The “constant pressure” on GPs to reduce antibiotic prescribing and referrals to A&E could have impacted the case of William Mead, the case report suggested.
William Mead, from Penryn, Cornwall, died on 14 December 2014, and his death was put down to natural causes. However, a coroners inquest in June 2015 found that he had treatable blood poisoning (septicaemia) caused by a chest infection.
His mother spoke to medics at least nine times in the 11 weeks leading up to William’s death, and on the day before his death, she called 111 for advice and also spoke to an out-of-hours GP who did not have access to her son’s medical records.
Jeremy Hunt, secretary of state for health, apologised to William’s mother in the House of Commons yesterday, stating that “we let her, William and her family down in the worst possible way” and that “the issues raised in this case have significant implications for the rest of the NHS, which we are determined to learn from”.
The report on his death stated that “significantly, it is clear from this investigation and from ongoing conversations with GPs that they are under constant pressure to reduce antibiotic prescribing and referrals to acute hospital A&Es.
“Again, the GPs did not cite this directly as an explicit issue, but it is the panel’s view that GPs feel this pressure acutely and it might well have had an impact on their decision-making and practice in this case,” they added.
Moreover, the “ongoing challenge of shared patient records” also needs national consideration, the report stated.
The day before the one-year-old baby died he was seen by an out of hours (OOH) GP, but there is no system for urgent care doctors to see the primary care records of a patient. The OOH doctor could not therefore see the detail and nature of the attendances of William in primary care since October.
“The panel concluded that if the OOH GP had had access to the primary care records and details of the attendances of William over the previous weeks, he might well have decided to insist on seeing William on the Saturday,” the report stated.
In response, Dr Maureen Baker, chair of the Royal College of GPs, said: “The case of William Mead is a tragic one and I know GPs and other healthcare professionals across the country will be deeply saddened by it.
“It is true that GPs are under considerable pressure not to prescribe antibiotics and we are constantly torn between prescribing these drugs because it might help a patient, and not-prescribing for the greater good in terms of curbing growing resistance to antibiotics,” she added.
The national report on sepsis by the Royal College of Physicians’, released in May 2015 recommended all GP practices establish Early Warning Scoring systems to help identify sepsis as early as possible. Baker is now calling on the government to provide general practice with the support and resources to do this.