moves away?) could be automatically recalled as in DM retinals screens, FOB screening and so on

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  • While most of the Consultant's realize the state we are in, there are some real bonkers there that tell you to even do blood forms and then send them the results.
    Or, better still, on the discharge there is a note saying 'GP to commence xxx medication' and this is not included in the patient's discharge drugs.
    Consultants have 20-30 min appointments, secretaries, they are paid extra for home visit and yet there is an instruction on one in 4 letters for the GP to do something.
    BTW, we are the only group that is not paid extra for home visits and have to pay the local provider - MEDDOC- 89.50 for a home visit to our patient while government pays only 77 per patient per year.
    Our local OOH Provider is contracted by the CCG to provide an OOH service after 6:30 but if the patient calls in 2 mins prior to cut off time - it is billed to the Surgery although visit is done during the CCG contracted hours - around mjidnight at times- which seems to be double billing for the same visit (?)
    Didn't know till yesterday that Pharmacists are paid for using EPS while we are doing it for free although our GMS Contract does not say this is mandatory.

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  • It is a useful axiom that whoever orders a test should be responsible for the result. It has the benefit of absolute clarity and shouldn't be discarded.

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  • It's not about being community house officers, it's the disregard to patient safety and increasing of mdu subscription costs which up is frustrating

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  • Simply man up and direct patient back (via a&e) if necessary or suck it up and hide behind your woollen jumper. Most GP' do the latter, hence the predicament we are in today.......

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  • We should work out a tariff system . Supply the services for which we are resourced and then everything else is an extra charge or not done. Pay for bronze get bronze ,mate!

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  • We have a benign, submissive GPC and RCGP.

    The main problem is that most GPs and RCGP / GPC still think that by moaning the Government will eventually put more financial resources into primary care. This is not going to happen. Don't forget that secondary care is now poorly resourced as well.

    Collectively all Doctors should be coming together to design a new NHS with private health insurance packages. The Government can part fund this if they wish, but we must make sure that our service meets high standards so that patients receive an excellent level of care without the burn out of Doctors and Nurses. Work load must be manageable and financial remuneration reasonable.

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