PRACTICE MATTERS PATIENT RECALL


now due… E


Review


Senior risk adviser Liz Price offers tips on avoiding “lost” patients needing recall


NSURING your practice has an effective and robust call and recall system is essential for a variety of reasons – most particularly for the safety of your patients. In our experience practice


managers or GPs tend to conduct routine chronic disease management recall well but may struggle with the more ad hoc examples illustrated below: • Prescribing where a drug is normally contraindicated. In this case the GP may wish to monitor the patient closely, for example via blood or urine samples, to keep an eye on whether they are experiencing an adverse effect.


• Results follow-up. A patient may need a repeat test in a couple of weeks or several months’ time to check if they require further investigation or follow-up after an abnormal reading.


•


Hospital discharge. A patient may have been discharged from secondary care either with a request from the specialist for the practice to follow-up monitoring or to consider re-referral at local level in the case of a DNA (did not attend). In our experience these letters can sometimes be filed with no action reminder set or clinical decision taken regarding active follow-up. The frequency of this could increase as practices try to improve workflow efficiency by utilising receptionists to review and direct incoming correspondence. In each of these situations – and I’m sure you can


think of others – there is the potential for the patient to get ‘lost’, resulting in the practice facing medicolegal action when that patient suffers harm and subsequently claims that they were not properly informed of the need for follow-up or the risk associated with not attending. Ensuring that a conscious decision has been made in partnership with the patient to follow all or some of the steps below – depending on the level of clinical risk if the patient defaults – will help to demonstrate that the practice has acted reasonably.


DOCUMENT PATIENT INSTRUCTIONS The patient should understand follow-up requirements and be made aware of the risks associated with failure to attend for testing or review, so that future recalls from the practice are taken seriously. In all scenarios, specific communication about the clinical reasons for follow-up should be unambiguous and also documented in the record so that, if an adverse event arises, the practice has an audit trail which will support their position. Instructions from clinicians via a non-clinical member of the team


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AUTUMN 2018  ISSUE 19


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