GP fears over claims affecting practice, finds MPS

The fear of being sued is a major factor in a significant number of GPs’ decisions to order more tests, make more referrals or prescribe medication, a Medical Protection Society (MPS) survey has found.

The MPS survey of more than 1,300 UK GPs revealed that 87% are increasingly fearful of being sued, while 84% said this has resulted in them ordering more tests or making more referrals.

Some 41% of GPs said the fear 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’.

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.”

One GP who responded to the MPS survey was quoted as saying: “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.”

“Doctors should be able to exercise their clinical skills and judgment without the fear of claims affecting their decision-making,” Dr Bradshaw explained.

“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.”

MPS recommended introducing a package of legal reforms “to create a more proportionate and sustainable system”.

These reforms include considering a minimum threshold for cash compensation relating to claims where only minor injuries or inconveniences are sustained—to help tackle the cultural acceptability for claims to be made for minor injuries.

Dr Bradshaw commented: “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.”

Mark Dugdale