Four in five GPs order extra tests or refer more due to fear of being sued

A fear of being sued is leading the vast majority of GPs to practise medicine more defensively, a survey of 1,300 family doctors suggests.

Some 87% of GPs said they were increasingly fearful of being sued in the survey that was carried out by the Medical Protection Society (MPS). Four in five (84%) said the fear of being sued had lead to them ordering more tests or making more referrals and 41% said it had resulted in them prescribing medicine when it was not clinically necessary.

Research published last month by Imperial College London showed that four in five doctors who have been the subject of a complaint practise more defensively. According to the MPS, a full-time GP can now expect to receive two clinical negligence claims over the course of their career.

The MPS said that legal reform was needed ‘to tackle the cultural acceptability to sue for minor injuries or inconveniences’. It is calling on the government to consider introducing a minimum threshold for such cases.

According to figures from NHS Resolution there were 646 NHS clinical negligence claims with damages paid out under £3,000 in 2015/16. This rose to 817 in 2016/17.

The medical defence organisation also called on the government to undertake more in-depth research to fully understand the impact the fear of being sued is having on doctors and the NHS.

One survey respondent 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.’

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Fear of being sued is taking its toll on GPs

MPS senior medico-legal adviser Dr Pallavi Bradshaw said: ‘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.

‘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.'

What GPs say about practising defensively

The following comments are from GPs who responded to the MPS survey:

‘The fear of being sued leads to increased referrals, investigations and unnecessary follow up appointments which in turn drive the cost of healthcare up’

‘I now practise in a world where I am frightened at the beginning of each day, and because of this, I am retiring early.’

‘I worry about claims which are inappropriate, patients threatening complaints if not given the tests they want, and more professionals managing cases driven by fear of litigation as opposed to what is in the best interests of the patient.’

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