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Independents' Day

Legal claims for GP medication errors 'up 60%'

Legal claims against GPs for medication errors have risen 60% since 2008, according to medical defence experts.

The Medical Defence Union reviewed 371 claims filed and 408 advice files in the years between 2008 and 2012. Over the time period, the number of files opened increased by 59% from 135 in 2008 to 215 in 2012, the MDU found.

Although the MDU said this was likely driven by an increase in GPs’ prescribing workloads, it said there were a range of things GPs can do to reduce the risk of claims for medication errors.

It said most of the claims where the patient was successful in their claims against GPs were in relation to wrong or inappropriate drugs being prescribed, problems with long-term administration of medication, dose errors and prescribing to a patient with a known allergy.

It advised GPs to ensure they are aware of current BNF, NICE and GMC guidance on prescribing, always check for contrainidications of drugs and to always ask when unsure. GPs should also always go over the patient’s medical history and check against any over-the-counter drugs the patients may be taking.

Out of the 371 actual claims, 109 were successfully defended or discontinued, 86 were settled and 177 remained active.

The MDU paid out £5 million in compensation over the time period and £400,000 in legal costs. The largest payout on behalf of a GP was £1.2 million to a patient who was left severely disabled after a failure to monitor levels of a long-term prescription for lithium, resulting in lithium toxicity, while the average compensation awarded to successful claimaints came in a just over £58,000.

MDU medico-legal adviser Dr Caroline Fryar commented: ‘Most medications are prescribed safely and appropriately by GPs, and even when errors do occur, they may not result in harm to the patient. However, medication errors are one of the main reasons for claims settled by the MDU on behalf of GPs.’

‘GPs are responsible for prescribing and monitoring increasingly complex drug regimes for patients following their discharge from hospital and for an ageing population. This means they need be aware of possible harmful drug interactions and whether a particular medication is contraindicated. It’s also important to remember that GPs bear professional responsibility not only for the prescriptions they sign, but also for the prescribing systems they run within their practice, such as repeat prescribing processes. So it’s important to have robust procedures in place.’

‘We hope our analysis and advice will help GPs and practice staff avoid some of the common prescribing problems that arise as well as helping practices to respond quickly to medication incidents and learn from them to prevent future errors.’

Earlier this year, Pulse reported that GPs are ‘more likely to be sued than ever before’, based on statistics from the Medical Protection Society.

Readers' comments (7)

  • May be we should just stop prescribing for secondary care. After all, "shared care prescribing" is only forcing us to prescibe medication we are less familiar with nor are we expected to use it to treat patients with generalist knowledge yet expected to do all the monitor and be responsible for it (e.g. lithium as above)

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  • The concept of 'joined up care' is clearly a bridge too far for some...

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  • No great surprise there are legal problems as a certain well known consultation system actually covers up the allergy box with a list of QOF requirements! You couldn't make this stuff up.

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  • Agree with Anon 4.53pm. As a patient I'm infuriated that the CMHT I was referred to cannot read and ignored the history given in GP referral letter. Note to Berkshire Healthcare Trust - a psychiatrist is a DOCTOR who can prescribe medication, a psychotherapist is NOT.

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  • In my view there are 3 main reasons .
    1. Increasing complex drug combinations in chronic disease and over prescribing e.g in neurology and psychiatry in particular.
    2. The pressures put on GPs for secondary care prescribing and failings of shared care monitoring.
    3. Newly trained GPs / fast tracked course graduates show a consistent deficiency in applied pharmacology and therapeutics knowledge .

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  • Is this a sign of a more litigious society, or hard pressed GPs making more mistakes through an ever greater workload? What then will happen then when fatigue ++ is added in by the 84 hour working week in addition to the 24/7 commitment to the vulnerable elderly. That's right! More mistakes and eventually some avoidable deaths. Is this what Jeremy Hunt wants? It would save paying pensions to those affected. 'Every Little Helps!!!'

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  • I agree joined up care rarely works. Patients that require monitoring (eg Methotreaxte), come in when they want to for bloods nto when they are needed. Secondary care drugs are increasingly being 'dumped' on primary care, the GP havign no experience with the drug and there being no written information from clinic, and the 'help-line' is always an ansaphone. Even hypertensives that dont coem in for monitoring of out of control BPs. The GP is left with the clinic responsibility of ongoing prescribing in a very poor situation.
    Really the hospital should arrange all blood testing and monitoring and post out the prescriptions - I'm sure patients would have something to say about it though!

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