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GP consultations undertaken remotely - either online or by phone - may lead to serious harm and even death, a recent study by a team including researchers from the University of Oxford and published in the BMJ Quality and Safety Journal has found. According to the report a remote consultation has a higher degree of inherent uncertainty. This is because a clinical assessment without a physical examination provides less information.
Remote GP consultations became commonplace during the pandemic and there have been reports that as many as one third of all GP appointments are now conducted ‘virtually’. This practice is something that I am becoming increasingly aware of in my work as a medical negligence solicitor. Indeed, the Oxford University study points out that concerns have been raised about the safety of this practice, including the potential for missed cancers and avoidable deaths.
The study found that problems included missed, inaccurate or delayed diagnoses, underestimating the severity or urgency of a patient’s condition and delayed referrals. It cited a number of instances where the patient died, including the case of a 16-year-old girl who was diagnosed with glandular fever over the telephone by a GP but who died from sepsis shortly thereafter.
Distracted reception staff
The study also highlighted the case of a breathless elderly woman who spoke with a GP receptionist on the telephone and was told that she would be put on a callback list. However, the receptionist failed to do this, having been distracted by another patient in the waiting room. The woman died that afternoon. The study noted that several incidents were linked to a busy staff member becoming distracted. This aspect of the study reinforces the views of many that the controversial Darnley v. Croydon Health Services NHS Trust decision was in fact logical and correct – and that a duty of care should be imposed on administrative support staff to provide accurate information.
Harder to get the true picture
The importance of face-to-face consultations in order to gather adequate information and make clinical assessments is clearly evident. With virtual consultations it can be difficult to fully assess someone’s overall health and wellbeing as well as their level of agitation, general demeanour and socio-economic circumstances. According to the Oxford University study some safety incidents suggested ‘perfunctory and transactional’ telephone consultations, with flawed decisions made based on incomplete information. Incidents were found to have occurred as a result of clinicians assuming that a diagnosis made on a remote consultation was definitive rather than provisional.
As a medical negligence lawyer, I am acutely aware of the significant importance of full assessments and clear communication between doctor and patient in avoiding patient safety incidents and poor patient outcomes.
The Government has confirmed that it wants more patients to be seen face-to-face and earlier this year a new plan was launched to ‘make it easier for patients to see their GP' by utilising the latest advances in phones and online systems. However, the Shadow Health Secretary Wes Streeting was reported by Sky News at the time as saying that nothing within the new plan would ‘allow patients to choose a face-to-face appointment’.
How we can help
The team at Kingsley Napley are very experienced in bringing claims for medical negligence where a patient has been harmed as a result of problems with GP care, including where there have been issues with the actions of reception or nursing staff. If you would like to speak to us to us for a no obligation discussion then you can contact us here.
FURTHER INFORMATION
If you have any questions, please contact James Bell in our Medical Negligence and Personal Injury team.
ABOUT THE AUTHOR
James Bell is the head of our Medical Negligence and Personal Injury practice and joined the firm in 2023 from Hodge, Jones & Allen. He has undertaken medical negligence cases for over 20 years.
We welcome views and opinions about the issues raised in this blog. Should you require specific advice in relation to personal circumstances, please use the form on the contact page.
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