Litigation is increasing 10% a year in General Practice and medical comorbidities are set to double over the next 10 years.

Read about some real clinical cases below and how BookYourGP would have helped avoid clinical errors.

Case #1: How Do You Ensure Recalls Don't Go Missing?

Mr Seymour Skinner, a 53 year old gentleman attended with tiredness all the time. He was seen by his GP who organised TATT bloods. His Hb came back as 10.7. Dr Lee asked the team at the surgery to contact the patient for a follow up appointment. Mr Skinner was not contactable / the recall went missing. One year later Mr Skinner returned to the surgery and was referred under the two week wait rule.

He was then diagnosed with metastatic colorectal cancer.

Mr Seymour Skinner sued Dr Lee and the other GPs involved in his care.

BookYourGP provides a medico-legally robust recall system, which can prevent recalls from going missing as demonstrated below

Case #2: Who Monitors the Monitoring?

Miss Carrie Mathison is a 41 year old lady who is known to the Psychiatric team. She requested a home visit because she was feeling dizzy and generally unwell.

The GP SpR initially visited. She felt that the dizziness could be due to a postural drop and so stopped her Lisinopril.

One week later Dr Thornton (one of the Partners) visited the patient. He realised that Mrs Mathison was on Lithium. He organised a blood test via the district nurses. Three days later the Lithium level returned as 1.56, but both the nurse and GP were unsure when she had taken her Lithium relative to her blood test.

Mrs Mathison's lithium level returned as 2.5 several days later and she was admitted as an emergency for Lithium toxicity. She was left with permanent ataxia and dysarthria.

Mrs Mathison sued all of the GP Partners at the surgery for not monitoring her medications properly and also the GP SpR for poor medical care.

BookYourGP comes with all amber drug recalls and chronic disease recalls preloaded. The recalls are tailor made for each surgery. We carry out hundreds of clinical reports and analyse them for you ensuring that they are done in a way where everyone - clinicians & patients - are happy.

We also provide you with all the reports and functionality you need to maintain your disease and amber drug registers as can be seen below.

Case #3: 7 Year Delay In Diagnosis Of Prostate Cancer Due To Relying On Manual Processes

Mr Ned Flanders attended the surgery due to nocturnal frequency. He had a past medical history of T2DM. It was suspected that Mr Flanders had nocturia due to poorly controlled T2DM and so his medication regime was altered.

Six weeks later he had a telephone consultation as he was concerned about weight loss, a loss of appetite, increased urinary frequency and night cramps. His F2F appointment the following day revealed 2-3Kg weight loss and that he was urinating 5-6 times a night. The GP felt that these symptoms and signs were due to poorly controlled T2DM. The GP further altered Mr Flanders' medication regime, arranged blood tests and a follow-up with the practice nurse.

The nurse followed up the patient a few days after with the blood tests, but the patient continued to have nocturia and more weight loss. The nurse advised another follow-up with the GP which occured 4 weeks later.

In the follow-up appointment the GP noted that 7 years previously the patient had a raised PSA. However, the patient had been unable to tolerate a biopsy for a definitive diagnosis, so 6 monthly PSA testing was advised; however, the patient did not have follow-up blood tests due to administrative errors by the surgery.

A repeat PSA was urgently organised. The PSA measured very high (>100 ng/mL). Mr Flanders was referred urgently and was diagnosed with Prostate Cancer.

BookYourGP removes the manual, ad-hoc process of organising patient care. In this instance it would have ensured that Mr Flanders was recalled every 6 months for a PSA blood test as requested by the Urology Team.

Case #4: Have You Ever Wanted To Follow-Up Blood Test Results With A Patient, But They Want To Talk About Something Else?

Mrs Luann Van Houten had a slightly elevated AST at 82. Mrs Van Houten returned to see Dr Williams where she complained of abdominal pain, tiredness, poor sleep, seasonal rhinitis, headaches and dizzines.

Mrs Van Houten had a number of follow-up consultations with the GP. As part of her work-up she went on to have an USS abdomen.

Dr Williams referred Mrs Van Houten for a a laparoscopic cholecystectomy after the USS showed gallstones.

Mrs Van Houten went on to have a number of consultations over the following years, but her LFTs did not get followed up during the time.

Three years later Mrs Van Houten presented with weight loss and ascites. She was later diagnosed with Hepatitis C.

Mrs Van Houten sued Dr Williams and the other GP Partners at the surgery.

BookYourGP ensures that important follow-ups simply get done. Whether it's a repeat HbA1c in three months for a diagnosis of Diabetes, or a repeat LFTs in 1-3 months with a view for a Liver Screen, BookYourGP will get it done.

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