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Rise in complaints and claims against nurse practitioners

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Increase in nurse practitioner complaints Increase in nurse practitioner complaints

Nurse practitioners are reporting an increase in the number of claims and complaints says the Medical Defence Union (MDU).

During 2015, the MDU's nurse practitioner members reported 25 clinical negligence claims from their practice, whereas in 2005 only two were reported.

Between 2010 and 2015, the MDU helped with over 400 complaints, claims, and other medico-legal matters involving nurse practitioners.

Dr Beverley Ward, MDU medico-legal adviser, said that one of the reasons for this could be because practices are now giving more responsibility to nurse practitioners. 'With an ageing population and more patients with long-term conditions being managed in primary care, many practices have devolved more responsibility to nurse practitioners in their team to cope with the increasing demand. However, in taking on roles such as assessing and diagnosing patients, prescribing medicines and running minor injury clinics, nurse practitioners are also at an increased risk of patients holding them individually accountable if something goes wrong.'

The most common reason for cases was wrong or delayed diagnosis followed by delayed referrals and prescribing errors.

She encourages nurses to take individual responsibility for their own indemnity and to ensure they keep up to date with the type of work they are doing. She says this is in line with the NMC requirement to 'have an appropriate indemnity arrangement in place relevant to your scope of practice'.

The MDU has issued advice to help nurse practitioners minimise the risk of a claim or complaint. This includes clearly communicating your actions to patients, checking whether patients have understood the medical care you are providing, keeping a record of all discussions with patients, including phone conversations and apologising to patients if things do go wrong and explaining what could be done to rectify the situation.

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How many nurse practitioners were registered with the MDU in 2005 compared to 2015?
Posted by: ,
Agree with above entirely.
One added concern is that nurses in GP practices are being given the title 'Nurse Practitioner' when they are not qualified to be so. A Nurse Practitioner should be qualified to Masters level and be an independent prescriber. Anything less than this will result in decisions being made without the background education and will inevitably lead to errors.
GP's need to understand that until they recruit properly and place appropriate expectations on their nurses then they will inevitably see a rise in the MDU costs.
GP's try and obtain 'cheap' nurses and give them roles above their level of competency but it will cost them in the long run because the MDU will keep hiking fees to cover this increased complaints work.
Ultimately the NMC need to take responsibility here and regulate the role!!
Posted by: ,
As nurse practitioners (in all specialities) are taking on greater independent clinical responsibilty for managing a significantly large (and ever expanding) number of patients with increasing clinical complexity it is inevitable that the number of complaints and litigation will also increase. This does not suggest that the standard of care provided by nurse practitioners is suboptimal compared to medical practitioners. It simply reflects the workload and the fact that clinical negligence allegations and claims are no longer directed primarily at our medical colleagues.

Nurse practitioners manage clinical risk, as long as practice demonstrates a level of 'reasonable competence' supported by good documentation and clear logical decision making then individual clinicians should be comfortable in their practice.

It is also vital that nurse practitioners maintain adequate professional defence be that RCN, MDU or other organisations. It would be wise not to assume that NHS Trusts or other employers will provide automatic 'cover' for advanced practice.
Posted by: ,

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