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”
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.
Nurse practitioners facing ’rise in claims and complaints’
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