Pandemic leaves three quarters of GPs fearing investigation over factors outside their control

Over three quarters of GPs fear the COVID-19 pandemic will leave them facing investigations triggered by factors outside their control such as delayed referrals or disruption to services, a poll shows.

GP phone consultation (Photo: sturti/Getty Images)

A total of 77% of GP fear criminal or regulatory investigation if patient outcomes are affected by delayed referrals or because non-COVID NHS services are limited or unavailable in the pandemic, it found.

A further 19% said they were ‘somewhat concerned’ about facing action, while just 5% said they were not concerned at all, according to the survey of 688 UK GPs by the Medical Protection Society (MPS).

The findings follow a joint survey by GPonline and the MDU, which found that two in five GPs had received a patient complaint during the pandemic - mostly for factors outside of their control.

Medico-legal dispute

The MPS has predicted ‘a significant number’ of medico-legal disputes and warned that the impact of investigations on ‘already emotionally and physically exhausted' doctors will be ‘significant’. Medico-legal organisations have urged the government to consider bringing in emergency laws to protect clinicians.

The pandemic has had a profound impact on delivery of patient care in general practice. GPs have been instructed by NHS England to adopt a 'total triage' system, and to use video, online and telephone consultations wherever appropriate.

Meanwhile, a GMC report in November 2020 found that four in five GPs had found their ability to maintain patient care in the pandemic undermined by problems with access to tests and referrals along with heavy workload.

The MPS survey reflected concerns about the impact of these changes. One respondent said: ‘As a GP, I’m unable to investigate my patients in the usual manner.

GP referral

‘Routine referrals for investigations are being rejected and sent back to GPs and it is then left up to us to explain to the patient why the investigation has not been done. Patients are being assessed remotely which will inevitably miss important pathology. 

‘There is a whole spectrum of undiagnosed pathology that will come to light once this pandemic is over and my worry is that GPs will then be at the coalface of this undiagnosed pathology and will undoubtedly be in the firing line for blame.’

Another said: ‘I’m very concerned that referrals are bounced back sometimes with a list of investigations which might not happen in a timely fashion. Patients are also not attending for treatment or follow up - who’s accountable?’

MPS medical director Dr Rob Hendry said: ‘Before the pandemic, there were already long-standing concerns about the extent to which individual doctors are held to account for delayed diagnoses and other incidents that occur due to system pressures or failures. COVID-19 has had a serious impact on the availability of services, and this has severely exacerbated the problem.

Patient outcomes

‘The prospect of a poor outcome under these circumstances would be devastating for any patient, but the psychological impact on the already emotionally and physically exhausted doctors involved would also be significant. On top of that, they face potential medico-legal disputes, complaints and investigations relating to situations they have had no control over.

‘We have called for emergency laws to protect healthcare workers from unfair investigation since the start of the pandemic and recently urged the government to introduce the legislation without delay to protect those at risk of inappropriate legal challenge following difficult decisions on how limited resources are allocated in hospitals.’

Health secretary Matt Hancock has agreed to keep the need for emergency laws under review despite numerous pleas from medical defence groups to introduce temporary protections for clinicians during the pandemic.

Medico-legal experts warned last year that GPs could face a huge wave of complaints due to changes to working practices adopted during the pandemic and delays in access to secondary care.

A GPonline poll revealed last November that more than two fifths of GPs thought their relationship with patients had worsened because of ways they had been asked to operate over the course of the pandemic.

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