Medical letter - duty of care

[JCE]

Hello

Medical letters seem to be outside GP's responsibilities under the NHS and are frequently charged for privately.

The question here is not about potential charges for such ex-NHS work rather than GP's duty of care / liability when declining to issue such letters or when the only way a GP practice is willing to issue such letter(s) eg. for insurance, travel, employment, law enforcement, court and other 3rd party recipients renders such medical letter useless for the purpose required?!

If a GP simply alleges patients should go private to get such letter(s) issued this would appear outright negligent and a breach of their duty of care in cases where the GP seeing patients under the NHS is the the primary care provider and only/main data controller having virtually exclusive access to a patient's medical records?

How are patients who are normally treated under the NHS supposed to receive medical letter(s) including prognosis from a private consultant when all their medical data is held by a GP operating under the NHS?

Slightly off-topic - under which circumstances would GP's have a legal duty to issue such letters under the NHS FOC?

Many thanks for constructive responses in advance!

[echat11]

Is it fair 'no' as GP's get paid well, just my opinion.

https://www.bma.org.uk/pay-and-contr...gps-pay-ranges

Here's some information -

https://www.bma.org.uk/pay-and-contracts/fees

https://www.bma.org.uk/pay-and-contr...or-charge-fees

[JCE]

Is it fair 'no' as GP's get paid well, just my opinion.

https://www.bma.org.uk/pay-and-contr...gps-pay-ranges

Here's some information -

https://www.bma.org.uk/pay-and-contracts/fees

https://www.bma.org.uk/pay-and-contr...or-charge-fees

Thanks -

As stated the OP wasn't about fairness of fees for ex-NHS work rather than GP's responsibility (even when privately paid for) as primary care providers to issue such letter or medical report (disregarding the fee element).

Is there any statutory / legal / contractual / duty of care / medical//oath of Hippocrates' obligation on them to issue such reports (privately)?

It seems utterly absurd receiving the bulk of medical treatment via a GP's NHS work when at the same time they would be able to reject ex-NHS' providing a prognosis based on such assessments?

As stated above:

If a GP simply alleges patients should go private to get such letter(s) issued this would appear outright negligent and a breach of their duty of care in cases where the GP seeing patients under the NHS is the the primary care provider and only/main data controller having virtually exclusive access to a patient's medical records?

How are patients who are normally treated under the NHS supposed to receive medical letter(s) including prognosis from a private consultant when all their medical data is held by a GP operating under the NHS?

Unless providing a private consultant with an all-encompassing power of attorney in order to access the main GP's records, risking significant delays, how would a private consultant be able to issue a medical report, unless they carried out all assessments themselves?

[echat11]

With everything that is available to the NHS, there is very little 'joined up thinking'. You could go into hospital as an emergency patient, but they will only provide treatment for that admission reason, although it might be linked to an existing condition. Then you have to see your own consultant about the existing condition which might be related to the emergency admission. I understand and get what you are saying.

https://www.gmc-uk.org/ethical-guida...es-of-a-doctor

[JCE]

https://www.gmc-uk.org/ethical-guida...es-of-a-doctor

Thanks, the GMC-guidance is rather fairly generic unless I missed any obligations when it comes to medical reports/letters.

...there is very little 'joined up thinking'.

Seems quite patchy, still not sure how to address this - actually having experienced a scenario

[islandgirl]

I thought that unless the patient has opted out the hospital can access a patient's notes via a new computer system so can see pre existing conditions etc?

[echat11]

Patient Access

https://www.patientaccess.com/gp-features

[JCE]

I thought that unless the patient has opted out the hospital can access a patient's notes via a new computer system so can see pre existing conditions etc?

My initial question is neither about opt-out nor hospitals - it is about where/from whom to get a comprehensive medical letter stating conditions and a prognosis.

Docs at a large hospital told me recently already they can only provide a summary report of current conditions and current diagnosis - no prognosis re: length or how the conditions might affect specific activities etc.

Patient Access
https://www.patientaccess.com/gp-features

Thank you - this is just an access portal in order to access GP practices - how does this patient portal relate to a GP's obligation (or not) of issuing medical letters?

[echat11]

My initial question is neither about opt-out nor hospitals - it is about where/from whom to get a comprehensive medical letter stating conditions and a prognosis.

Docs at a large hospital told me recently already they can only provide a summary report of current conditions and current diagnosis - no prognosis re: length or how the conditions might affect specific activities etc.



Thank you - this is just an access portal in order to access GP practices - how does this patient portal relate to a GP's obligation (or not) of issuing medical letters?

If you can't get a GP to write a letter (putting GP's obligations aside), then the PatientAccess portal has a lot of patient information.
I sympathize with the lack of help / understanding from you GP, you could consider contacting your MP, Ministers etc.

[islandgirl]

I have been copied on consultant's letters to the Doc before - could you ask for copies of those? They will be scanned in I assume already so you could have them emailed which will cost nothing.

[echat11]

I have been copied on consultant's letters to the Doc before - could you ask for copies of those? They will be scanned in I assume already so you could have them emailed which will cost nothing.

They always do that. GP's are getting high tech, I'm text's all sorts. They certainly should 'embrace' technology more.

My GP has automated answerphone message that says, 'if you are unconscious dial 999', she's missed out the word 'not', when reading the script. My GP clearly knows something the rest of the 'world' doesn't.