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GPs should be careful declaring patients fit for extreme sports, warns MDO

GPs should be careful declaring patients fit for extreme sports, warns MDO

GPs should be careful and ‘remain objective’ when declaring patients fit to participate in extreme events, according to a medical defence organisation.

The Medical Protection Society (MPS) has warned that such requests from patients are high in summer, when activities such as skydives, marathons and swimming challenges are more popular.

Since signing ‘fit to participate’ forms is not contractual and would be considered private work, GPs are not covered by the state-backed indemnity scheme

As such, the MPS has strongly recommended GPs ensure they have adequate professional protection to cover any instances where the patient may become injured and make a clinical negligence claim for compensation.

The organisation said that compensation claims could be very high so practices should ideally ensure their protection has no limits.

MPS deputy medical director Dr Sarah Townley said GPs can often ‘feel under pressure’ to sign such forms as patients are participating in ‘once in a lifetime events’ and may have raised money for charity. 

However, she warned: ‘Sadly, although very rare, when extreme events go wrong the injuries may be serious and the compensation sought if a claim is successful may be high – even into millions of pounds. GPs will struggle to pay this from their own pockets.’

The defence organisation has also advised that protection covers all GPs in the practice, in case ‘a claim against a GP without adequate professional protection is deflected to the practice under vicarious liability or non-delegable duty of care’.

Dr Townley said: ‘Once adequate indemnity is ensured, we would always advise GPs to remain objective when asked to sign fit to participate forms. They should take a detailed history from the patient and review any relevant clinical notes. 

‘They should feel confident that they have sufficient knowledge about the patient and the nature of the event, and should avoid undertaking assessments beyond their area of clinical competence.’

She added: ‘Where a patient’s medical history is not straightforward or they are under the care of a specialist, the GP may wish to obtain advice first or refer the patient to a doctor with relevant expertise. The GP should fully explain their actions and any concerns to the patient.’

Last month, the Government invited GPs to respond to a consultation on further extending the pool of professionals who can sign fit notes for the Department of Work and Pensions.

The group was extended out to nurses, occupational therapists, pharmacists and physiotherapists last summer under legislative changes.

And earlier this month, the Government suggested in future it may encourage GPs to refer patients to life coaches and job support schemes instead of signing sick notes.



Please note, only GPs are permitted to add comments to articles

Robert Caudwell 18 August, 2023 3:26 pm

An easier option, with no risk of being sued would be to say no?

Avradeep Chakrabarti 18 August, 2023 5:35 pm

Best answer is No and advise they see a doctor specialised in the sport they want to do.

Nicholas Sharvill 18 August, 2023 6:09 pm

So sad to se this from a defence organisation. I wonder if there are case reports when this has happened? For many what we are checking is not if the said sport or experience is safe, that is for the individual and the organisers to sort. What we are assessing is if there is any major risk that can be predicted from a history and examination that should prevent them taking part or put theta extra risk should they do so. What we don’t want , in my view is to get to the sad sate of things such as in France where you cant take part in a Park run with our a medical certificate .Hence no park runs in France . As such park runs are possibly the greatest thing we have in the Uk for physical and mental health to disappear would be a major negative effect on peoples health. As A GP you can charge for this and it is actually a pleasant way of spending clinical time. I find it alarming that the defence organisation hinted you would not be covered. i though we all paid”extra” for non NHS work cover assuming it is only tiny part of our work?

Not on your Nelly 18 August, 2023 6:11 pm

No. There Is no other option for an nhs GP. Also a complete sentence

Some Bloke 18 August, 2023 7:53 pm

Isn’t this just indemnity organisations reminding of their relevance? This sort of work will not be covered by NHS resolutions, so don’t forget to get the cover you need for your private work with us.

Dr No 19 August, 2023 10:43 am

I’d be interested to know if this has EVER happened (being sued after a “Fit To” letter). It’s unlikely organisers will stop asking for such things. It seems very churlish not to help. Provided of course there are no obvious problems. If it’s for charity I never charge a fee anyway.

David Banner 20 August, 2023 11:57 am

Why do such “charidee” stunts have to involve daft narcissistic feats of ego-inflating life-threatening danger?
If you really desire to appear in the local paper with a giant cheque raising funds for some no doubt worthy cause try a sponsored silence or go sit in a bath of baked beans.
Or even better donate your own money anonymously.
Just don’t expect your hapless GP to risk financial ruin pandering to your reckless whim to risk life and limb harvesting “Likes” and “You Go Girl!”s on Facebook.

Rebecca Lewis 21 August, 2023 6:09 pm

this nonsense would all stop if the patient participating in such “events” was required to take out the same level of insurance as one does (sensible folk anyway) to go on holiday, or insure your car etc etc. If this was the case, I suspect no-one would be doing anything like this for charity if they had to pay some insurance company mega-bucks in case they came off worst! when purchasing holiday insurance- it is often extra for sports cover like skiing as it is recognised to be risky, so perhaps patients should be sign posted to get a quote from “compare the market”!

J Landen 25 August, 2023 10:37 am

Every year we see otherwise fit young to middle aged individuals die in marathons. The only way to be sure is ECG/Echo which is apparently the way France works. Very sad. Given the medicolegal risk I no longer complete these forms.