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Reacting to a patient's claim against you

What should GPs do if they receive a claim for clinical negligence? The MDDUS's Simon Dinnick offers advice.

While the Medical and Dental Defence Union of Scotland's (MDDUS) experience is that the number of claims for clinical negligence has stopped rising, they are often for higher amounts of compensation, and are usually better prepared, than before.

Under English procedures, solicitors will usually have gone to some trouble to investigate the complaint and take expert advice, so a letter notifying you of a claim must be taken seriously.

But whether you practice in Perth or Penzance, the basic principles for how it is advisable to react remain the same.

If you are notified of a claim, simply acknowledge it and let the author know that you are taking advice from your defence organisation (or professional indemnity insurer).

Contact your organisation as soon as possible to tell it about the claim. Its advisers will explain to you what to do next.

Prepare a written report as soon as you can, while the memory of events is as fresh as it can be. Detail what you know about the patient and each aspect of the consultation(s) in question. Answer the allegations and give your general impressions.

This report is confidential to your defence organisation, so share your thoughts and concerns honestly.

If you cannot recall a specific event - it may have been some time ago - then say so.

If you have moved on in the meantime, contact the GP practice concerned.

Collect and take copies of the relevant medical records, in case the patient moves to another practice or - perish the thought - dies. In either case, the records may be removed from the surgery before you have had a chance to write your report.

If your notes are difficult to interpret, make a verbatim transcript.

It is usually a good idea to tell your partners or an immediate colleague about the claim. This should provide you with a point of reference and support if you need it within your working environment. It is also important that your colleagues are not upset by finding out about something potentially significant by accident.

Do not be tempted to write letters to or sound off to the claimant's lawyers. You may compromise your defence organisation and yourself, and risk forfeiting your cover.

Once you have given your organisation your report, try to regard the problem as no longer yours. It is your organisation's job to deal with it.

Do not dwell on the claim or try to deal with it yourself. If it is causing you stress, defence organisations generally have staff who are skilled at listening and offering practical advice.

What to do

- Simply acknowledge the claim, stating that you are taking advice.

- Contact your defence organisation as quickly as possible.

- Prepare a written report as soon as you can.

- Collect and take copies of the relevant medical records.

- Tell your partners or an immediate colleague.

- Don't write letters or sound off to the claimant's lawyers.

Any negligence claim may take up to three years to run its course. Try to be patient.

Answer questions as they arise and attend any necessary meetings with barristers or relevant experts. Such meetings will be held only when essential.

Of course, a negligence claim must be taken seriously. But in terms of process, it is similar to a claim following a road accident - with emotion thrown in.

Trust your advisers and do nothing to distress your patient further. They will need and expect sympathy and tact as the situation is likely to be difficult and stressful for them too.

Be reassured that few cases go to court. Claimants often withdraw or are persuaded to abandon their cases. Sometimes detailed analysis leads defence advisers to conclude that it is better settled out of court.

If you are asked to go to court, this is more likely to be because your defence organisation believes you have not been negligent than the opposite.

Finally, bear in mind that, sadly, claims for clinical negligence are a fact of modern life.

- Mr Dinnick is head of legal services, Medical and Dental Defence Union of Scotland, www.mddus.com

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