‘Catastrophic injury’ claims are more likely to occur in out of hours practice settings, it is claimed.
Citing anecdotal evidence, Dr Stephanie Brown, the Medical Protection Society’s (MPS) director for policy and communication, said both the frequency and severity of claims appears to grow in out of hours care in 70% of cases during a working week.
The MPS claims this is due to the skills and experience of staff varying “greatly” out of hours when compared to normal practice.
“Risks are increased by limited patient knowledge, unfamiliar working environment, restricted access to equipment and drugs and the stress and demands of out of hours practice,” said Dr Brown.
Financial restraints have meant there has been an increasing demand for nurses to work with GPs in out of hours services.
The MPS warns that delegating higher levels of responsibility to nurses can cause a pressure to work beyond their competence and thereby increase the risk of error.
It is “imperative” that nurses receive specific training “to be able to make sound clinical judgements.”
“For some years, out of hours care has been evolving into a differentiated part of general practice, with its own risk profile,” said Dr Brown.
“It is vitally important that we continue to study closely emerging risks, learn from past events and make necessary changes to improve the safety and quality of care in this specialised setting.”