GP careers: Dr. Grey and the ombudsman

Published: 30 Nov 2017 By Dr. Paul Grey


Profile: Dr Paul Gray

Roles: GP partner, Sale, Manchester. Medical adviser to Parliamentary and Health Service Ombudsman (PHSO), Manchester

Hours: Eight hours every Wednesday at PHSO. Eight clinical sessions over four days at the practice

07:30 I arrive at the Parliamentary and health service ombudsman (PHSO) offices in central Manchester after the 20-minute commute. I go through emails, then check and approve reports submitted by lay assessors. I’m one of four clinical advisers in general practice and largely my role is to advise on medical aspects of a complaint made against a GP or practice.

08:30 I start preparing for ‘documented discussions’ where I meet with assessors to go through cases. The PHSO makes determinations on maladministration and service failure, rather than medical negligence. We provide advice based on professional standards and clinical guidelines; where none exists we go by established good clinical practice. This differs from medical negligence cases tested in court, which use the Bolam/Bolitho principle (the ‘reasonable body of clinical opinion’).

One case this morning is that of an elderly woman who was found dead two days after her GP prescribed antibiotics for a UTI during a telephone triage assessment. Her son has complained that the GP refused a request for a visit. I find a widely used LMC guideline, which indicates it was reasonable for the GP to do telephone triage in the circumstances. In addition I look up NICE guidelines on uncomplicated UTI, which confirm the GP did not need to take a urine sample, and that he prescribed the recommended antibiotic. I conclude he acted correctly.

Researching a case makes you much more aware of some conditions and guidelines 

09:30 Once I’ve prepared the background for each case, I discuss it with the assessors, and provide information and references for their report. Researching a case makes you much more aware of some conditions and guidelines and provides an element of self-directed learning.

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