Fear of legal action impacting on way GPs practise

Survey reveals that fear of legal action is impacting the way that GPs practice – impacting medical decisions such as making referrals, ordering tests and prescribing medicine

A significant number of GPs say the fear of being sued is a major factor in their decisions to order more tests, make more referrals or prescribe medication – according to survey results published by a leading medical protection organisation.

In the survey of over 1300 UK GPs by the Medical Protection Society (MPS), 87% said they are increasingly fearful of being sued. 84% said the fear of being sued has resulted in them ordering more tests or making more referrals and 41% said it has resulted in them prescribing medication when not clinically necessary.

The survey results follow research by Imperial College London showing that four in five doctors who have been the subject of a complaint also now practise more ‘defensively’.

MPS, a not for profit organisation supporting 300,000 healthcare professionals worldwide, said GPs routinely order tests and make referrals to other specialists to confirm a diagnosis, and may naturally be more cautious in a litigious environment. However, it warned that if the fear of legal action is driving decisions on additional tests and referrals that are not necessary, this is different and a potential societal concern.

MPS said a range of measures* are needed, but pointed to the ‘cultural acceptability’ to sue when only minor injuries or inconveniences are sustained, and there is no loss of income. It called for a minimum threshold for these types of cases which would mean the financial loss caused by an injury would have to exceed a minimum threshold before a claim could be made. In a YouGov survey of over 2000 adults, 65% said it has become easier to make a claim for clinical negligence than ever before, and 33% said they should have access to compensation when something goes wrong regardless of whether harm was caused.

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Dr Pallavi Bradshaw, Senior Medicolegal Adviser at MPS, said: “These survey results raise concerns about how the fear of being sued is manifesting itself across the country, and we call on the Government to undertake more in-depth, definitive research to fully understand the issue and its impact. Unnecessary tests or investigations are not in the best interests of patients and may use up limited NHS resources.

“Doctors should be able to exercise their clinical skills and judgment 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.

“We must get to the heart of why so many patients sue their doctor. This includes making continual improvements in patient safety to prevent adverse incidents, but we must also look at legal reform to tackle the cultural acceptability to sue for minor injuries or inconveniences.  In 2016/17 there were 817 clinical negligence claims against the NHS for minor injuries, where the compensation paid was less than £3,000.

“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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