Are GPs responsible for patients outside their care? Case in focus

In a pressurised and evolving healthcare environment, expectations placed on GPs are rising. But when does duty become a risk? The Medical Defense Society explores a real-life case that reveals the professional, ethical and legal tensions GPs face at the edge of their defined responsibilities.

This is part of the Pulse Partners series. This article has been paid for by the Medical Defense Society, with editorial input by Pulse. The opinions in this article do not necessarily reflect the views of Pulse

Summary of the complaint

One weekday afternoon, while clinicians were fully engaged in patient consultations, a registered patient of a high-volume urban practice fell and sustained head trauma and suspected rib injuries outside a shop located directly across the road from the surgery. Emergency services were called promptly, but the ambulance response time was estimated to be two hours. As minutes passed and bystanders grew concerned, a request was made for a GP from the practice to attend to the patient at the scene. The request was acknowledged, but no clinician left the building.

The practice subsequently received a formal complaint from the injured patient, who alleged that the surgery had failed in its duty of care by not intervening. The complaint focused heavily on the physical proximity of the incident, the patient’s registration status with the practice, and a perceived lack of compassion. The situation quickly raised complex questions: does duty of care extend beyond the physical walls of the practice? Can an instinct to help override operational boundaries? And how should GPs navigate split-second ethical decisions under public scrutiny?

The GPs’ case

At the time the request was made, all GPs were actively consulting with other patients. Leaving those appointments would have meant abandoning ongoing care, potentially breaching duty to those patients and introducing further clinical and legal risks. The surgery is not designated as an emergency care facility, and no clinician onsite was equipped to manage a trauma case outside a clinical setting. It was, by all measures, an uncontrolled and unpredictable environment.

In reviewing the case, the Medical Defense Society’s legal team evaluated whether a duty of care had been established under these circumstances. GMC guidance states that doctors must make the care of patients their first concern and take prompt action if they believe patient safety is compromised. However, this duty is generally understood to apply within the context of a professional relationship, namely, when a patient is actively under the care of the clinician, either through presence, request, or appointment. In this case, while the patient was registered with the practice, they had not presented at the surgery nor made direct contact with the clinical team. No GP had assumed care of the patient at the time of the incident.

Moreover, the legal team highlighted the contractual realities. Under the NHS Standard Contract and CQC regulations, GPs are obliged to deliver care that is safe, effective, and within scope. They are not expected or obligated to respond to off-site emergencies unless they are directly involved, or the incident occurs on practice premises. There are, of course, moral considerations that can weigh heavily. The instinct to help, to cross the road, to act is natural and deeply human. But in these moments, GPs must also consider risk to themselves, to their current patients, and to the overall safety of the care environment. These are not decisions to be taken lightly.

In managing the fallout from the complaint, the surgery responded by explaining its actions clearly, referencing the timely call to emergency services, the constraints of clinician availability, and the risks associated with leaving active consultations. Calm and comprehensive documentation supported the response. The involvement of indemnity experts early on ensured that the practice was able to frame its position within accepted legal and regulatory standards, while also showing empathy to the patient’s distress and acknowledging the emotional complexity of the event.

The outcome

Following the initial complaint response, the complainant requested additional information as she intended to escalate the matter to the GMC.

However, none of the GPs in the practice had been made aware of the issue at the time, as it had been handled solely by the practice manager. As such, there was no valid basis for a referral to the GMC. The matter was ultimately resolved through a face-to-face meeting between the complainant and the practice team, during which the concerns were discussed and addressed.

Subsequently, the legal team collaborated with the practice and the Local Medical Committee to review the current approach in the context of broader practice standards.

This ensured that the practice’s procedures were aligned with all relevant policies, GMC guidance, and the requirements of the GMS contract – providing reassurance and a clear framework should a similar situation arise in future.

Lessons learned

Cases like this are becoming more common. GPs are increasingly expected to fill the gaps left by under resourced services from mental health to emergency response, social care to community safety. As the system strains, the public perception of the GP as a universal safety net only deepens. The boundaries of duty are blurring, and clinicians are often left to make difficult calls in real time, with little guidance and high emotional stakes.

There are lessons here that go beyond legal process. Physical proximity does not automatically confer a professional obligation. Context, capacity, and competence all matter. Practices should consider developing internal protocols for handling emergency requests from the public particularly when those requests fall outside the surgery doors. Reception teams and practice managers should be trained to respond confidently and clearly, reducing the pressure on individual clinicians in the moment. There is also an urgent need to improve public understanding of what GPs can and cannot provide. A clear, respectful conversation around scope, responsibility, and system wide limitations can help manage expectations before incidents arise.

Crucially, real time documentation of decisions including who was involved, what was communicated, and why certain actions were or weren’t taken provides a safeguard for everyone involved. In complaints that hinge on perception and emotion, contemporaneous notes can make all the difference.

At a wider level, there is growing consensus that the structures surrounding GPs must adapt. From onboarding new clinicians with clearer training on duty-of-care boundaries, to equipping practices with resources to debrief after stressful events, the culture must evolve alongside the expectations. The GMC’s Good Medical Practice 2024 guidance acknowledges the psychological impact of complaints on clinicians and calls for compassionate systems that enable open discussion and timely advice. This is a positive step but more is needed.

At the Medical Defense Society, we continue to advocate for early access to advice, strong legal foundations, and supportive frameworks that respect both clinical judgement and emotional wellbeing. GPs are not emergency responders in the traditional sense but they are under increasing pressure to act as if they are. We must be realistic about what the profession can deliver, and proactive in how we support it.

No GP should be left to navigate these blurred lines alone. Whether it’s a complaint, a moment of uncertainty, or a public facing incident like this one, support should be immediate, human, and grounded in the reality of general practice. Because in modern medicine, the question isn’t just ‘What should I do?’ it’s ‘What am I expected to do, and what protects me when I do it?’