As many as one-and-a-half million people in Britain believe that they have been harmed by avoidable mistakes or failings at their GP practice, dentist, or walk in centre in the past year, a study has found.
This could be as high as 3 million people when avoidable “near misses” are included, and these changes can have a lasting impact on the trust patients have in using these services in the future.
Errors include having the wrong tooth extracted, a failure to spot a recurrent nose bleed was actually cancer and medication prescribed without necessary tests leading to cardiac arrest.
But there were many more cases of less obvious harm, including failings in communication or delayed appointments and diagnosis that were only preventable with hindsight.
The research, led by University of Manchester, shows doctors are much less likely to judge scenarios that patients see as a cause for concern as potentially harmful. This may mean practices slower to address these issues when they’re raised or issues may go unnoticed.
“Our survey suggests there are probably a large number of patients in Great Britain who believe they have experienced a potentially-harmful preventable problem in primary care,” said Dr Jill Stocks, who led the study.
This follows warnings from GP leaders that a lack of doctors and growing patient demand means many GPs are seeing three times as many patients as safe, and some are unable to see non-urgent conditions.
An IPSOS MORI poll of 4,000 adults across England, Scotland and Wales asked about preventable problems in primary care – including GP, dentistry, pharmacy, optician and out-of-hours services – in the past 12 months.
The study, in the BMJ Open today, found 7.6 per cent said they had been harmed or experienced a near miss that could have been prevented, half of who say they have experienced actually harm.
General practice, which sees roughly a million people a day, accounted for 70 per cent of the issues raised. It also found more regular users – such as mothers with young children or people with a long-term condition – were more likely to believe they had been harmed.
Of the 300 individuals who said they had been harmed or experienced a near miss, 39 per cent said the incident was probably the cause of their harm, or would have probably harmed them if it hadn’t been caught.
The most common issue related to medication errors, including the wrong drugs or dose being issued or a medication that the patient was allergic to being prescribed.
However missed or incorrect diagnosis or problems accessing an appointment were also reported as having the potential to cause harm which may not be preventable or harmful.
Compared to two-fifths of patients, doctors reviewing the incidents said just eight per cent were preventable problems that would probably lead to patient harm.
“Clinicians may need to address patient-perceived problems that they do not believe to be harmful if they seek to improve public confidence and trust in primary care,” the authors write.
They note explaining realities of general practice, such as diagnosing through a process of elimination ruling out the most serious option, can help address these perception differences or feelings of delay or harm.
“This study shows that the views of patients are important when something goes wrong, irrespective of whether significant harm is caused,” said Professor of General Practice Aneez Esmail who was also part of the study.
“Working with patients when something has gone wrong can help re-build trust with the GPs and other clinicians.”