GPs are being advised about the importance of keeping minutes of practice meetings, appointment books and results follow-up books for as long as possible by the Medical Defence Union (MDU). The MDU issued the warning in response to a case in which six GPs were sued when a woman developed cervical cancer after failing to attend for smear tests over a nine-year period, despite several reminders. The MDU, the UK's leading medical defence organisation, successfully defended the case at trial and the GPs were able to use meeting minutes to prove that the practice's policy on when postnatal smear tests were carried out had changed.

The case history, published in the latest edition of the MDU's GP registrar update journal*, explains how a woman was diagnosed with cervical cancer when aged 28 and later developed secondary lung metastasis. The patient alleged this was because she had not been told in strong enough terms that she needed a repeat smear at age 19. The judge found that the woman would not have attended even if warned of the risks.

Dr Glynis Parker, senior medical claims handler at the MDU, said: "The case was brought 16 years after the patient alleged she had not been properly informed about the importance of attending for a repeat smear. Fortunately, the practice had kept meeting minutes and one of the GPs involved was able to use these to show that a smear had not been done at a six-week postnatal check because the practice had changed its policy to perform smears at six months post delivery. Documents such as meeting minutes and appointment books are important in providing a complete picture of practice policies and procedures in the event of a claim, which can arise many years after an incident.

"The MDU has long advised about the importance of documenting all patient advice fully in the medical records, to ensure a clear and accurate picture of patient care and to help resolve any patient dissatisfaction. In this case, although the records were of a reasonable standard, the GPs did not record in the first few years every time the patient had been advised to attend for a smear. Later consultations did record this however.

"While GPs have a responsibility for the overall care of their patients, patients themselves also retain some responsibility for their care, such as attending for routine screening. Despite the practice repeatedly reminding the patient in this case, both verbally and in writing, to attend for smear tests, she did not attend for many years, with severe consequences."

The MDU is a mutual, not for profit, organisation owned by our members who include over 50 per cent of the UK's hospital doctors and GPs. Established in 1885, we were the world's first medical defence organisation. We defend the professional reputations of our members when their clinical performance is called into question. Our benefits of membership include insurance for claims of clinical negligence and a wide range of medico-legal advisory services.

Source
Dawn Boyall
Media Relations Manager
Medical Defence Union
230 Blackfriars Rd
London SE1 8PJ