NHS Resolution publishes review of first year of the Clinical Negligence Scheme for General Practice
01 September 2022
A report has been released reviewing the first year of the Clinical Negligence Scheme for General Practice (CNSGP) from 01 April 2019 to 31 March 2020.
The CNSGP is ‘a state-backed clinical negligence indemnity scheme for general practice’. It ‘covers all clinical negligence claims for compensation arising from NHS services provided by general practice in England and covers all incidents occurring on or after 01 April 2019 relating to care provided under GP contracts’.
The report aims to understand the causes of claims that occur in general practice, to identify common themes and to consider opportunities for learning and improvement. It includes the following:
- Clinical negligence claims associated with general practice accounted for 401 (3.4%) of the 11,682 claims notified in the first year of the scheme. This appears surprisingly low given that 90% of patient contact with the NHS is in general practice, but a delay in claims notification may explain this. The number of formal claims notified was just 81 of the 401 cases. The report also confirms that over 3000 individual queries were made by general practitioners, practice managers and others requesting guidance on the scheme.
- The most commonly reported cause was delay/failure to diagnose (43.5%), medication errors (18.5) and delay/failure to refer (10%).
- There were 70 incidences of mortality in the period representing 18% of the claims notified, with cardiac, deep vein thrombosis/pulmonary embolism and medication errors accounting for the higher proportion of these cases.
- There were 21 sepsis notifications, within which ten categories of sepsis were identified. A 33% mortality rate was noted.
- 74 medication errors were identified representing 18.5% of the claims notified in the year. It is noted that medication error rates of 4.9% of all prescription items have been found in general practice. Failure/delay to prescribe/dispense accounted for 23% of medication errors, followed by adverse reaction to medication (20.3%) and incorrect medication and medication dose (12% each).
The report makes a number of recommendations to address the key findings around delay/failure in diagnosis, medication errors and prison healthcare. These focus on the use of diagnostic tools and risk assessments, cross system communication and research and cross system education to address the theme of delay/failure in diagnosis, improving competency and knowledge of potential adverse drug reactions to avoid medication errors and improvements in prison healthcare.
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