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April 18, 2022

MDO Warns That GPs Could be Liable for Hospital Specialists' Advice Under A&G

In the past GPs had warned about the implications of managing more complex patients via A&G where specialist advice is given to GPs by telephone or IT platforms instead of referring patients for a hospital investigation.

However, we have learnt there is now a confusion about who should bear the brunt for the actual advice given to GPs through the scheme.

Medico-legal adviser of the Medical Defense Union (MDU), Dr John Dale-Skinner told Pulse that responsibility for the patients lies with the medical personnel using the A&G service unless a decision is made to refer the patient. In his words, ‘To help manage the unprecedented demands on NHS hospital services, there is pressure on GPs to avoid unnecessary outpatient activity, unless a referral is necessary. Advice and guidance (A&G) services can be useful in helping GPs to make sure patients are seen and treated appropriately in a timely manner.

He added that it is however important to recognize that the healthcare professional making use of the A&G service is responsible for the patient unless a decision to refer is made.’ He went further to say that it is the duty of GPs to ensure that patients understand the process and ‘who to come to if they have questions.

Contrastingly, other MDOs have said that GPs are ‘unlikely’ to be held solely liable and the medico-legal position remains ambiguous. Dr Rob Hendry, Medical director at Medical Protection Society (MPS) says that practitioners are ‘responsible for the advice and care they provide’.

He says that it is not likely that all the clinical risk will be held by the GP if a claim is made but it is likely that the specialist who advised the GP will be one of the defendants alongside the GP. He however adds that the conditions of liability will be a function of the particular circumstances of any claim, including whether the patient history given to the specialist was accurate and if the advice received was appropriate.

He therefore advised GPS to document the discussion with the specialist as well as the background provided, specific questions asked and the specialist’s response, along with the time and date of the discussion.

Chief medical officer at MDDUS Dr John Holden also adds that GPs should make sure that the advice they receive in the management of a patient is from an appropriate specialist after all relevant information has been provided in line with GMC guidance.

Current GMC guidance about clinical risk during A&G states that doctors are ‘not accountable to the GMC for the actions (or omissions) of those to whom [they] delegate care or make referrals.

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