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Nurse practitioners facing 'rise in claims and complaints’

  • 7 Comments

Advanced nurse practitioners working in primary care settings are reporting an increasing number of claims and complaints, according to figures from a medical indemnity organisation.

The Medical Defence Union warned that during 2015 its nurse practitioner members reported 25 clinical negligence claims arising from their practice, whereas in 2005 there were just two.

“Many practices have devolved more responsibility to nurse practitioners in their team to cope with the increasing demand”

Beverley Ward

The MDU also said it was seeing a growing number of allegations being made against nurse practitioners in their own right.

One claim was settled for more than £2m in a case where a patient suffered a stroke after being prescribed a contraceptive.

The MDU said it helped with over 400 complaints, claims and other medico-legal matters between 2010 and 2015, involving nurse practitioners.

The most common reason for cases was wrong or delayed diagnosis, which featured in 30% of complaints and 40% of claims, followed by delayed referrals and prescribing errors.

Medical Defence Union

Nurse practitioners facing ’rise in claims and complaints’

Beverley Ward

MDU medico-legal adviser Dr Beverley Ward said: “It is well known that complaints and claims against GPs are increasing year on year, but the rise is even steeper among nurse practitioners working in primary care.

“With an ageing population and more patients with long-term conditions being managed in primary care, many practices have devolved more responsibility to nurse practitioners in their team to cope with the increasing demand,” she said.

“However, in taking on roles such as assessing and diagnosing patients, prescribing medicines, and running minor injury clinics, nurse practitioners are also at an increased risk of patients holding them individually accountable if something goes wrong,” she added.

The MDU has issued the following advice to help nurses minimise the risk of a claim or complaint:

  • Keep your knowledge up to date and work within your level of competence
  • If there is doubt about a diagnosis, get advice from a medical colleague or refer the patient for further investigations or treatment
  • Clearly communicate with patients including explaining what you are doing and why. Check the patient has understood and ensure they know under what circumstances and timeframe to seek further medical care
  • Tell patients about the risks, benefits and alternative options open to them, including the option of doing nothing, so they can make an informed choice
  • Keep a record of all discussions with patients, including over the phone. Record positive as well as negative findings
  • If things go wrong, apologise to the patient and explain what has happened, and what can be done to rectify things
  • 7 Comments

Readers' comments (7)

  • michael stone

    Nurses - especially senior nurses - are now doing things which were once the preserve of doctors: if nurses 'get it wrong', they will therefore attract complaints in the same way that doctors do.

    It is a little disturbing, that the MDU feels the need to explain to nurses that our law is now 'Informed Consent':

    'Tell patients about the risks, benefits and alternative options open to them, including the option of doing nothing, so they can make an informed choice'

    And, an unfortunate consequence of 'a litigation culture' seems to be [I say 'unfortunate', because this could potentially take up a lot of time]:

    'Keep a record of all discussions with patients, including over the phone. Record positive as well as negative findings'

    I do have an issue with 'the NHS' re records of discussions - in my opinion, such a record should be 'signed-off' by both sides of the conversation - but I won't go deeply into that, here.

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  • Nurse Practitioners not a problem in itself...but Nurses need appropriate training in consultation and diagnosis and I suspect that is what is being skimped on...
    Also some good triaging software that can assist and record the consultation perhaps...

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  • Not really cutting edge journalism to pretty much just reproduce an MDU press release - check it on the MDU website.
    Any checking of whether all claims against nurse practitioners have gone up or just claims against members of the MDU? The article and press release seems to suggest this is just based on claims against MDU members.
    Is it Nurse Practitioners or Practice Nurses - does the MDU differentiate?
    Any checking as to whether this is because GP employers are now having to take responsibility for the vicarious liability for the nurses they employ?
    Previously MDU would name the individual nurse employed by the GP practice as a co-respondent to allow the MDU to move the claim against the nurse employee over to the old RCN indemnity cover (if the nurse was a member of the RCN). That option doesn't exist any more and so GP employers are having to take liability for the actions of their nurse employees in the same way as other employers have to. Perhaps this explains why MDU claims have gone up?
    Call me a cynic, but I wonder if it's more of a scare story from MDU to get nurses to pay for MDU membership so that their employer doesn't have to then take on the liability cover for their employees?

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  • Unfortunately everyone nowadays is after a 'quick buck' and all seem to think that the money comes out of thin air. Whilst there are a few genuine cases of negligence, most are not. However with all the law firms cold calling around in the hope of talking to someone who has 'suffered' from 'negligence' it is no wonder all claims are rising. Cases are often settled because it is cheaper than fighting them, and law firms know this. It can only get worse until the NHS can no longer afford to treat patients and pay the huge insurance premiums that cripple it.

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  • So the claims have gone from 2 to 25 in 10 years. How many more ANPs are there now compared to 10 years ago? how does this increase compare statistically with any(?!) rise in Dr claims over the same period? Are we not now a much more litigious society? Although I support their about documentation. Write it, write it, write it. If it's not written down it did not happen.

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  • To Carol Ellison

    Your statement is based upon what evidence?

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  • The role of the NP has progressed, and we are seeing much more of the Advanced Nurse Practitioner role, which involves masters and PHD level education. It is a very different role to that of an NP. Unfortunately no advanced level nursing is regulated in the UK by the NMC (there's no additional area for ANPs to register) therefore anyone can call themselves an ANP, the risk is that they haven't received the right training and therefore there's an increase in litigation risk. Until these roles are regulated we will probably see a further increase in cases. Let's hope the NMC is on the case !!!

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