Decision Report 201402210

Summary

Ms C said that when she changed her medical practice she had to see the practice nurse before she could be seen by a doctor. She said that this registration procedure created delays in her seeing a doctor. She also said that there were obstacles to accessing the medication she needed, and that other medications she was given put her at significant harm because they were contraindicated (should not be given) with drugs she was already taking for her complex health problems. Ms C was also unhappy because she said she had been blamed for an act of vandalism to the practice's premises and information about this had been added to her medical records. She complained about the way in which the practice dealt with her complaints about these matters.

We took independent medical advice from one of our medical advisers, who confirmed that it was not a requirement of the General Medical Council contract for a patient to have a medical with a practice nurse before seeing a doctor, as this could lead to delay in prescribing or seeing a doctor. This was what happened in Ms C's case. When Ms C did see a doctor her initial prescription requests were dealt with appropriately but subsequently there was evidence that she was over-prescribed medication without being properly assessed or reviewed. Finally, the investigation showed that non-medical information had been added to Ms C's records inappropriately and that the practice had not handled her complaint in accordance with required timescales. We upheld all of Ms C’s complaints, except that about the medicines she was prescribed, as we found no evidence that any of these was contraindicated.

Recommendations

We recommended that the practice:

• make a formal apology for the difficulties encountered in obtaining GP appointments;
• review their acute prescription request system in terms of how they respond to patient requests for antibiotics. They should confirm to us that they have done so;
• make a sincere apology for the inappropriate entry in the medical records;
• seek to ensure that an appropriate amendment is made (in accordance with relevant guidance) to the complainant's medical records;
• apologise for the way in which the complaint was dealt with; and
• emphasise to all those staff involved the importance of making full and timely replies to complaints in accordance with stated procedures.