Out of sight, out of mind - Medical negligence compensation increase

The introduction of a new contract in 2004 concerning out-of-hours GP care could be one explanation for a rise in the number of medical negligence compensation claims being made.

Now, nine out of ten GPs choose to opt out of providing evening and weekend care, meaning that nurses and paramedics are more heavily relied upon. But these resources are pushed to the limit and such staff may not have the specialist expertise needed for diagnosis and treatment of some trickier conditions.

Quite often, when no other medical experts can be sought, the public rely on NHS Direct, the 24-hour advice line for aid. Equally, this is not the best method when dealing with patients who need to be examined.

Around 40% of parents report that their child is suffering from a feverish illness every year and it is the second most commonly reported symptom in accidents and emergency departments.

Particular concern has been raised about young children with feverish illnesses after research revealed that as many as half of children with meningococcal disease were sent home after their first consultation. Associated symptoms, such as high temperatures and mottled skin need careful monitoring which might not be possible in the absence of adequate out-of-hours care.

A reliance on over-stretched departments of under qualified staff, just as with the state of the UK's maternity departments, could lead to an abundance of clinical errors and a sudden increase in claims for medical negligence compensation.

In a feature from the British Medical Journal, lecturer in general practice, Dr Harnden commented, "Changes in NHS policy have led to the primary care of febrile (feverish) children presenting outside office hours being delivered by an increasing number of professional groups."

"Doctors, nurses, staff working for the telephone helpline NHS Direct, out-of-hours centres and accident and emergency departments may all have different levels of skill and experience.

"This is a major concern because the most solid evidence for recognising clinical severity in febrile children in primary care is a global assessment by an experienced clinician.

"The global assessment involves eliciting a clear history and careful observation of signs, including alertness, activity, colour and respiratory effort."

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