Dr Caroline Fryar is a former GP and head of advisory services at the Medical Defence Union (MDU) and Sam O'Gram is one of the organisation's GP liaison managers. They explain some of the medico-legal issues that their members are experiencing and highlight how the MDU has been able to help.
What medico-legal concerns have GPs encountered during the pandemic?
CF: There’s been such an outpouring of new guidance and rules that GPs have been calling on us to keep them up to date with issues like death certification, advance care planning and PPE.
Another popular topic is the increased use of remote consultations and triage and the implications for storing patient images, intimate examinations and chaperones. GPs also want advice on dealing with patients who decline to wear face coverings in the practice and those with symptoms who aren’t following self-isolation rules.
SO: Inevitably, for every member who calls us, there will be others struggling with the same issue so we regularly feature FAQs on our website. Our website visitors are up by over 50% as healthcare professionals access our COVID-19 resources including articles, videos and podcasts.
In addition, our GP GROUPCARE and GPST scheme members are benefitting from seminars on topics such as telephone triage, good record keeping and dealing with challenging patients. Nearly 200 seminars have been delivered or arranged.
Have you seen an increase in demand for your support?
CF: Yes we have. Between April and July, our advice line received more than 5,000 calls. GPs’ time is always precious but a swift response was particularly important at the height of the pandemic so I’m pleased that in over 99% of calls, members were able to speak to an adviser within 20 seconds.
Our membership team dealt with almost 40,000 calls and 46,000 emails from members in the same period. These contacts were often from doctors who needed to adjust their subscription after their work circumstances had changed.
SO: GPs, practice managers and their teams have been very engaged with the remote learning and support we’ve provided and we’ve had a big rise in requests for advice on remote consultations and telephone triage. A current hot topic is the challenge of delivering the seasonal flu vaccination campaign during a pandemic and we’ve published information on our website and on GPonline.
What challenges do you foresee over the coming months?
CF: Unfortunately, we could be sitting on a ticking timebomb. We have opened over 1,700 complaint and adverse incident case files from the start of lockdown to September and some of these have the potential to become clinical negligence claims and GMC investigations.
In fact, we have seen an influx of GMC cases since the GMC restarted its investigations in July - almost 25% of GMC cases we received in the year to date have arrived in the last month. Many relate to the pandemic so we welcome the GMC’s new guidance for its decision makers which says they should take into account issues such as working in unfamiliar settings, availability of PPE and the difficulties caused by wearing it and working with changing and sometimes conflicting guidance.
The MDU has been working with the GMC on members’ behalf to encourage a fair and proportionate approach to regulation and we are calling on the government to exempt all NHS healthcare professionals from COVID-19 related litigation, and the additional distress and anxiety it causes.
What support and reassurance can the MDU offer GP members?
CF: Our team of advisers, lawyers and claims handlers have a strong track record of defending our members. For example, last year, 82% of GMC cases involving MDU members at the case examiner stage were resolved without referral to an MPTS hearing while over 80% of medical claims were successfully defended without compensation being paid.
To pre-empt problems, MDU members can obtain expert medico-legal advice on issues arising from the pandemic, either on our 24-hour advisory helpline or via our website. Our free online courses deal with a range of subjects including confidentiality, dealing with complaints, death certification and cremation forms.
SO: We know that GPs and practice staff are susceptible to burnout and poor wellbeing, especially during the current health crisis. I’d encourage all practices to consider whether they are eligible to join the MDU’s GROUPCARE scheme, which offers a free confidential helpline to support the whole team with issues in their personal or work life.
Other benefits include free risk assessments and medico-legal training seminars which ensure everyone in the team is updated and supported during these challenging times.
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