NHS complaints rise as GPs strike off patients "with no warning"


According to the Health Service Ombudsman, some GPs are striking patients from their practice lists without warning, in some cases with entire families told to find a new doctor after one person’s apparent abuse.

The ombudsman, which examines serious NHS complaints which cannot be locally resolved, also said the health service was failing adequately to deal with complaints, and that many minor disputes were escalating.

NHS Complaints

They investigated 10 cases where GPs had struck patients from their lists - a 5th of the total GP-related cases taken on. All were upheld.

Ombudsman Ann Abraham said it was most worrying that GPs often do not seem to know what is required of them by their NHS contracts.

"Their contracts require them to give a warning before people are removed unless circumstances are exceptional," said Ms Abraham.

But she added: "What we see in far too many cases is a knee-jerk response to a single incident where an individual, and sometimes a whole family, is removed."

In 1 case sited by the report, a terminally-ill woman was struck off a GP list weeks before her death because her daughter changed the battery in a medication device. In another, a dispute over a baby’s vaccination led to removal of the mother and infant from their GP's practice list.

A Department of Health spokesman said: "If any patient feels that they have been removed unreasonably or without warning they can raise this with their local primary care trust."

Ms Abraham also took issue with how complaints generally were being handled.

"Minor disputes over unanswered telephones or mix-ups over appointments can end up with the ombudsman because of knee-jerk responses by NHS staff.

"The escalation of such everyday incidents represents a hidden cost, adding to the burden on clinical practitioners and taking up time for health service managers, while causing added difficulty for people struggling with illness or caring responsibilities."

Neil Fearn of Simpson Millar LLP acknowledged that some of the cases did not immediately appear to be critical, especially when set beside clinical judgements that can be seen as life-threatening. "However, these are highly personal issues, and they form an important part of how patients interact with the NHS,” he said. “If some patients are de-listed for what sometimes seem to be just minor infringements of etiquette, this sends out very negative signals."

Neil went on to say that: "I have come across incidents of patients being de-listed in response to complaints that they have made to the GP. Further, de-listed patients may find it very inconvenient to travel to a different medical practice. Sometimes there is only one medical practice in the area and registering with a different practice can often involve travelling – which may be difficult for patients in rural areas."

Although last year 15,186 complaints were referred to the ombudsman, only 349 were investigated with 79% (276) upheld. The others were deemed unjustified or were withdrawn for falling beyond the ombudsman’s remit.

Patient groups said the small number of complaints investigated was cause for concern.

"The ombudsman investigates a pathetic 2% of complaints reaching her office," said Joyce Robins, co-director of Patient Concern. "There is no other right of appeal and the majority of dissatisfied patients are left at the mercy of trusts concerned only with watching their backs."

Neil Fearn believes it is vital that the NHS raises its game. "Healthcare by its very nature carries risk. But being treated respectfully is the right of every patient, particularly where there are genuine grievances which must be investigated."

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