latest health care news

21.12.17

GPs order unnecessary tests due to fear of litigation

GPs are changing their practice due to fear of being sued, a new study has found.

In a survey carried out by the Medical Protection Society (MPS), “a significant number” of GPs revealed that the prospect of litigation is a major factor in their decision to order more tests for patients, make more referrals, or prescribe medication.

Over 1,300 UK GPs were questioned, with 87% saying that they are increasingly fearful of being sued, and 84% revealing that they had ordered more tests or made more referrals because of the threat.

These results follow recent research by Imperial College London which showed that 80% of doctors who have been subject to a complaint now practice medicine “more defensively.”

One GP said: “The stress, anxiety and sleepless nights this causes us is terrible and disproportionate - time that could be spent caring for patients and reviewing process and protocol to improve future care is spent worrying about this.

“It also leads to defensive practice, over-investigating and that itself incurs more cost to the NHS.”

In a climate where the UK is experiencing a critical GP shortage, one respondent said: “I now practice in a world where I am frightened at the beginning of each day, and because of this, I am retiring early.”

The society also said that it is natural for GPs to be more cautious in a litigious environment, but warned that doctors being forced to carry out additional tests and unnecessary referrals, is a “potential societal concern.”

The MPS has called for a minimum threshold of financial loss caused by an injury before a claim can be made, saying that there is a “cultural acceptability” to sue when only minor injuries or inconveniences are sustained.

In 2016-17 there were 817 clinical negligence claims with damages paid out amounting to under £3,000, including the delayed diagnosis of a foot injury where the patient made a full recovery, and the wrong sized thromboembolic stockings being applied to a patient.

Dr. Pallavi Bradshaw, senior medical advisor at MPS, said that the results “raise concerns about how the fear of being sued is manifesting itself across the country,” and called on the government to carry out more in-depth research to fully understand the issue.

She added: “Unnecessary tests or investigations are not in the best interests of patients and may use up limited NHS resources.”

She argued that doctors should be able to exercise their clinical judgement without the fear of claims affecting their decision making.

“A full-time GP can now expect to receive two clinical negligence claims over their career; the environment is challenging and the temptation to over prescribe or over investigate is understandable,” she explained.

Bradshaw said that while it is important to make continuous improvements in patient safety to prevent adverse incidents, there should also be a legal reform to tackle the “cultural acceptability” to sue for minor injuries or inconveniences.

She went on to say: “While those who suffer serious and long term harm due to clinical negligence should be reasonably compensated, it is right that we question the extent to which those who sustain minor injuries can recover compensation.

“We are calling on government to consider a minimum threshold for these types of claims and we stand ready to work together on what we recognise is a difficult debate.”

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