Medical defence experts flag up ‘serious concerns’ over practice boundary pilots


By Andrew McNicoll | 06 Feb 2012

Exclusive: The Government's pilots trialling the abolition of practice boundaries will sow confusion over GP accountability for follow-up investigations and referrals, medical defence experts have warned.

The Medical and Dental Defence Union of Scotland (MDDUS) said the pilots – due to launch in London, Manchester and Nottingham in April – raised ‘serious concerns' over accountability and also continuity of care, particularly for patients with complex health needs.

Department of Health guidance issued last week said it was hoped patients in the pilots would ‘typically be working-age adults without complex health problems who are less likely to require home visits', but admitted PCT clusters needed to make arrangements for patients with complex care needs as part of the NHS ‘duty of care'.

Medico-legal advisers said GPs involved in the pilots needed a ‘clear agreement' on which practices are responsible for following up referrals and investigations, and that communications between practices in the pilots was vital.

Dr Barry Parker, MDDUS medical adviser, said: ‘Actions such as prescriptions of drugs, treatment plans and referrals must always be co-ordinated to avoid confusion, or duplication. Otherwise patients could inadvertently be prescribed medicines that interact with each other, or receive excessive supplies.'

Dr Richard  Vautrey, GPC deputy chair, said:  ‘There are clearly increased risks to patient safety if care becomes fragmented and this is one of the main reasons we've had so much concern about this policy.  We are encouraging the DH to take this issue seriously and put in place robust mechanisms to achieve this as part of this pilot.'

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